Kardiyopulmoner Bypass Sırasında Hemofiltrasyon/Ultrafiltrasyon Kullanımının Perioperatif Sonuçlar Üzerine Etkisi

Yıl 2024, Cilt: 5 Sayı: 1, 105 - 113, 30.04.2024

Bişar Amaç , Murat Ziya Bağış

https://doi.org/10.58605/bingolsaglik.1400943

Öz

Bu çalışmada kardiyopulmoner bypass (KPB) sırasında konvansiyonel hemofiltrasyon/ultrafiltrasyon kullanımının intraoperatif ve postoperatif kan kullanımı, sistemik inflamatuar yanıt sendromu ve böbrek fonksiyonları üzerine olan etkilerini araştırmak amaçlandı.
KPB eşliğinde kardiyak cerrahisi uygulanmış, toplam 60 hasta retrospektif olarak çalışmaya dahil edildi. Operasyon sırasında KPB ekipmanı üzerinde konvansiyonel hemofiltrasyon/ultrafiltrasyon kullanılmamış ve kullanılmış olan hasta verileri gruplandırılarak karşılaştırıldı. Hastaların biyokimyasal, hematolojik ve diğer verileri gruplar arasında karşılaştırıldı.
Grupların demografik, tanımlayıcı ve preoperatif kan parametre verileri benzerdi (p>0,05). Grupların postoperatif 1.gün hemoglobin, hematokrit, üre, kreatinin, lökosit (WBC-White Blood Cell) ve C-reaktif protein (CRP) değerleri ve peroperatif değişkenlerinden; kan transfüzyon miktarı, peroperatif drenaj miktarı ve akut böbrek yetmezliği (ABY) oranı arasında anlamlı fark vardı (p<0,05). Grupların; idrar miktarı, intra-kardiyak defibrilasyon ihtiyacı, inotrop destek ihtiyacı, mekanik ventilasyon destek süresi, yoğun bakım ünitesi (YBÜ) kalış süresi, hastanede kalış süresi ve erken dönem mortalite oranları arasında ise anlamlı fark yoktu (p>0,05).
KPB eşliğinde kardiyak cerrahi operasyonu yapılan hastalarda KPB sırasında hemofiltrasyon/ultrafiltrasyon kullanımının intraoperatif ve postoperatif kan kullanımı, sistemik inflamatuar yanıt sendromu ve böbrek fonksiyonları üzerinde olumlu etkileri olduğunu düşünmekteyiz

Anahtar Kelimeler

Kardiyopulmoner Bypass, Perfüzyon, Hemofiltrasyon, Ultrafiltrasyon.

Etik Beyan

Bu araştırma için çalışma öncesi; çalışmanın yapılacağı kurum (Şanlıurfa Mehmet Akif İnan Eğitim ve Araştırma Hastanesi) ve yerel etik kurulundan (Harran Üniversitesi Klinik Araştırmalar Etik Kurulu) onay alındı (Etik Kurul Onay No: HRÜ/22.24.13, Tarih:12.12.2022). Çalışma Helsinki Bildirgesi prensiplerine uygun olarak yapıldı.

Effect of Hemofiltration/Ultrafiltration Use on Perioperative Outcomes During Cardiopulmonary Bypass

Öz

In this study, it was aimed to investigate the effects of conventional hemofiltration/ultrafiltration use on intraoperative and postoperative blood use, systemic inflammatory response syndrome and kidney functions during cardiopulmonary bypass (CPB).
A total of 60 patients who underwent CPB-guided cardiac surgery were included in the study retrospectively. The data of patients who did not use conventional hemofiltration/ultrafiltration on CPB equipment and which were used during the operation were grouped and compared. Biochemical, hematological and other data of the patients were compared between the groups.
Demographic, descriptive and preoperative blood parameterdata of the groups were similar (p>0.05). From the postoperative 1st day hemoglobin, hematocrit, urea, creatinine, leukocyte (WBC-White Blood Cell) and C-reactive protein (CRP) values and perioperative variables of the groups; there was a significant difference between the amount of blood transfusion, the amount of peroperative drainage and the rate of acute renal failure (ARF) (p<0.05). Groups; There was no significant difference between the amount of urine, need for intra-cardiac defibrillation, need for inotropic support, duration of mechanical ventilation support, duration of intensive care unit (ICU) stay, duration of hospital stay and early mortality rates (p>0.05).
We think that the use of hemofiltration/ultrafiltration during CPB has positive effects on intraoperative and postoperative blood use, systemic inflammatory response syndrome and renal functions in patients undergoing CPB-guided cardiac surgery.

Anahtar Kelimeler

Cardiopulmonary Bypass, Perfusion, Hemofiltration, Ultrafiltration.

Kaynakça

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