Kardiyopulmoner bypass sırasında akciğer ventilasyonunun total oksidatif durum, total antioksidan kapasite ve oksidatif stres indeksine etkisi

Yıl 2019, Cilt: 16 Sayı: 1, 154 - 158, 22.03.2019

Mahmut Padak Mustafa Göz Reşat Dikme Mehmet Salih Aydın İsmail Koyuncu Ömer Göç

Öz

Amaç: 
Bu çalışmadaki amaç kardiyopulmoner bypass sırasında bir grup hastayı
%10 volüm diğer grup hastayı solunumu tamamen durdurularak pre-op ve bypass
sonrası TAS (Total Antioksidan Kapasite), TOS (Total Oksidatif Durum), OSİ (Oksidatif
Stres İndeksi) bakılarak Akciğer ventilasyonun Bypass sırasında gerekliğinin
belirlenmesidir.

Materyal ve Metod: Göğüs Kalp
Damar Cerrahisi bölümünde çeşitli sebeplerden dolayı kardiyopulmoner bypass
cerrahisi ile ameliyat olan toplam 30 (14 E + 16 K) hasta seçildi. Hastalar 2
gruba (akciğer ventilasyonu tamamen durdurulan grup ve akciğer %10 cc volum ile
çalıştırılan grup)  ayrıldı. İki gruba
ayrılan hastalardan kardiyopulmoner bypass öncesinde, pompaya giriş sırasında,
pompadan çıkış sırasında ve ameliyat sonrası olmak üzere toplam 4 jelsiz tüpe
kan alınarak bir çalışma grubu oluşturuldu. Alınan kanlar santrifüjde ayrıştırıldıktan
sonra plazmaları -80 °C’de saklanarak numunelerin çalışma gününde Erel
yöntemiyle Total oksidatif stress, Total antioksidan kapasite ve oksidatif
stres indeks çalışıldı.

Bulgular: TAS değeri 1,0945±0,25, TOS değeri
15,38±6,10 ve OSi değeri 1,4827±0,67 olarak bulunmuştur. Ventile edilmeyen
hastaların TAS değeri 1,1514±0,24, TOS değeri 25,73±9,25 ve OSi değeri
2,2993±0,85 olarak bulunmuştur. Hastalarda TOS değeri ventile edilmeyen
hastalarda artmıştır. Çalışmamızdaki TOS değerindeki artış TAS değeri üzerinde
herhangi bir değişiklik oluşturmamıştır. OSİ değeri üzerinde anlamlı fark
oluşmuştur. (p<0.05)

Sonuç: iki grup karşılaştırıldığında TAS
değerinde anlamlı bir değişkenlik olmazken, TOS ve OSİ değerleri açısından
anlamlı bir sonuç çıkmıştır. KPB sırasında ventile edilmeyen hastalar % 10
ventile edilen hastalara göre TOS ve OSİ değerleri yüksek ve anlamlı
bulunmuştur. Bu durum bize KPB sırasında % 10 ventile edilen hastalardaki
oksidatif stres parametrelerinin azaldığını göstermektedir.

Anahtar Kelimeler

Kardiyopulmoner baypas, Oksidatif stres, Antioksidanlar, Oksidatif stres

The effect of lung ventilation on total oxidative condition, total antioxidant capacity and oxidative stress index during cardiopulmonary bypass

Öz

Background:The aim in this study is to obtain the necessity
of pulmonary ventilation during cardiopulmonary bypass by starting respiration
of a group of patients with 10% volume and the other group stopping respiration
totally as well as by examining TAS (Total Antioxidant Status), TOS (Total
oxidative status), OSİ (oxidative stress index) in pre-op and after bypass. 

Methods:Totally 30 patients (14
M+ 16 F) that had cardiopulmonary bypass surgery in Thoracic and Cardiovascular
Surgery Department for various reasons, were chosen. The patients were
seperated into 2 groups (as pulmonary respiration was stopped completely and
pulmonary respiration was started by 10% cc volume). Before carrdiopulmonary
bypass working group was formed among patients seperated into 2 groups by
taking totally 4 tubes of blood before cardiopulmonary bypass, at pump inlet,
pump outlet and after operation. After eluting taken blood in centrifuge, they
were kept at  -80 °C. Then TAS, TOS and OSİ
were studied by using Erel method. 

 ResultsTAS value was found as
1,0945±0,25, TOS value as 15,38±6,10 and OSi value was found as
1,4827±0,67.  TAS value of unventilated
patients was found as 1,1514±0,24, TOS value was as 25,73±9,25 and OSi value
was found as 2,2993±0,85. TOS value in patients increased in unventilated
patients. The increase in  TOS value in
our study did not form any change on TAS value however there occured a
significant difference on  OSİ value.
(p<0.05)

Conclusions: As two groups were
compared there did not occur a significant difference on TAS value, there came
out a significant result in terms of TOS and OSİ values. During CPB, TOS and
OSİ values of unventilated patients were found high and significant compared to
10% ventilated patients. This situation shows that oxidative stress parameters
in 10% ventilated patients decreases during CPB. 

Anahtar Kelimeler

Cardiopulmonary Bypass, Oxidative stress, Antioxidants, Oxidative stress

Kaynakça

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