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Hazır Kardiyopleji Seti ve Sıvı Seti Yolu ile Verilen Kardiyoplejilerin, Veriliş Süresi Yönünden Karşılaştırılması

Year 2025, Volume: 22 Issue: 2, 239 - 244, 27.06.2025
https://doi.org/10.35440/hutfd.1614923

Abstract

Amaç: Kardiyopulmoner Bypass eşliğinde açık kalp cerrahisi uygulanan hastalarda hazır setler ile verilen kardiyoplejik solüsyonların, sıvı setler ile verilenlere göre veriliş sürelerine etkisi incelenerek postoperatif morbidite ve mortalite yönünden araştırılmasını amaçladık.
Materyal ve metod: Kardiyopulmoner baypas ile açık kalp ameliyatı geçiren 18 yaş üstü toplam 88 hasta (59 erkek ve 29 kadın) retrospektif olarak çalışmaya dahil edildi. Bu hastalara ait ilk 24 saatlik postoperatif bilgiler incelendi. Hastalar kardiyopleji verilme setlerine göre iki gruba ayrıldı. Grup 1 (n= 44): hazır set ile kardiyopleji verilen grup, grup 2 (n=44): sıvı sette hazırlanarak kardiyopleji verilen grup. Gruplar arasında kardiyopleji veriliş sürelerinin toplam kros klemp sürelerine etkisi ve postoperatif laktat, üre, kreatinin, potasyum, CRP, WBC, idrar seviyeleri ile ekstübasyon, yoğun bakım, hastanede yatış süreleri ve mortalite-nin istatistiksel analizi ve karşılaştırmaları yapıldı.
Bulgular: Gruplar arasında tanımlayıcı istatistik verileri incelendiğinde sıvı set kullanılan grup ile karşılaştı-rıldığında; hazır set kullanılan grupta postoperatif laktat düzeyinin anlamlı olarak daha düşük (p=0,002), ekstübasyon süresi (p<0,001), yoğun bakım ünitesinde kalış süresi (p=0,043), kros klemp süresi (p<0,001) ve total bypass süresinin de (p<0,001) anlamlı olarak daha kısa olduğu tespit edildi.Ancak, gruplar arasında mortalite açısından anlamlı bir farklılık olmadığı saptandı (p=0,246).
Sonuç: Hazır set ile kardiyopleji verilen grupta ekstübasyon süresi, yoğun bakım ünitesinde kalış süresi, kros klemp süresi ve total bypass süresi daha kısa olsa da hazır setler ile sıvı setlerin mortalite açısından benzer sonlanımlara sahip olduğu saptandı.

Ethical Statement

Çalışmamız, Harran Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi Klinik Araştırmalar Etik Kurulu'ndan 07.10.2024 tarih ve 24.15.23 nolu karar alınarak gerçekleştirildi.

