Evaluation The Efficiency of Hemodilution with Vasomotor Reactivity and Cerebral Oximeter in Acute Ischemic Stroke Treatment

Yıl 2020, Cilt: 42 Sayı: 2, 203 - 211, 17.03.2020

İrfan Yavaş Demet Özbabalık Adapınar

https://doi.org/10.20515/otd.541616

Öz

Hemodilution (HD) which
increases cerebral blood flow has a neuroprotective effect. We aim to test
short and long term results of this effect with vasomotor reactivity test and
cerebral oximetry Materials and Methods: Patients who had an ischemic stroke
were included in the study consecutively. Hemodilution was performed
hipervolemic, isovolemic and hypovolemic according to hematocrit levels and
performed within first 24 hours. Patients underwent vasomotor reactivity test
(VMR) with transcranial doppler ultrasonography, distribution of oxygen was
measured with INVOS 3100 Cerebral Oximeter and simultaneous clinical
assessments were done with Glascow Coma Scale, Bartel Index, Rankın Score, MCA
Neurological Scale, Scandinavian Stroke Scale and Hemispheric Stroke Scale.
These assessments were done in the first day, 5 days and 90 days after HD. The
results were analyzed by descriptive statistics, variant analysis and t-test Result:
We enrolled 21 patients whom hemodilution was performed and 20 control subjects
in our study. Mean age of all subjects was 61.2 years. There was no significant
difference between the two groups oxygen levels cerebral oximetry and results
of vasomotor reactivity test. Hemodilution group had better clinical recovery
in the third month. Hemodilution had no effect in VMR test and distribution of
oxygen but it contributed to clinical recovery in long term. 

Anahtar Kelimeler

Hemodilution, ischemic stroke, vasomotor reactivity, cerebral oximeter

Akut İskemik Strok Tedavisinde Hemodilüsyonun Etkinliğinin Vasomotor Reaktivite ve Serebral Oksimetre ile Değerlendirilmesi

Öz

Hemodilüsyon serebral kan akımını
artırarak nöroprotektif etki göstermekte. Bu etkinin kısa ve uzun vadedeki
sonuçlarını vasomotor reaktivite testi ve serebral oksimetre ile test etmeyi
amaçladık. Gereç ve yöntemler: İskemik stroklu hastalar ardışık sistemle
hemodilüsyon ve kontrol grubuna kabul edildi. Hemodilüsyon ilk 24 sa içinde
uygulandı. Hematokrit düzeyine göre hipervolemik, izovolemik ya da hipovolemik
hemodilüsyon uygulandı. Hemodilüsyon öncesi, sonrası 5.gün ve 90.gün
transkranial doppler ile vasomotor reaktivite (VMR) testi, INVOS 3100 Cerebral
Oximeter ile oksijen dağımı ve klinik değerlendirmeleri yapıldı. Klinik
değerlendirmede Glaskow koma skalası, Bartel, Rankın, SSS, MCANS, HSS
kullanıldı. Sonuçlar descriptive statistics, varyans analizi ve t- test ile
değerlendirildi. Bulgular: Hemodilüsyon grubunda 21, kontrol grubunda 20 hasta
vardı. Yaş ortalaması 61,2 idi. VMR testinde ve oksimetride oksijen değerlerinde
iki grup birbiri ile ve günlere göre karşılaştırmada anlamlı bir farklılık
bulunmamıştır. Klinik değerlendirmede 90. Günde hemodilüsyon grubunda SSS ve
MCANS değerleri daha iyi bulunmuştur. Hemodilüsyon WMR testinde ve oksijen
dağılımında anlamlı bir etki göstermemiştir. Uzun dönemde klinik iyileşmede
etkili bulunmuştur.

Anahtar Kelimeler

Hemodilüsyon, İskemik strok, vasomotor reaktivite, serebral oksimetre

Kaynakça

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