Mahmut PADAK, Mustafa GÖZ, Reşat DİKME, Mehmet Salih AYDIN, İsmail KOYUNCU, Ömer GÖÇ

Kardiyopulmoner bypass sırasında akciğer ventilasyonunun total oksidatif durum, total antioksidan kapasite ve oksidatif stres indeksine etkisi

Amaç: Bu çalışmadaki amaç kardiyopulmoner bypass sırasında bir grup hastayı %10 volüm diğer grup hastayı solunumu tamamen durdurularak pre-op ve bypass sonrası TAS (Total Antioksidan Kapasite), TOS (Total Oksidatif Durum), OSİ (Oksidatif Stres İndeksi) bakılarak Akciğer ventilasyonun Bypass sırasında gerekliğinin belirlenmesidir.Materyal ve Metod: Göğüs Kalp Damar Cerrahisi bölümünde çeşitli sebeplerden dolayı kardiyopulmoner bypass cerrahisi ile ameliyat olan toplam 30 (14 E + 16 K) hasta seçildi. Hastalar 2 gruba (akciğer ventilasyonu tamamen durdurulan grup ve akciğer %10 cc volum ile çalıştırılan grup) ayrıldı. İki gruba ayrılan hastalardan kardiyopulmoner bypass öncesinde, pompaya giriş sırasında, pompadan çıkış sırasında ve ameliyat sonrası olmak üzere toplam 4 jelsiz tüpe kan alınarak bir çalışma grubu oluşturuldu. Alınan kanlar santrifüjde ayrıştırıldıktan sonra plazmaları -80 °C’de saklanarak numunelerin çalışma gününde Erel yöntemiyle Total oksidatif stress, Total antioksidan kapasite ve oksidatif stres indeks çalışıldı.Bulgular: TAS değeri 1,0945±0,25, TOS değeri 15,38±6,10 ve OSi değeri 1,4827±0,67 olarak bulunmuştur. Ventile edilmeyen hastaların TAS değeri 1,1514±0,24, TOS değeri 25,73±9,25 ve OSi değeri 2,2993±0,85 olarak bulunmuştur. Hastalarda TOS değeri ventile edilmeyen hastalarda artmıştır. Çalışmamızdaki TOS değerindeki artış TAS değeri üzerinde herhangi bir değişiklik oluşturmamıştır. OSİ değeri üzerinde anlamlı fark oluşmuştur. (p<0.05) Sonuç: iki grup karşılaştırıldığında TAS değerinde anlamlı bir değişkenlik olmazken, TOS ve OSİ değerleri açısından anlamlı bir sonuç çıkmıştır. KPB sırasında ventile edilmeyen hastalar % 10 ventile edilen hastalara göre TOS ve OSİ değerleri yüksek ve anlamlı bulunmuştur. Bu durum bize KPB sırasında % 10 ventile edilen hastalardaki oksidatif stres parametrelerinin azaldığını göstermektedir.

Anahtar Kelimeler:

Kardiyopulmoner baypas, Oksidatif stres, Antioksidanlar, Oksidatif stres

The effect of lung ventilation on total oxidative condition, total antioxidant capacity and oxidative stress index during cardiopulmonary bypass

Background:The aim in this study is to obtain the necessity of pulmonary ventilation during cardiopulmonary bypass by starting respiration of a group of patients with 10% volume and the other group stopping respiration totally as well as by examining TAS (Total Antioxidant Status), TOS (Total oxidative status), OSİ (oxidative stress index) in pre-op and after bypass. Methods:Totally 30 patients (14 M+ 16 F) that had cardiopulmonary bypass surgery in Thoracic and Cardiovascular Surgery Department for various reasons, were chosen. The patients were seperated into 2 groups (as pulmonary respiration was stopped completely and pulmonary respiration was started by 10% cc volume). Before carrdiopulmonary bypass working group was formed among patients seperated into 2 groups by taking totally 4 tubes of blood before cardiopulmonary bypass, at pump inlet, pump outlet and after operation. After eluting taken blood in centrifuge, they were kept at -80 °C. Then TAS, TOS and OSİ were studied by using Erel method. ResultsTAS value was found as 1,0945±0,25, TOS value as 15,38±6,10 and OSi value was found as 1,4827±0,67. TAS value of unventilated patients was found as 1,1514±0,24, TOS value was as 25,73±9,25 and OSi value was found as 2,2993±0,85. TOS value in patients increased in unventilated patients. The increase in TOS value in our study did not form any change on TAS value however there occured a significant difference on OSİ value. (p<0.05)Conclusions: As two groups were compared there did not occur a significant difference on TAS value, there came out a significant result in terms of TOS and OSİ values. During CPB, TOS and OSİ values of unventilated patients were found high and significant compared to 10% ventilated patients. This situation shows that oxidative stress parameters in 10% ventilated patients decreases during CPB.

Keywords:

Cardiopulmonary Bypass, Oxidative stress, Antioxidants, Oxidative stress,

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