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Acute Increase in Postoperative White Cell Count Predicts Mortality in Isolated Aortic Valve Replacement Patients

Yıl 2014, Cilt: 17 Sayı: 3, 163 - 166, 01.03.2013

Öz

Introduction: Inflammatory reaction after cardiac surgery is well documented. In this study we aimed to investigate association with acute increase in white blood cell count after cardiopulmonary bypass with mortality. Patients and Methods: We included 35 patients with isolated aortic valve replacement procedure with cardiopulmonary bypass during time phrase June 2009 to July 2013. Blood sampled the day before the operation and on postoperative 24th hour. White blood cell counted and preoperative postoperative difference was calculated. Results: Total 35 patients were included to study. 14 (40%) of them were female. Mean age of patients was 61.14±13.25. Mortality observed patients had two fold increase in mean white blood cell count (preoperative/postoperative white blood cell count 4.971±1.11/ 8.19±3.47 p=0.03 95% CI 1.88-8.06/3.88-12.50). Conclusion: Acute increase in white cell count after aortic valve replacement procedure is associated with mortality.

Kaynakça

  • 1. Kirklin JK, Westaby S, Blackstone EH, Kirklin JW, Chenoweth DE, Pacifico AD. Complement and the damaging effect of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983;86:845-57.
  • 2. Edmunds LH Jr. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 1998;66:12-6.
  • 3. Menasche P, Edmunds LH Jr. Extracorporeal circulation: the inflammatory response. In: Cohn LH, Edmunds LH Jr, eds. Cardiac Surgery in the Adult. New York: McGraw-Hill 2003:349-60.
  • 4. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia 1997;78:606-17.
  • 5. Giannoudis P, Dinopoulos H, Chalidis B, Hall G. Surgical stress response. Injury, Int. J. Care Injured 2006;37:3-9.
  • 6. Okamura T, Ishibashi N, Zurakowski D, Jonas RA. Cardiopulmonary bypass increases permeability of the blood cerebrospinal fluid barrier. Ann Thorac Surg 2010;89:187-94.
  • 7. Breda MA, Drinkwater DC, Laks H, Bhuta S, Corno AF, Davtyan HG, et. al. Prevention of reperfusion injury in the neonatal heart with leukocytedepleted blood. J Thorac Cardiovasc Surg 1989;97:654-65.
  • 8. Byrne JG, Appleyard RF, Lee CC, Couper GS, Scholl FG, Laurence RG, et. al. Controlled reperfusion of the regionally ischemic myocardium with leukocyte-depleted blood reduces stunning, the no-reflow phenomenon, and infarct size. J Thorac Cardiovasc Surg 1992;103:66-72.
  • 9. Bando K, Pillai R, Cameron DE, Brawn JD, Winkelstein JA, Hutchins GM, et.al. Leukocyte depletion ameliorates free radical-mediated lung injury after cardiopulmonary bypass. J Thorac Cardiovasc Surg 1990;99:873-7.
  • 10. Bechtel JF, Mühlenbein S, Eichler W, Marx M, Sievers HH. Leukocyte depletion during cardiopulmonary bypass in routine adult cardiac surgery. Interact Cardiovasc Thorac Surg 2011;12:207-12.
  • 11. Emiroğulları NÖ, Aşgün F, Kahraman C, Taşdemir K, Ceyran H, Serhatlıoğlu F, ve ark. The influence of leukocyte filtration during cardiopulmonary bypass on early postoperative myocardial function. Turk Gogus Kalp Dama 2008;16:91-100.
  • 12. Sürer S, Bolat A, Koç M, Gülbahar O, Kutsal A. Investigation of the effects of leukocyte filtration in congenital heart surgery. Turk Gogus Kalp Dama 2014;22:298-304.
  • 13. Beilin B, Shavit Y, Trabekin E, Mordashev B, Mayburd E, Zeidel A, et al. The effects of postoperative pain management on immune response to surgery. Anesth Analg 2003;97:822-7.
  • 14. Scholl R, Bekker A, Babu R. Neuroendocrine and Immune Responses to Surgery. The Internet Journal of Anesthesiology. 2012 Volume 30 Number 3.
  • 15. Hirai S. Systemic Inflammatory response syndrome after cardiac surgery under cardiopulmonary bypass. Ann Thorac Cardiovasc Surg 2003;9:365-70
  • 16. Brown JR, Landis RC, Chaisson K, Ross CS, Dacey LJ, Boss RA Jr, et al. Preoperative white blood cell count and risk of 30-Day readmission after cardiac surgery. Int J Inflam 2013;2013:781024. doi: 10.1155/2013/781024.
  • 17. Jankovicová K, Kudlová MT, Kolácková M, Kunes P, Mand’ák J, Lonský V, et. al. The effect of cardiac surgery on peripheral blood lymphocyte populations. Acta Medica (Hradec Kralove) 2008;51:25-9.
  • 18. Demirağ M. K, Bedir A. Evaluation of preoperative neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients undergoing major vascular surgery. Turk Gogus Kalp Dama 2013;21:930-5.
  • 19. Laffey JG, Boylan F, Cheng DC. The systemic inflammatory response to cardiac surgery Implications for the Anesthesiologist. Anesthesiology 2002;97:215-52.
  • 20. Muller H, Hugel W, Reifschneider HJ, Horpacsy G, Hannekum A, Dalichau H. Lysosomal enzyme activity influenced by various types of respiration during extracorporeal circulation. Thorac Cardiovasc Surg 1989;37:65-71.
  • 21. Slutsky AS. Mechanical ventilation. American College of Chest Physicians’ Consensus Conference. Chest 1993;104:1833-59.

İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir

Yıl 2014, Cilt: 17 Sayı: 3, 163 - 166, 01.03.2013

Öz

Giriş: Kalp cerrahisi sonrası inflamatuvar reaksiyon iyi dökümente edilmiştir. Bu çalışmada, kardiyopulmoner bypass sonrası beyaz kan hücrelerinde akut artış ile mortalite arasındaki ilişkiyi incelemeyi amaçladık.Hastalar ve Yöntem: Haziran 2009- Temmuz 2013 arasında kardiyopulmoner bypass eşliğinde izole aort kapak replasmanı uygulanan 35 hasta çalışmaya dahil edildi. Kan örnekleri operasyondan önceki gün ve postoperatif 24. saatte alındı. Beyaz kan hücreleri sayıldı ve operasyon öncesi ve sonrası değerler hesaplandı.Bulgular: Toplam 35 hasta çalışmaya alındı. Ondört tanesi (40%) kadındı. Ortalama yaş 61.14+ 13.25 idi. Mortalite izlenen hastalarda beyaz kan hücresi sayısında iki kat artış olduğu görüldü ( preoperatif-postoperatif beyaz hücre sayıları 4.971+1.11/ 8.19+3.47 p=0.03 95% CI 1.88-8.06/3.88-12.50).Sonuç: Aort kapak replasmanı sonrası beyaz kan hücrelerinin akut artışı mortalite ile ilişkilidir.

Kaynakça

  • 1. Kirklin JK, Westaby S, Blackstone EH, Kirklin JW, Chenoweth DE, Pacifico AD. Complement and the damaging effect of cardiopulmonary bypass. J Thorac Cardiovasc Surg 1983;86:845-57.
  • 2. Edmunds LH Jr. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg 1998;66:12-6.
  • 3. Menasche P, Edmunds LH Jr. Extracorporeal circulation: the inflammatory response. In: Cohn LH, Edmunds LH Jr, eds. Cardiac Surgery in the Adult. New York: McGraw-Hill 2003:349-60.
  • 4. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia 1997;78:606-17.
  • 5. Giannoudis P, Dinopoulos H, Chalidis B, Hall G. Surgical stress response. Injury, Int. J. Care Injured 2006;37:3-9.
  • 6. Okamura T, Ishibashi N, Zurakowski D, Jonas RA. Cardiopulmonary bypass increases permeability of the blood cerebrospinal fluid barrier. Ann Thorac Surg 2010;89:187-94.
  • 7. Breda MA, Drinkwater DC, Laks H, Bhuta S, Corno AF, Davtyan HG, et. al. Prevention of reperfusion injury in the neonatal heart with leukocytedepleted blood. J Thorac Cardiovasc Surg 1989;97:654-65.
  • 8. Byrne JG, Appleyard RF, Lee CC, Couper GS, Scholl FG, Laurence RG, et. al. Controlled reperfusion of the regionally ischemic myocardium with leukocyte-depleted blood reduces stunning, the no-reflow phenomenon, and infarct size. J Thorac Cardiovasc Surg 1992;103:66-72.
  • 9. Bando K, Pillai R, Cameron DE, Brawn JD, Winkelstein JA, Hutchins GM, et.al. Leukocyte depletion ameliorates free radical-mediated lung injury after cardiopulmonary bypass. J Thorac Cardiovasc Surg 1990;99:873-7.
  • 10. Bechtel JF, Mühlenbein S, Eichler W, Marx M, Sievers HH. Leukocyte depletion during cardiopulmonary bypass in routine adult cardiac surgery. Interact Cardiovasc Thorac Surg 2011;12:207-12.
  • 11. Emiroğulları NÖ, Aşgün F, Kahraman C, Taşdemir K, Ceyran H, Serhatlıoğlu F, ve ark. The influence of leukocyte filtration during cardiopulmonary bypass on early postoperative myocardial function. Turk Gogus Kalp Dama 2008;16:91-100.
  • 12. Sürer S, Bolat A, Koç M, Gülbahar O, Kutsal A. Investigation of the effects of leukocyte filtration in congenital heart surgery. Turk Gogus Kalp Dama 2014;22:298-304.
  • 13. Beilin B, Shavit Y, Trabekin E, Mordashev B, Mayburd E, Zeidel A, et al. The effects of postoperative pain management on immune response to surgery. Anesth Analg 2003;97:822-7.
  • 14. Scholl R, Bekker A, Babu R. Neuroendocrine and Immune Responses to Surgery. The Internet Journal of Anesthesiology. 2012 Volume 30 Number 3.
  • 15. Hirai S. Systemic Inflammatory response syndrome after cardiac surgery under cardiopulmonary bypass. Ann Thorac Cardiovasc Surg 2003;9:365-70
  • 16. Brown JR, Landis RC, Chaisson K, Ross CS, Dacey LJ, Boss RA Jr, et al. Preoperative white blood cell count and risk of 30-Day readmission after cardiac surgery. Int J Inflam 2013;2013:781024. doi: 10.1155/2013/781024.
  • 17. Jankovicová K, Kudlová MT, Kolácková M, Kunes P, Mand’ák J, Lonský V, et. al. The effect of cardiac surgery on peripheral blood lymphocyte populations. Acta Medica (Hradec Kralove) 2008;51:25-9.
  • 18. Demirağ M. K, Bedir A. Evaluation of preoperative neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients undergoing major vascular surgery. Turk Gogus Kalp Dama 2013;21:930-5.
  • 19. Laffey JG, Boylan F, Cheng DC. The systemic inflammatory response to cardiac surgery Implications for the Anesthesiologist. Anesthesiology 2002;97:215-52.
  • 20. Muller H, Hugel W, Reifschneider HJ, Horpacsy G, Hannekum A, Dalichau H. Lysosomal enzyme activity influenced by various types of respiration during extracorporeal circulation. Thorac Cardiovasc Surg 1989;37:65-71.
  • 21. Slutsky AS. Mechanical ventilation. American College of Chest Physicians’ Consensus Conference. Chest 1993;104:1833-59.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Mehmet Kalender Bu kişi benim

