Özgün CUVAŞ, Fatma Öztürk YALÇIN, Bayezit DİKMEN

Dilate kardiyomiyopatili bir hastada anestezik yaklaşım

Dilate kardiyomiyopati, ventriküler sistolik fonksiyonlarda depresyon ve geniş ventriküler kavite boyutu ile birliktedir. Dilate kardiyomiyopatili hastada anestezi, klinisyenler için önemli zorluklar taşır. Miyokard fonksiyonlarında depresyon ve hemodinamik değerlerde değişiklik olmaksızın anestezinin idamesi gereklidir. Konjestif kalp yetmezliği bulgularını hafifletmek için hastanın operasyon öncesinde etkin şekilde hazırlanması, tam hemodinamik monitorizasyon, aritmilerin önlenmesi, anestezik ajanların kardiyak fonksiyonları baskılamayacak dozlarda dengeli kullanımı, önyükün en uygun değerde tutulması ve ard yükün azaltılması dikte kardiyomiyopatili hastalarda anestezi sırasında en önemli noktalardır. Bu olguda dilate kardiyomiyopatili yaşlı bir hastada olan anestezik yaklaşımımızı sunmayı amaçladık.

Anaesthetic management of a patient with dilated cardiomyopathy

Dilated cardiomyopathy is associated with depressed ventricular systolic function and large ventricular cavity dimension. Anaesthesia for patients with dilated cardiomyopathy presents considerable challenges to the clinicians. Maintanence of anaesthesia without depression in myocardial functions and changes in hemodynamic values is necessary. Effective preoperative preparation of the patient to attenuate the signs of congestive heart failure, overall monitoring of hemodynamics, prevention of arrhythmias, balanced use of anesthetic agents in the doses that exert no cardiosuppressive effect, preload optimization and postload reduction are the essential points in patients with dilated cardiomyopathy during anaesthesia. Here we aimed to report our anaesthetic management of an elderly patient with dilated cardiomyopathy.

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