TY  - JOUR
T1  - Kardiyopulmoner Baypasa Girilen Açık Kalp Cerrahisi Hastalarında Solunum Fonksiyon Testlerinin Mortalite ve Morbiditeye Etkisi
TT  - Effect of Pulmonary Function Tests on Mortality and Morbidity Associated with Open Heart Surgery Performed with Cardiopulmonary Bypass
AU  - Saçlı, Hakan
AU  - Diler, Mevriye Serpil
PY  - 2019
DA  - August
JF  - Koşuyolu Heart Journal
PB  - Kartal Koşuyolu Yüksek İhtisas EAH
WT  - DergiPark
SN  - 2149-2972
SP  - 85
EP  - 90
VL  - 22
IS  - 2
LA  - tr
AB  - Giriş: Solunumfonksiyon testi değerleri normal ve düşük olan açık kalp cerrahisi uygulananhastalarda solunum fonksiyonlarının mortalite ve morbiditeye olan etkileriniincelemeyi amaçladık.  Hastalar ve Yöntem:Çalışmaya Mayıs 2018-Ekim 2018 tarihleri arasında açık kalp cerrahisine giren60 hasta katıldı. Hastalar iki gruba ayrıldı. Düşük solunum fonksiyon testine(SFT) sahip hastalar Grup 1 (n= 30), normal solunum fonksiyon testi olanhastalar Grup 2 (n= 30) olarak planlandı. Tüm hastalar kardiyopulmoner baypas(KPB)’a girilerek açık kalp cerrahisi işlemi gerçekleştirilen hastalardanoluşmaktaydı. Acil ameliyat edilen hastalar ve SFT yapılması kontrendike olmasıdolayısıyla yapılamayan hastalar çalışmaya dahil edilmedi. Tüm hastalardastandart cerrahi prosedürler uygulanmıştır. Karşılaştırma ameliyat öncesidemografik veriler, ameliyat esnasındaki cerrahi veriler, ameliyat sonrasıdönemde ise hemodinamik veriler, entübasyon süresi, inotrop kullanımı vesüresi, yoğun bakım ve serviste kalış süresi verileri ile birlikte komplikasyonve mortalite gelişimi durumuna göre yapıldı.  Bulgular: Erkendönemde gruplar arasında mortalite açısından fark yoktu (p= 1.000). Ekstübasyonsüreleri ve inotrop kullanım süreleri Grup 1’de daha yüksek idi ancakistatistiksel olarak anlamlı sonuç elde edilmedi (p= 0.170). Solunumsalkomplikasyonlar Grup 1’de daha yüksek görüldü (Grup 1; n= 10 (%33.33), Grup 2;n= 6 (%20), p= 0.125). Devamlı pozitif hava yolu basınçlı (CPAP) invazivolmayan ventilasyon destek ihtiyacı ve solunum fonksiyonları ile ilişkili aritmive atriyal fibrilasyon (AFR) görülme sıklığı istatistiksel olarak Grup 1’deanlamlı idi (sırasıyla p= 0.043, p= 0.049).  Sonuç: Solunumfonksiyon değerleri düşük olan hastalarda KPB’ye girilen açık kalp cerrahisisonrası erken dönemde mortalite etkilenmese de ameliyat sonrası morbiditeyeetki edecek solunumsal komplikasyonlar ve hayati ritm problemleri daha sıkgörülmektedir. Bu hastalarda ameliyat öncesi iyi bir değerlendirme ve riskoranını düşürmek için solunumsal tedavi gerekmektedir.
KW  - Kardiyopulmoner baypas
KW  - solunum fonksiyon testi
KW  - spirometri testi
KW  - kronik obstrüktif akciğer hastalığı
KW  - koroner arter baypas cerrahisi
KW  - açık kalp cerrahisi
N2  - Introduction: Weaimed to evaluate the relationship of mortality and morbidity associated withnormal and low pulmonary function test results of patients undergoing opencardiac surgery.  Patients and Methods:Sixty patients who underwent open cardiac surgery between May 2018 andSeptember 2018 were included in the study. Patients were divided into twogroups: Group 1 (n= 30) included patients with low pulmonary function testresults and Group 2 (n= 30) included patients with normal pulmonary function testresults. Cardiopulmonary bypass (CPB) was used in all patients who underwentopen cardiac surgery. Patients who underwent emergency surgery and who couldnot undergo respiratory function tests for contraindicated reasons wereexcluded from the study. Surgical procedures were same in both the groups.Comparison was made using preoperative demographic data, intraoperativesurgical data, postoperative hemodynamic data, intubation process data,inotropic support use and duration, complication status, intensive care unitand day care unit stays, and mortality.  Results: Mortalityrate was similar in both the groups (p= 1.000). Extubation time and inotropicsupport time was longer in Group 1 than in Group 2 but was not statisticallysignificant (p= 0.170). However, respiratory complications were more common inGroup 1 [n= 10 (33.33%) in Group 1; n= 6 (20%) in Group 2; p value= 0.125].Non-invasive ventilation requirement using continuous positive airway pressurewas more common in Group 1 than in Group 2 (p= 0.043). Life-threateningsupraventricular arrhythmia and new-onset atrial fibrillation was more commonin Group 1 than in Group 2 (p= 0.049).  Conclusion: Earlyperiod mortality is not affected so much in the patients with low pulmonaryfunction test results who are undergoing open heart surgery with CPB.Nevertheless respiratory complications and life threatening arrhythmias aremore common in this group of patients. Preoperative, detailed examination andrespiratory interventions are necessary and useful to reduce the risk ofoperation.
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UR  - https://dergipark.org.tr/tr/pub/khj/article/605806
L1  - https://dergipark.org.tr/tr/download/article-file/785729
ER  -