Mehmet Taşar Bu kişi benim

Ata Niyazi Ecevit Bu kişi benim

Okay Guven Karaca Bu kişi benim

Ahmet Nihat Baysal Bu kişi benim

Salih Salihi Bu kişi benim

Yayımlanma Tarihi 1 Mart 2013
Yayımlandığı Sayı Yıl 2014 Cilt: 17 Sayı: 3

Kaynak Göster

APA Kalender, M. ., Taşar, M. ., Ecevit, A. N. ., Karaca, O. G. ., vd. (2013). İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir. Koşuyolu Kalp Dergisi, 17(3), 163-166. https://doi.org/10.5505/pajes.2013.46036
AMA Kalender M, Taşar M, Ecevit AN, Karaca OG, Baysal AN, Salihi S. İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir. Koşuyolu Kalp Dergisi. Mart 2013;17(3):163-166. doi:10.5505/pajes.2013.46036
Chicago Kalender, Mehmet, Mehmet Taşar, Ata Niyazi Ecevit, Okay Guven Karaca, Ahmet Nihat Baysal, ve Salih Salihi. “İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir”. Koşuyolu Kalp Dergisi 17, sy. 3 (Mart 2013): 163-66. https://doi.org/10.5505/pajes.2013.46036.
EndNote Kalender M, Taşar M, Ecevit AN, Karaca OG, Baysal AN, Salihi S (01 Mart 2013) İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir. Koşuyolu Kalp Dergisi 17 3 163–166.
IEEE M. . Kalender, M. . Taşar, A. N. . Ecevit, O. G. . Karaca, A. N. . Baysal, ve S. . Salihi, “İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir”, Koşuyolu Kalp Dergisi, c. 17, sy. 3, ss. 163–166, 2013, doi: 10.5505/pajes.2013.46036.
ISNAD Kalender, Mehmet vd. “İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir”. Koşuyolu Kalp Dergisi 17/3 (Mart 2013), 163-166. https://doi.org/10.5505/pajes.2013.46036.
JAMA Kalender M, Taşar M, Ecevit AN, Karaca OG, Baysal AN, Salihi S. İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir. Koşuyolu Kalp Dergisi. 2013;17:163–166.
MLA Kalender, Mehmet vd. “İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir”. Koşuyolu Kalp Dergisi, c. 17, sy. 3, 2013, ss. 163-6, doi:10.5505/pajes.2013.46036.
Vancouver Kalender M, Taşar M, Ecevit AN, Karaca OG, Baysal AN, Salihi S. İzole Aort Kapak Replasmanı Yapılan Hastalarda Postoperatif Beyaz Küre Artışı Mortalite Belirtecidir. Koşuyolu Kalp Dergisi. 2013;17(3):163-6.