Yasemin HACANLI, Mehmet Halit ANDAÇ, Ezhar KORKMAZ ERSÖZ, Mehmet Salih AYDIN, Reşat DİKME

Kardiyopulmoner Bypass’ ta Magnezyumun Önemi

Kardiyopulmoner Bypass’ ta Magnezyumun Önemi Öz Amaç: Magnezyum sülfat majör aritmilerin engellenmesinde kullanılan önemli bir elektrolittir. Potasyum desteğine cevabı artırmak ve atriyal fibrilasyonun oluşumunu engelleyebilmek için magnezyum desteği kalp cerrahisinde genellikle tercih edilen bir uygulamadır. Bu çalışmamızda, kardiyopulmoner bypass ameliyatı geçiren hastalarda postoperatif aritmiler üzerine magnezyumun etkisi araştırıldı. Materyal ve Metod: Kardiyopulmoner bypass cerrahisi uygulanan otuz hasta çalışmaya dahil edildi ve rastgele iki gruba ayrıldı. Çalışma grubundaki hastaların (n=15) prime solüsyonu içerisine 10 cc magnezyum sülfat eklendi. Kontrol grubundaki hastaların (n=15) prime solüsyonu içerisine ise 5 cc magnezyum sülfat ilave edildi. Magnezyum sülfat uygulanmadan önce preoperatif dönemde, prime solüsyonuna magnezyum sülfat eklendikten sonra intraoperatif dönemde ve postoperatif ilk 4 saat içerisinde kan örnekleri alındı. Bulgular: Hastaların demografik verilerinde çalışma ve kontrol grubu arasındaki fark istatistiksel olarak anlamlı bulunmadı. (p>0,05). Gruplar postoperatif dönemde atriyal fibrilasyon açısından karşılaştırıldığında, çalışma grubunda atriyal fibrilasyon dahil majör aritmi izlenmedi (P>0,05). Kontrol grubundaki hastaların %33,3'ünde atriyal fibrilasyon görüldü (P<0,05) ve istatistiksel olarak anlamlı bulundu. Sonuç: Benzer demografik verileri olan ve kardiyopulmoner bypass ameliyatı olacak hastalarda, kardiyopulmoner bypass uygulamalarında uygulanan ve prime solüsyonuna eklenen magnezyum sülfat değerlerinin arttırılması ve hastaya daha yüksek doz verilmesinin postoperatif atriyal fibrilasyon ve aritmiler üzerine etkili olduğunu düşünmekteyiz. Importance of Magnesium During Cardiopulmonary Bypass Operation Abstract Background: Magnesium sulfate is an important electrolyte used in the prevention of major arrhythmias. Magnesium supplementation is generally preferred in cardiac surgery in order to increase the response to potassium supplementation and to prevent the formation of atrial fibrillation. In this study, the effect of magnesium on postoperative arrhythmias in patients undergoing cardiopulmonary bypass surgery was investigated. Materials and Methods: Thirty patients who underwent cardiopulmonary bypass surgery were included in the study and randomly divided into two groups. 10 cc magnesium sulfate was added to the prime solution of the patients in the study group (n=15). 5 cc magnesium sulfate was added to the prime solution of the patients in the control group (n=15). Blood samples were taken preoperatively before the application of magnesium sulfate, intraoperatively after adding magnesium sulfate to the prime solution, and within the first 4 hours postoperatively. Results: The difference between the study and control groups in the demographic data of the patients was not found to be statistically significant. (p>0.05). When the groups were compared in terms of atrial fibrillation in the postoperative period, no major arrhythmias including atrial fibrillation were observed in the study group (p>0.05). Atrial fibrillation was seen in 33.3% of the patients in the control group (p<0.05) and was found to be statistically significant. Conclusions: In patients with similar demographic data and who will undergo cardiopulmonary bypass surgery, it is thought that increasing the magnesium sulfate values applied in cardiopulmonary bypass applications and added to the prime solution and giving a higher dose to the patient are effective on postoperative atrial fibrillation and arrhythmias.

Anahtar Kelimeler:

Magnezyum, Atriyal Fibrilasyon, Prime Solüsyon, Kalp-Akciğer Makinesi, Kardiyopulmoner Bypass, Magnesium, Atrial Fibrillation, Prime Solution, Heart-Lung Pump, Cardiopulmonary Bypass

Importance of Magnesium During Cardiopulmonary Bypass Operation

Background: Magnesium sulfate is an important electrolyte used in the prevention of major arrhythmias. Magnesium supplementation is generally preferred in cardiac surgery in order to increase the response to potassium supplementation and to prevent the formation of atrial fibrillation. In this study, the effect of mag-nesium on postoperative arrhythmias in patients undergoing cardiopulmonary bypass surgery was investigat-ed. Materials and Methods: Thirty patients who underwent cardiopulmonary bypass surgery were included in the study and randomly divided into two groups. 10 cc magnesium sulfate was added to the prime solution of the patients in the study group (n=15). 5 cc magnesium sulfate was added to the prime solution of the pa-tients in the control group (n=15). Blood samples were taken preoperatively before the application of magne-sium sulfate, intraoperatively after adding magnesium sulfate to the prime solution, and within the first 4 hours postoperatively. Results: The difference between the study and control groups in the demographic data of the patients was not found to be statistically significant. (p>0.05). When the groups were compared in terms of atrial fibrilla-tion in the postoperative period, no major arrhythmias including atrial fibrillation were observed in the study group (p>0.05). Atrial fibrillation was seen in 33.3% of the patients in the control group (p<0.05) and was found to be statistically significant. Conclusions: In patients with similar demographic data and who will undergo cardiopulmonary bypass surgery, it is thought that increasing the magnesium sulfate values applied in cardiopulmonary bypass applications and added to the prime solution and giving a higher dose to the patient are effective on postoperative atrial fibrillation and arrhythmias. Key Words: Magnesium, Atrial Fibrillation, Prime Solution, Heart-Lung Pump, Cardiopulmonary Bypass

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