Ekstrakorporeal Sirkülasyonun Magnezyum Metabolizması Üzerine Etkisi

Year 1971, Volume: 24 Issue: 5, 939 - 951, 31.10.1971

Gürler İliçin

Abstract

In 8 cases that underwent closed commissurotomy, serum magnesium was determined preoperatively, immediately after surgery, and at the 24th hour postoperatively, and in 23 patients that underwent open heart surgery, it was determined preoperatively, during the pump, immediately after surgery, and at the 24th hour postoperatively. Although magnesium was not added to the hemodilution fluid in 13 of the 23 cases that underwent open heart surgery, 2 mEq magnesium was added to 1000 ml of Ringer lactate added to the pump in 10 cases. It was determined that there was no change in serum magnesium in cases that underwent closed commissurotomy, and in those that underwent open heart surgery, serum magnesium decreased most significantly during the pump and remained low in the early postoperative period in the group that did not receive magnesium, but this value did not show a significant difference from the control group in which magnesium was added to the pump. Although magnesium levels remained low at 24 hours postoperatively in both groups, they did not show any significant statistical difference from controls. It was suggested that hemodilution, hyperaldosteronism, hyperparathyroidism and diuretic use may be responsible for hypomagnesemia, and the importance of magnesium addition to the pump was emphasized, especially in terms of preventing early postoperative arrhythmias. The relevance of hypomagnesemia to early thromboembolic complications was discussed. The literature on this subject was reviewed.

Keywords

closed commissurotomy, serum magnesium, metabolism

Effect of Extracorporeal Circulation on Magnesium Metabolism

Abstract

Kapalı komissurotomi uygulanan 8 vak'ada serum magnezyumu preoperatif, ameliyattan hemen sonra ve postoperatif 24. saatte, açık kalp cerrahisi uygulanan 23 hastada ise preoperatif, pompa esnasında, operasyondan hemen sonra ve postoperatif 24. saatte tayin edildi. Açık kalp cerrahisine alınan 23 vak'anın 13 ünde hemodilüsyon mayiine magnezyum ilâve edilmemesine karşın, 10 vak'ada pompaya ilâve edilen Ringer laktatın 1000 ml. sine 2 mEq magnezyum konuldu. Kapalı komissurotomi yapılan vak'alarda serum magnezyumunda değişiklik olması, Açık kalp cerrahisi uygulananlarda ise serum magnezyumu en belirgin olarak pompa esnasında düştüğü ve hemodilusyon mayiine magnezyum ilâve edilmeyen grupta erken
postoperatif devrede de düşük olarak kalmasına rağmen, pompaya magnezyum ilâve edilen grupta bu değerin, kontrolle önemli farklılaşma göstermediği tesbit edildi. Her iki grupta da postoperatif 24. saatte magnezyum değerleri düşük olarak kalmasına rağmen, kontrollerle önemli istatistiki fark göstermedi. Hipomagnezemiden hemodilüsyon, hiperaldosteronizm, hiperparatiroidizm ve diüretik kullanılmasının sorumlu olabileceği ileri sürülerek, özellikle erken postoperatif aritmilerin önlenebilmesi açısından pompaya magnezyum ilavesinin önemi üzerinde duruldu. Hipomagnezeminin erken tromboembolik komplikasyonlarla alâkası tartışıldı. Bu konuyla alâkalı olarak literatür gözden geçirildi.

Keywords

serum magnezyumu, kapalı komissurotomi, metabolizma

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