Congenital Cardiac Surgery and New Methods of Monitoring

Year 2016, Volume: 25 Issue: 1, 14 - 32, 31.03.2016

Aysun Yılbaş Başak Akça Meral Kanbak

Abstract

Adequate tissue perfusion and oxygenation is fundamental for a safe anesthesia practice in congenital cardiac surgery. Despite the significant decrease in mortality after congenital cardiac surgery, the incidence of neurological complications still range between 2% and 25%. Technological improvements led to the development of many non-invasive but continuous monitoring methods. The close watching of hemodynamic and neurophysiological changes can give us the chance to early intervention of conditions like decreased cardiac output, hypoxemia and hypoperfusion. The aim of this review is to discuss the use and safety of new monitoring techniques that are taking more and more part in anesthesia practice each day and their effects on postoperative outcome.

Keywords

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Konjenital Kalp Cerrahisi ve Yeni Monitorizasyon Yöntemleri

Abstract

Konjenital kalp cerrahisinde güvenli bir anestezi yaklaşımı için yeterli doku perfüzyonu ve oksijenasyonun sağlanması şarttır. Günümüzde konjenital kalp cerrahisinde mortalite önemli ölçüde azalmış olsa da, nörolojik komplikasyon insidansı hala %2 ile %25 arasında değişmektedir. Teknolojik gelişmelerle birlikte, pek çok non-invaziv ama devamlı monitorizasyon yöntemi geliştirilmiştir. Nörofizyolojik ve hemodinamik değişikliklerin takibi kardiyak debinin düşmesi, hipoperfüzyon ve hipoksemi gibi durumlarda erken müdahale şansı verebilir. Bu derlemede; konjenital kalp cerrahisinde perioperatif dönemde gün geçtikçe daha da fazla yer bulan yeni monitorizasyon yöntemlerinin kullanım alanları, güvenilirliği ve postoperatif sonuçlara etkisini tartışmak amaçlanmıştır.

Keywords

Kardiyak anestezi, pediatrik, serebral monitorizasyon, kardiyak debi

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