Erişkin Kalp Cerrahisinde Kardiyopulmoner Baypas Sırasındaki Beyin Perfüzyonu ile Mortalite Skorlarının Etkileşimi

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Relation Between Cerebral Perfusion Changes and Mortality Scores During Cardiopulmonary Bypass at Adult Cardiac Surgery

<!-- /* Font Definitions */ @font-face {font-family:Times; panose-1:2 0 5 0 0 0 0 0 0 0; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:"MS 明朝"; mso-font-charset:78; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:1 134676480 16 0 131072 0;} @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:Cambria; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:-536870145 1073743103 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} /* Page Definitions */ @page {mso-footnote-numbering-restart:each-section;} @page WordSection1 {size:595.3pt 841.9pt; margin:36.0pt 36.0pt 36.0pt 36.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} --> Introduction: This study aims to investigate the correlation between cerebral perfusion changes and mortality rate in individuals undergoing adult cardiac surgery.   Patients and Methods: Between April 2018-August 2018, 91 adult individuals who underwent open heart surgery with cardiopulmonary bypass (CPB) were prospectively evaluated. Cerebral perfusion was monitored via near-infrared spectroscopy (NIRS). The NIRS values were recorded at four intervals: T0, just before CPB; T1, cooling period (time taken to reach targeted hypothermia); T2, warming period (time taken to reach normal body temperature); and T3, following minutes of termination of CPB. Euro Score II and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were recorded for each individual.   Results: The operations performed include coronary artery bypass surgery (n= 41, 45%), valvular surgery (n= 47, 51%), and coronary artery bypass combined with valvular surgery (n= 3, 4%). Median Euro Score II was calculated to be 1.1 (range 0.7-36.6), and median APACHE II score was calculated to be 6 (range 0-23). Mortality occurred in four individuals for whom the Euro Score II C index was 0.702 (confidence interval, 0.411- 0.993; p= 0.048) and APACHE-II score C index was 0.871 (confidence interval, 0.660-1; p= 0.010). During the operative period, cerebral NIRS values decreased during T3 period, and significant changes occurred at T0-T3 period, consequently leading to an increase in the APACHE-II scores and the prediction of mortality.   Conclusion: The changes at NIRS values were related with higher mortality, morbidity, and predicting scores. It is now suggested that these changes can eventually be a good guide and predictor for the management of patients during preoperative and postoperative periods.

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Koşuyolu Heart Journal-Cover
  • ISSN: 2149-2972
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1990
  • Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi
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