Kardiyopulmoner Bypass Sırasında Nitrik Oksit Kullanımının Kardiyak ve Renal Hasar Üzerine Etkileri

Öz

Kardiyopulmoner bypass (KPB) uygulaması gerektiren kardiyak cerrahi sistemik inflamatuar yanıt, iskemi/reperfüzyon hasarı ve hemolize neden olmakta ve vücutta kalp, böbrek gibi çeşitli organlarda disfonksiyona yol açmaktadır. KPB sırasında eksojen nitrik oksit (NO) uygulamasının bu komplikasyonları engelleyebileceği gösterilmiştir. Pulmoner hipertansiyonu tedavi etmek için kullanılan bir gaz olan NO, vasküler NO tükenmesini önleyerek organ perfüzyonunu korur. NO’in iskemi-reperfüzyonu takiben miyokardiyal koruyucu bir etkiye sahiptir. Son yıllarda yapılan klinik çalışmalarda, kalp cerrahisi sırasında ve sonrasında NO gazı uygulanması ile postoperatif miyokard hasarı ve akut böbrek hasarında önemli bir azalma olduğunu gösterilmiştir.

Anahtar Kelimeler

• Kardiyopulmoner bypass,, nitrik oksit,miyokard

Effects Of Nitric Oxide Administration On Cardiac And Renal Injury Durıng Cardiopulmonary Bypass

Abstract

Aim: Cardiac surgery requiring cardiopulmonary bypass (CPB) application causes systemic inflammatory response, ischemia/reperfusion injury and hemolysis and causes dysfunction in various organs in the body such as heart and kidney. Exogenous nitric oxide (NO) administration during CPB has been shown to prevent these complications. NO, a gas used to treat pulmonary hypertension, protects organ perfusion by preventing vascular NO depletion. NO has a myocardial protective effect following ischemia-reperfusion. Recent clinical trials have showed a significant reduction of postoperative myocardial injury and acute kidney injury when NO gas has been administered during and after cardiac surgery.

Keywords

• Nitric oxide

Kaynakça

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