otsbd Online Turkish Journal of Health Sciences 2459-1467 Oğuz KARABAY 10.26453/otjhs.811833 Health Care Administration Sağlık Kurumları Yönetimi Kardiyopulmoner Bypass'ın Hemogram Parametreleri Üzerine Etkisi The Effect of Cardiopulmonary Bypass on Hemogram Parameters https://orcid.org/0000-0003-0320-4239 Amaç Bişar ŞANLIURFA MEHMET AKİF İNAN SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ https://orcid.org/0000-0003-3874-8762 Koçarslan Aydemir KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI https://orcid.org/0000-0002-6652-6035 Aydın Mehmet Salih HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI https://orcid.org/0000-0001-7111-7503 Kankılıç Nazım HARRAN ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KALP VE DAMAR CERRAHİSİ ANABİLİM DALI https://orcid.org/0000-0001-6863-1907 Padak Mahmut HARRAN ÜNİVERSİTESİ, SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU https://orcid.org/0000-0001-9157-7830 Dikme Reşat HARRAN ÜNİVERSİTESİ, SAĞLIK HİZMETLERİ MESLEK YÜKSEKOKULU 03 05 2021 6 1 102 111 10 17 2020 11 16 2020 Copyright © 2016, Online Türk Sağlık Bilimleri Dergisi 2016 Online Türk Sağlık Bilimleri Dergisi

Amaç: Bu çalışmada, kardiyopulmoner bypass yöntemi ile kardiyovasküler cerrahi geçiren hastaların farklı zamanlarda alınan hemogram örneklerinin değerlendirilmesi amaçlanmıştır.Materyal ve Metot: Prospektif olan çalışmamıza çeşitli sebeplerden dolayı kardiyovasküler cerrahi geçiren 30 hastadan preoperatif, anestezi indüksiyonu sonrası, aortik kross klemp sonrası, KPB çıkışından hemen sonra ve postoperatif 5.gün olmak üzere beş farklı zamanda hemogram tüpüne kan örnekleri alındı. Numuneler tam kan sayım cihazında çalışıldı ve istatistiksel analizleri yapıldı. Bulgular: Çalışmaya dahil edilen hastaların yaşları 49,57±14,25, boyları 165,33±0,06 cm, kiloları 71,00±12,98 kg, aortik kross klemp süreleri 75,23±28,45 dakika, total perfüzyon süreleri 112,50±46,23 dakika, hastanede kalış süreleri 13,53±10,18 gün, yoğun bakım kalış süreleri 1,9±2,04 gün, vücut yüzey alanları 1,78±0,17 m2, flow değerleri 4177,90±831,91 ml/dk/m2 bulundu. Lökosit, lenfosit, monosit, eoznofil, eritrosit, hematokrit ve platelet düzeylerindeki değişim istatistiksel olarak anlamlı bulundu (p<0,05). Nötrofil, bazofil ve hemoglobin düzeylerinde de ciddi düzeyde değişim vardı ancak istatistiksel olarak anlamlı değildi (p>0,05).Sonuç: Kardiyopulmoner bypass yöntemi ile kardiyovasküler cerrahisi sırasında uygulanan hemodilüsyon, heparinizasyon ve kanın endotel olmayan yüzeylerle teması neticesinde hasar ve enflamatuar yanıta bağlı olarak hemogram parametrelerinde ciddi düzeyde değişimler oluşmaktadır.

Objective: This study aims to evaluate the hemogram samples taken at different times from patients who underwent cardiovascular surgery with cardiopulmonary bypass method.Materials and Methods: In this prospective study, blood samples were taken from 30 patients who underwent cardiovascular surgery for various reasons at five different times: preoperatively, after anesthesia induction, after aortic cross clamp, immediately after CPB, and on the postoperative 5th day. Complete blood count was performed for the samples and statistical analysis was made.Results: The patients were found to have the following values: age 49.57±14.25 years, height 165.33±0.06 cm, weight 71.00±12.98 kg, aortic cross clamp time 75.23±28.45 minutes, total perfusion time 112.50±46.23 minutes, hospital stay 13.53±10.18 days, intensive care stay 1.9±2.04 days, body surface areas 1.78±0.17 m2, flow values 4177.90±831.91 ml/min/m2. The change in leukocyte, lymphocyte, monocyte, eosinophil, erythrocyte, hematocrit and platelet levels was statistically significant (p<0.05). There was also a significant change in neutrophil, basophil and hemoglobin levels, but it was not statistically significant (p>0.05).Conclusion: As a result of hemodilution, heparinization and blood contact with non-endothelial surfaces during cardiovascular surgery with cardiopulmonary bypass method, serious changes in hemogram parameters occur due to damage and inflammatory response.

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