Supporting Institution

yok

References

  • 1. Hacanlı Y, Andaç MH, Ersöz E, Aydın MS, Dikme R. Kardiyopul-moner Bypass’ ta Magnezyumun Önemi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):122-127.
  • 2. Coşkun MB, Eği K, Çiçek A. Kardiyopulmoner Bypass’ta Kristal-loid ve Kolloid Solüsyonlarının Kullanımı: Literatür Taraması ve Klinik Uygulamalar. Mehes journal. 2024;2(3):58-67.
  • 3. Pourmoghadam KK, Ruzmetov M, O'Brien MC, Piggott KD, Plancher G, Narasimhuluet SS, et al. Comparing del Nido and Conventional Cardioplegia in Infants and Neonates in Congeni-tal Heart Surgery. Ann Thorac Surg. 2017;103(5):1550-56.
  • 4. Lafcı A, Gokcinar D, Budak AB, McCusker K, Dag O, Gunaydin S. Comparison of metabolic effects of del Nido cardioplegia, blood cardioplegia, and St. Thomas cardioplegia solutions in adult patients undergoing isolated minimally invasive aortic valve replacement surgery. Turk J Clin Lab. 2018;4:260-265.
  • 5. Lopes JB, Santos CCMD. Coronary Perfusion Pressure during Antegrade Cardioplegia in On-Pump CABG Patients. Braz J Car-diovasc Surg. 2017;32(3):171-176.
  • 6. Mehmood A, Nadeem RN, Kabbani MS, Khan AH, Hijazi O, Ismail SR, et al. Impact of Cardiopulmonary Bypass and Aorta Cross Clamp Time on the Length of Mechanical Ventilation af-ter Cardiac Surgery among Children: A Saudi Arabian Experien-ce. Cureus. 2019;11(8):1-9.
  • 7. Qiu Z, Chen X, Xu Y, Huang F, Xiao L, Yanget T, et al. Does full sternotomy have more significant impact than the cardiopul-monary bypass time in patients of mitral valve surgery?. J Car-diothorac Surg. 2018;13(1):29-36.
  • 8. Madhavan S, Chan SP, Tan WC, Eng J, Li B, Luo HD, et al. Cardi-opulmonary bypass time: every minute counts. J Cardiovasc Surg (Torino). 2018;59(2):274-281.
  • 9. Amaç B, Bağış MZ. Kardiyopulmoner Bypass Eşliğinde Kalp Kapak Cerrahisi Uygulanan Hastalarda Perfüzyon Süresinin Pos-toperatif Sonuçlar Üzerine Etkisi. BUSAD. 2023;4(2):252-262.
  • 10. Martins RS, Ukrani RD, Memon MK, Ahmad W, Akhtar S. Risk factors and outcomes of prolonged cardiopulmonary bypass time in surgery for adult congenital heart disease: a single-center study from a lowmiddle-income country. J Cardiovasc Surg (Torino). 2021;62(4):399-407.
  • 11. Nadeem R, Agarwal S, Jawed S, Yasser A, Altahmody K. Impact of Cardiopulmonary Bypass Time on Postoperative Duration of Mechanical Ventilation in Patients Undergoing Cardiovascular Surgeries: A Systemic Review and Regression of Metadata. Cu-reus. 2019;11(11):1-7.
  • 12. Pagowska-Klimek I, Pychynska-Pokorska M, Krajewski W, Moll JJ. Predictors of long intensive care unit stay following cardiac surgery in children. Eur J Cardiothorac Surg. 2011;40(1):179–184.
  • 13. Hu J, Liu Y, Huang L, Song M, Zhu G. Association between cardiopulmonary bypass time and mortality among patients with acute respiratory distress syndrome after cardiac surgery. BMC Cardiovasc Disord. 2023;23(1):622
  • 14. Kapadohos T, Angelopoulos E, Vasileiadis I, Nanas S, Kotanidou A, Karabinis A, et al. Determinants of prolonged intensive care unit stay in patients after cardiac surgery: a prospective obser-vational study. J Toraks Dis. 2017;9(1):70-79.

Comparison of Cardioplegia Given by Ready Cardioplegia Set and Liquid Set in Terms of Administration Time

Year 2025, Volume: 22 Issue: 2, 239 - 244, 27.06.2025
https://doi.org/10.35440/hutfd.1614923

Abstract

Background: We aimed to investigate the effect of cardioplegic solutions given with ready-made sets on the duration of administration compared to those given with liquid sets in patients undergoing open heart surgery with Cardiopulmonary Bypass in terms of postoperative morbidity and mortality.
Materials and Methods: A total of 88 patients (59 males and 29 females) over 18 years of age who un-derwent open heart surgery with cardiopulmonary bypass were retrospectively included in the study. The first 24 hours postoperative data of these patients were analyzed. Patients were divided into two groups according to cardioplegia administration sets. Group 1 (n=44): cardioplegia was administered with a prepared set, group 2 (n=44): cardioplegia was administered with a liquid set. Statistical analysis and comparison of the effect of cardioplegia administration times on total cross-clamp times and postoperati-ve lactate, urea, creatinine, potassium, CRP, WBC, urine levels, extubation, intensive care unit, hospitali-zation times and mortality were performed between the groups.
Results: When the descriptive statistical data between the groups were analyzed, it was found that the postoperative lactate level was significantly lower (p=0.002), extubation time (p<0.001), intensive care unit stay (p=0.043), cross-clamp time (p<0.001) and total bypass time (p<0.001) were significantly shorter in the group using the ready-made set compared to the group using the liquid set. However, there was no significant difference in mortality between the groups (p=0.246).
Conclusions: Although extubation time, intensive care unit stay, cross-clamping time and total bypass time were shorter in the group given cardioplegia with ready-made sets, it was found that ready-made and liquid sets had similar outcomes in terms of mortality.

