Ciddi Düşük Ejeksiyon Fraksiyonlu Kalp Yetmezliği Olan Bir Olguda Perioperatif Yönetim

Radikal sistektomi kas invaziv non-metastatik mesane kanserleri için standart tedavidir. İskemik kalp hastalığı, dünya çapında morbidite ve mortalitenin en yaygın nedenleri arasındadır. Bu olguda invaziv mesane kanseri nedeniyle radikal sistektomi üriner diversiyon uygulanan ciddi kalp yetmezliği bulunan bir hastada perioperatif anestezi yönetimimiz aktarılmıştır.

Relationship Between Serum Asymmetric Dimethylarginine (ADMA) Level And Obstructive Sleep Apnea Syndrome (OSAS) Severity

Introduction: The repetitive hypoxemia can induce oxidative stress mechanisms. Oxidative stress increases serum ADMA levels in patients with OSAS. Aim: To investigate the relationship between serum levels of ADMA and OSAS severity. Methods: 330 patient’s records, who underwent overnight polysomnography (PSG) were retrospectively examined. The patients who had a abnormal serum glucose, lipid, thyroid, renal and liver function tests levels, had excluded. 72 patients had participating criteria. Patients were categorized into five groups according to apnea/hipopnea index (AHI). Measurement of ADMA levels was performed by ELISA kit. Results: The mean age was 44,19 ± 14,24 years. 31,9 % of the patients were female. Patients in normal group, severe, medium, mild and positional–REM dependent OSAS group were 26,4%, 25%, 6,9 %, 16,7% and 25%; respectively. A significant positive correlation was found between AHI and ADMA (r= 0,483; p 10) and the negative likelihood ratio was (LR-) 0,28 (R-

Keywords:

obstructive sleep apnea, hypoxemia ADMA,

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