Can Aksu, Tülay Çardaközü, Ali Ahmet Arıkan

AÇIK KALP CERRAHİSİNDE DÜŞÜK TİDAL VOLÜM VENTİLASYON: 8 ML/KG VE 6 ML/KG TİDAL VOLÜMDEN HANGİSİ DAHA İYİ?

Amaç: Koroner arter baypas greftleme operasyonunda düşük tidal hacim stratejisi ile akciğer koruyucu ventilasyonda 6ml/kg ile 8 ml/kg tidal hacim sonuçlarını karşılaştırması amaçlanmıştır. Yöntem: Randomize, tek merkezli, prospektif çalışmaya alınan ardışık 32 hasta, iki eşit gruba ayrıldı. 6ml/kg ve 8ml/kg tidal volüm ile ventilasyonun sonuçları karşılaştırıldı. Arterial kan basınçları, kalp hızı, santral venöz basınç, ekspirasyon tidal hacimi, solunum frekansı, alveolar dakika ventilasyonu, inspirasyon süresi, statik kompliyans, pik hava yolu basıncı, plato basıncı, sürüm basıncı, arter kan gazı verileri ve PaCO2-EtCO2 farkı T1(CPB'den 15 dak. önce), T2 (kardiyopulmoner baypasın sonlandırılmasından 15 dak. sonra) ve T3 (ameliyatın sonunda) zamanlarında kaydedildi. PaO2 /FiO2 oranı ekstübasyon sonrası T1, T2 ve T3ile 6. (T4) ve 12. saatte (T5) kaydedildi. Bulgular: Grup 6 ml/kg'da ekstübasyon süresi ve yoğun bakımda kalış süresi anlamlı olarak daha uzundu (sırasıyla p

LOW TIDAL VOLUME VENTILATION IN OPEN HEART SURGERY: WHICH TIDAL VOLUME IS BETTER 8 ML/KG OR 6 ML/KG?

Objective: To compare the outcomes of 6m/kg vs. 8 ml/kg tidal volume in the lung protective ventilation - low tidal volume strategy in coronaryartery bypass grafting operation.Methods: Thirty-two patients enrolled in a randomized, single-center, prospective study were divided into two groups. The outcomes of 6m/kg vs. 8ml/kg were compared. Arterial blood pressures, heart rate, central venous pressure, expired tidal volume, respiratory frequency, the alveolar minuteventilation, the inspiratory time, static compliance, peak airway pressure, plateau pressure, driving pressure, arterial blood gas data and PaCO2-EtCO2 difference were recorded at T1(15 min. prior to CPB), T2(15 min. following the termination of cardio pulmonary bypass), and T3times (atthe end of the surgery). PaO2/FiO2ratio was recorded at T1, T2 and T3 and 6th (T4) and 12th hours (T5) after extubation.Results: In Group 6ml/kg, extubation time and length of stay in the intensive care unit were significantly longer (p

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