Ezhar KORKMAZ ERSÖZ, Mehmet Salih AYDIN, Aydemir KOÇARSLAN, Lütfiye KAFAF YAZAR, Yasemin HACANLI, Mehmet YAZAR

Kardiyopulmoner Bypass’ta Sıvı Dengesinin Oksidan ve Antioksidan Denge Üzerine Etkisi

Amaç: Kardiyopulmoner Bypass (KPB) sırasında prime solüsyonu olarak kullanılan farklı sıvıların oksidatif stresi nasıl etkilediğini ortaya koyarak açık kalp cerrahisine katkı sağlamayı amaçlıyoruz. Yöntem: Bu çalışmaya çeşitli nedenlerle açık kalp ameliyatı geçiren 21 erkek ve 9 kadın olmak üzere toplam 30 hasta dahil edildi. Hastalar kullanılan prime solüsyonlarına göre 1. Grup: Laktatlı Ringer, 2 Grup: Isolyte S olarak iki gruba ayrıldı. Bu hastalardan anestezi indüksiyonu sonrası, KPB sırasında cross-klemp takıldıktan sonra, ameliyat sonrası 1. gün ve 5. gün olmak üzere toplam 4 kan alındı. Alınan numunelerden total antioksidan stres (TAS), total oksidatif stres (TOS) ve oksidatif stres indeksi (OSİ) çalışıldı. Sonuçlar istatistiksel olarak değerlendirildi. Materyal ve Metod: Bu çalışmada toplanan numuneler prime solüsyonu verilmeden önce (KPB önce) ve KPB’ dan sonrası karşılaştırıldı. Postoperatif 5. gün Ringer Laktat (RL) kullanan grupta TOS değeri preoperatif döneme göre istatistiksel olarak anlamlı derecede düşüktü (p=0,015). Yine OSİ değerleri karşılaştırıldığında Ringer Laktat (RL) grubunun OSİ değerinin istatistiksel olarak anlamlı derecede daha düşük olduğu görüldü (p=0,032). Sonuç: Çalışmamızın sonucunda Kardiyopulmoner Bypass (KPB) sırasında sıklıkla kullanılan iki tip prime solüsyonun (Ringer Laktat ve İsolayt S) TOS ve OSI değerlerinin Ringer Laktat (RL) grubunda daha düşük, Isolayt S grubundan daha üstün olduğu görüldü. Aim: We aim to contribute to open heart surgery by revealing how different fluids used as prime solution during Cardiopulmonary Bypass (CPB) affect oxidative stress. Material and Methods: A total of 30 patients, 21 men and 9 women, who underwent open heart surgery for various reasons were included in this study. Patients according to the prime solutions used 1. Group: Lactic Ringer was divided into two groups as 2 Groups: Isolyte S. A total of 4 blood samples were taken from these patients after anesthesia induction, after cross-clamping during CPB, on the 1st day and the 5th day after the operation. Total antioxidant stress (TAS), total oxidative stress (TOS) and oxidative stress index (OSSI) were studied from the samples taken. The results were evaluated statistically. Results: Samples collected in this study were compared before prime solution (before CPB) and after CPB. In the group using Ringer Lactate (RL) on the 5th day postoperatively, the TOS value was statistically significantly lower than the preoperative period (p=0.015). Again, when the OSI values were compared, it was seen that the OSI value of the Ringer Lactate (RL) group was statistically significantly lower (p=0.032). Conclusions: As a result of our study, it was seen that the TOS and OSI values of the two types of prime solutions (Ringer Lactate and Isolayt S) frequently used during Cardiopulmonary Bypass (CPB) were lower in the Ringer Lactate (RL) group and superior in the Isolayt S group.

Anahtar Kelimeler:

Kardiyopulmoner Bypass, sıvı Dengesi, Oksidan ve Antioksidan Denge, Prime Solüsyonu, Cardiopulmonary Bypass, Fluid Balance, Oxidant and Antioxidant Balance, Prime Solution

Effect of Fluid Balance on Oxidant and Antioxidant Balance During Cardiopulmoner Bypass

Background: We aim to contribute to open heart surgery by revealing how different fluids used as prime solution during Cardiopulmonary Bypass (CPB) affect oxidative stress. Materials and Methods: A total of 30 patients, 21 men and 9 women, who underwent open heart surgery for various reasons were included in this study. Patients according to the prime solutions used 1. Group: Lactic Ringer was divided into two groups as 2 Groups: Isolyte S. A total of 4 blood samples were taken from these patients after anesthesia induction, after cross-clamping during CPB, on the 1st day and the 5th day after the operation. Total antioxidant stress (TAS), total oxida-tive stress (TOS) and oxidative stress index (OSSI) were studied from the samples taken. The results were evaluated statistically. Results: Samples collected in this study were compared before prime solution (before CPB) and after CPB. In the group using Ringer Lactate (RL) on the 5th day postoperatively, the TOS value was statistically significantly lower than the preoperative period (p=0.015). Again, when the OSI values were compared, it was seen that the OSI value of the Ringer Lactate (RL) group was statisti-cally significantly lower (p=0.032). Conclusions: As a result of our study, it was seen that the TOS and OSI values of the two types of prime solutions (Ringer Lactate and Isolayt S) frequently used during Cardiopulmonary Bypass (CPB) were lower in the Ringer Lactate (RL) group and superior in the Isolayt S group.

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