References

  • 1. Hacanlı Y, Andaç MH, Ersöz E, Aydın MS, Dikme R. Kardiyopul-moner Bypass’ ta Magnezyumun Önemi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(1):122-127.
  • 2. Coşkun MB, Eği K, Çiçek A. Kardiyopulmoner Bypass’ta Kristal-loid ve Kolloid Solüsyonlarının Kullanımı: Literatür Taraması ve Klinik Uygulamalar. Mehes journal. 2024;2(3):58-67.
  • 3. Pourmoghadam KK, Ruzmetov M, O'Brien MC, Piggott KD, Plancher G, Narasimhuluet SS, et al. Comparing del Nido and Conventional Cardioplegia in Infants and Neonates in Congeni-tal Heart Surgery. Ann Thorac Surg. 2017;103(5):1550-56.
  • 4. Lafcı A, Gokcinar D, Budak AB, McCusker K, Dag O, Gunaydin S. Comparison of metabolic effects of del Nido cardioplegia, blood cardioplegia, and St. Thomas cardioplegia solutions in adult patients undergoing isolated minimally invasive aortic valve replacement surgery. Turk J Clin Lab. 2018;4:260-265.
  • 5. Lopes JB, Santos CCMD. Coronary Perfusion Pressure during Antegrade Cardioplegia in On-Pump CABG Patients. Braz J Car-diovasc Surg. 2017;32(3):171-176.
  • 6. Mehmood A, Nadeem RN, Kabbani MS, Khan AH, Hijazi O, Ismail SR, et al. Impact of Cardiopulmonary Bypass and Aorta Cross Clamp Time on the Length of Mechanical Ventilation af-ter Cardiac Surgery among Children: A Saudi Arabian Experien-ce. Cureus. 2019;11(8):1-9.
  • 7. Qiu Z, Chen X, Xu Y, Huang F, Xiao L, Yanget T, et al. Does full sternotomy have more significant impact than the cardiopul-monary bypass time in patients of mitral valve surgery?. J Car-diothorac Surg. 2018;13(1):29-36.
  • 8. Madhavan S, Chan SP, Tan WC, Eng J, Li B, Luo HD, et al. Cardi-opulmonary bypass time: every minute counts. J Cardiovasc Surg (Torino). 2018;59(2):274-281.
  • 9. Amaç B, Bağış MZ. Kardiyopulmoner Bypass Eşliğinde Kalp Kapak Cerrahisi Uygulanan Hastalarda Perfüzyon Süresinin Pos-toperatif Sonuçlar Üzerine Etkisi. BUSAD. 2023;4(2):252-262.
  • 10. Martins RS, Ukrani RD, Memon MK, Ahmad W, Akhtar S. Risk factors and outcomes of prolonged cardiopulmonary bypass time in surgery for adult congenital heart disease: a single-center study from a lowmiddle-income country. J Cardiovasc Surg (Torino). 2021;62(4):399-407.
  • 11. Nadeem R, Agarwal S, Jawed S, Yasser A, Altahmody K. Impact of Cardiopulmonary Bypass Time on Postoperative Duration of Mechanical Ventilation in Patients Undergoing Cardiovascular Surgeries: A Systemic Review and Regression of Metadata. Cu-reus. 2019;11(11):1-7.
  • 12. Pagowska-Klimek I, Pychynska-Pokorska M, Krajewski W, Moll JJ. Predictors of long intensive care unit stay following cardiac surgery in children. Eur J Cardiothorac Surg. 2011;40(1):179–184.
  • 13. Hu J, Liu Y, Huang L, Song M, Zhu G. Association between cardiopulmonary bypass time and mortality among patients with acute respiratory distress syndrome after cardiac surgery. BMC Cardiovasc Disord. 2023;23(1):622
  • 14. Kapadohos T, Angelopoulos E, Vasileiadis I, Nanas S, Kotanidou A, Karabinis A, et al. Determinants of prolonged intensive care unit stay in patients after cardiac surgery: a prospective obser-vational study. J Toraks Dis. 2017;9(1):70-79.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Cardiovascular Surgery
Journal Section Research Article
Authors

Murat Ziya Bağış 0000-0002-4088-7510

Yasemin Hacanlı 0000-0002-4427-8149

Early Pub Date May 27, 2025
Publication Date June 27, 2025
Submission Date January 7, 2025
Acceptance Date April 14, 2025
Published in Issue Year 2025 Volume: 22 Issue: 2

Cite

Vancouver Bağış MZ, Hacanlı Y. Hazır Kardiyopleji Seti ve Sıvı Seti Yolu ile Verilen Kardiyoplejilerin, Veriliş Süresi Yönünden Karşılaştırılması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2025;22(2):239-44.