Ümit ÖZYURDA, Zeynep Baştüzel EYİLETEN, Adnan UYSALEL, Burak AÇIKGÖZ, Bülent KAYA, Tümer ÇORAPÇIOĞLU, Mustafa Bahadır İNAN, Kemalettin UÇONAK, Atilla ARAL, Levent YAZICIOĞLU

Kalp cerrahisi ve lokal hipotermi: 731 hastanın retrospektif değerlendirilmesi

Giriş: Bu çalışmanın amacı miyokard koruma yöntemlerinden topikal hipoterminin postoperatif so- lunumsal fonksiyonlarına etkisini değerlendirmektir.Materyal Metod: Hastalar 2 gruba ayrıldı: Grup Ada (n=258) topikal hipotermi olmaksızın miyokardkoruması uygulanan hastalar bulunurken, Grup Bde (n=473) topikal hipotermi uygulanan hastalarmevcuttu. Topikal hipotermi kardiyopleji verilmesi esnasında epikardiyal olarak tekrarlandı. Hastala- rın postoperatif entübe kalış süreleri, reentübasyon sayısı, yoğun bakım ve hastanede kalış süreleri,morbidite ve mortalite ve diğer klinik bulgular retrospektif olarak değerlendirildi.Sonuçlar: Her iki grubun demografik dataları benzerdi. Ortalama entübasyon süresi her iki gruparasında istatistiksel olarak anlamlı değildi (6.8±3.1 saat Grup A, 7.4±2.8 saat Grup B, p>0.05). Or- talama yoğun bakım kalış ve hastane kalış süreleri kıyaslandığında her iki grup arasında belirginbir fark bulunmamaktaydı (p>0.05). Mortalite oranları gruplar arasında benzerdi ve hiçbiri solunumproblemlerine bağlı değildi. Solunum yetmezliği sebebiyle Grup Ada 10 hasta reentübe edilirkenGrup Bde 18 hasta reentübe edildi ve istatistiksel olarak gruplar arasında anlamlı bir fark bulunmadı(p>0.05).Tartışma: Kalp cerrahisinde topikal hipoterminin yararı oluşabilecek muhtemel komplikasyonlararağmen halen kabul edilebilir düzeydedir. Bununla birlikte, hastanın preoperative durumunun de- ğerlendirilerek cerrahi için uygun miyokard koruma metoduna karar vermek akılcı olacaktır.

Cardiac surgery and local hypothermia: Retrospective evaluation of the 731 patients

ntroduction: The aim of this study is to evaluate the effects of topical hypothermia on postopera- tive respiratory functions.Material Methods: The patients were divided into 2 groups: In Group A (n=258) there were patientswho had myocardial protection without topical hypothermia, in Group B (n=473) was consistingof topical hypothermia applied patients. Topical hypothermia was repeated epicardially in everycardioplegia administration. The duration of postoperative intubation, number of reintubations,duration of intensive care unit stay and hospitalization, morbidity and mortality and other clinicalfindings were retrospectively evaluated.Results: The demographic data were similar in both groups. The mean intubation duration wasn tstatistically significant between the two groups (6.8±3.1 hours for Group A, 7.4±2.8 hours for GroupB, p>0.05). There was no significant difference between two groups when durations of mean in- tensive care unit stay and hospital stay were compared (p>0.05). The mortality rates were similarbetween the groups and none of them were due to respiratory problems. In Group A, 10 patientswere reintubated while in Group B, 18 patients were reintubated because of respiratory failure andshowed no significant difference between the groups statistically (p>0.05).Discussion: The benefit of topical hypothermia in cardiac surgery is still acceptable despite possi- ble complications, which may occur. However, it will be logical to decide the appropriate myocardialprotection method for surgery according to the patient s preoperative status.

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