Hülya YILMAZ AK, Mustafa YILDIZ, Nurgül YURTSEVEN, Deniz ÖZSOY, Doğaç OKŞEN, Hakkı Kürşat ÇETİN

Konjenital Kardiyak Cerrahi Sonrası Yoğun Bakım Ünitesinde Takip Edilen 7 Gün ile 16 Yaş Aralığındaki Hastalarda Troponin I Seviyelerinin Postoperatif Mortalite ve Morbidite ile İlişkisi

Giriş: Troponin I miyokardiyal hasarın tahmininde önemli bir belirteçtir. Pediyatrik kardiyak cerrahide miyokardiyal hasarın en önemli mortalite ve morbidite nedeni olduğu anlaşılmıştır. Bu çalışma ile konjenital kalp ameliyatı olan çocuklarda troponin I değerlerinin postoperatif mortalite ve morbidite üzerine etkisini değerlendirmek amaçlanmıştır. Hastalar ve Yöntem: Konjenital kardiyak cerrahi uygulanan 99 hastanın perioperatif, postoperatif 24. ve 48. saatteki troponin I değerleri kaydedildi. Hastalar hesaplanan cut off değerine göre 24. saat troponin I seviyelerine göre iki gruba ayrıldı (15 ng/mL’den yüksek olanlar ve olmayanlar). Hastaların aortik kros klemp süreleri, kardiyopulmoner baypas süresi, entübasyon süresi, yoğun bakımda kalış süresi ve inotropik ajan düzeyleri kaydedildi. Bulgular: Konjenital kalp ameliyatı olan hastalarda postoperatif 24. saatte ölçülen troponin I seviyelerinin 15 ng/mL’nin üzerinde olmasının: kardiyopulmoner baypas süresi, aortik kross klamp süresi, entübasyon süresi ve yoğun bakım kalış süresini anlamlı olarak arttırdığı gösterildi. Sonuç: Konjenital kalp ameliyatı olan hastalarda postoperatif 24. saat yüksek troponin I düzeyleri yüksek morbidite riski ile uyumludur.

Anahtar Kelimeler:

Konjenital kalp ameliyatı, mortalite, morbidite, troponin I

Relation of Troponin I Levels with Postoperative Mortality and Morbidity Rates in Patients Followed in Intensive Care Unit After Congenital Cardiac Surgery Whose Ages Between 7 Days and 16 Years Old

Introduction: Troponin I levels are the most important predictive marker of myocardial injury. Myocardial injury has been reported as the most significant cause of morbidity and mortality in pediatric cardiac surgery. In this study, we aimed to evaluate the effect of troponin I on postoperative mortality and morbidity in the child population. Patients and Methods: Ninety-nine patients to whom congenital cardiac surgery were included in this study. Perioperative and postoperative troponin I values at 24th and 48th hours were recorded. Patients were divided into two groups according to troponin I values at 24th hour (lower and higher than 15 ng/mL, respectively). Aortic cross-clamp time, cardiopulmonary bypass (CPB) time, intubation time, and the duration of intensive care unit stay and medication of inotropic agents were recorded. Results: Postoperative troponin I levels at 24th hour were higher than 15 ng/mL in patients who underwent congenital cardiac surgery and were related with significantly higher CPB, aortic cross-clamp, intubation time, and longer stay in intensive care unit. Conclusion: Higher troponin I levels at 24th hour are associated with increased morbidity in patients who undergo congenital cardiac surgery.

Keywords:

Congenital cardiac surgery, troponin I, mortality, morbidity,

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