Erişkin Kalp Cerrahisinde Ekstrakorporeal Dolaşım Sırasında NIRS Yöntemi ile Hepatik ve Renal somatik Oksijen Saturasyonu Takibi Anlamlı mı?

Amaç: Erişkin açık kalp cerrahisinde, NIRS yöntemiyle karaciğer ve böbrek dokusu oksijen saturasyonu KSO2 ,BSO2 ölçümünün, sonuç parametreleri üzerine olan etkisinin araştırılması. Hastalar ve Yöntemler: Üniversitemiz etik kurul onayı ve onamları alınan koroner bypass cerrahisi olacak 88 hasta prospektif olarak çalışmaya alındı. Hastalara kliniğimizin rutin açık kalp cerrahisi protokolu dışında preoperatif dönemde, USG ile karaciğer ve sağ böbreğin cilde en yakın yerleri saptanarak operasyon sırasında bu lokalizasyonlara yerleştirilen NIRS problarıyla karaciğer ve böbrek satürasyonlarının takipleri alındı. Ölçümler; indüksiyon öncesi T1 , indüksiyon sonrası T2 , ekstrakorporeal dolaşımın EKD 10. dk.sı T3 , EKD’ın 20. dk.sı T4 , ısınma sonrası T5 , EKD bitiminde T6 tekrarlandı.. Aynı süreçlerde pH, pCO2, pO2, laktat, ortalama arter basıncı ve kalp hızı KH değerleri de kaydedildi. Karaciğer ve böbrek fonksiyonları preoperatif, postoperatif 2. ve 4. günlerde kreatinin, üre, ALT, AST değerleriyle değerlendirildi. Sonuçlar Pearson korelasyonu ile karşılaştırıldı. Bulgular: Karaciğer ve böbrek oksijen saturasyonu değerleri T2 periyodu dışında paralel değişim göstermiş olup Pearson korelasyonu yaklaşık r:0,6 düzeylerinde p

Is It Efficient To Use Nirs To Calculate Hepatic and Renal Oxygen Saturation During Extracorporeal Circulation?

Aim: This study was performed to evaluate the effects of hepatic and renal oxygen saturation calculation on the outcome parameters in the adult cardiac surgery. Patients and Methods: Eighty-eight open heart surgery patients were admitted to the study. They had undergone open heart surgery under routine protocol of our clinic.In addition to routine protocol; the nearest localization of the liver and right kidney to the skin was marked with USG, preoperatively. In the operation room the NIRS probes were placed, the saturation measurements were noted before induction T1 , after induction T2 , in the 10th min. of extracorporeal circulation ECS T3 , in the 20th min. of ECS T4 , after rewarming T5 , at the end of ECS T6 as well as pH, pCO2, pO2, lactate, mean arterial pressure/pump pressure and heart rate measurements. Creatinine, urea and ALT-AST values were evaluated in the preoperative day and postoperative day 2 and 4. The results were compared with Pearson correlation. Results: Hepatic and renal saturation levels were in concordance with pO2 levels Pearson correlation p

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