Yasemin YAVUZ, Fatma UKIL IŞILDAK, Seda ARISÜT, Abdullah Arif YILMAZ, Füsun GÜZELMERİÇ

Pediatrik Açık Kalp Cerrahisi Yapılan Hastalarda Perioperatif ve Postoperatif Teofilin Uygulamasının İnflamasyon Üzerine Etkisi

Giriş: Bu çalışmanın amacı, konjenital kalp hastalıkları nedeniyle kardiyopulmoner baypas (KPB) ile açık kalp cerrahisi yapılan çocuklarda intraoperatif ve postoperatif teofilin infüzyonunun inflamasyon üzerine etkilerini değerlendirmektir. Hastalar ve Yöntem: Bu randomize kontrollü çalışma, üçüncü basamak bir hastanede KPB ile açık kalp ameliyatı geçiren 140 çocuk üzerinde gerçekleştirildi. Hastalar rastgele iki gruba alındı (teofilin grubu= 70, kontrol grubu= 70). Anestezi indüksiyonunu takiben teofilin alan kişilere operasyonun başlangıcından ameliyat sonrası 24. saatin sonuna kadar santral venöz kateter (SVK) ile teofilin infüzyonu uygulandı. Kontrol grubundaki hastalara aynı hacim ve sürede %0.9 NaCl solüsyonu SVK ile infüze edildi. Bulgular: Postoperatif kırmızı kan hücre dağılım genişliği teofilin grubunda preoperatif değerlere göre anlamlı olarak yüksek bulunmuştur (p= 0.003), ancak kontrol grubunda anlamlı fark bulunmamıştır (p= 0.188). Her iki grupta da postoperatif vazoaktif-inotropik skorlar, lenfosit ve trombosit sayıları preoperatif ölçümlerden daha düşük saptanmıştır (her iki grupta p< 0.001). Preoperatif beyaz küre sayıları benzer iken teofilin grubunda postoperatif değerler daha düşük bulunmuştur (p= 0.022). Sonuç: Kardiyopulmoner baypas ile açık kalp cerrahisi geçiren pediatrik hastalarda intraoperatif ve postoperatif teofilin kullanımı, düşük beyaz kan hücresi sayımlarının gösterdiği gibi postoperatif inflamasyonu azaltmada etkili olabilir; ancak diğer klinik özellikleri önemli ölçüde etkilemez.

The Effect of Perioperative and Postoperative Theophylline Administration on Inflammation in Patients Undergoing Pediatric Open-Heart Surgery

Introduction: The aim of this study was to evaluate the effects of intraoperative and postoperative theophylline infusion on inflammation in children who underwent open heart surgery with cardiopulmonary bypass (CPB) for congenital heart diseases. Patients and Methods: This randomized controlled study was carried out with 140 children who underwent open heart surgery with CPB in a tertiary hospital. The patients were randomly enrolled into two groups (theophylline group= 70, control group= 70). Following the induction of anesthesia, theophylline infusion was applied to theophylline recipients from the beginning of the operation to the end of the 24th hour after surgery via a central venous catheter (CVC). The patients in the control group were infused with 0.9% NaCl solution at the same volume and duration via CVC. Results: Postoperative red blood cell distribution width was significantly higher than preoperative values in the theophylline group (p= 0.003), but no significant difference was found in the control group (p= 0.188). In both groups, postoperative vasoactive-inotropic scores, and lymphocyte and platelet counts were lower than preoperative measurements (p< 0.001 for each in both groups). While preoperative white blood cell counts were similar, postoperative values were found to be lower in the theophylline group (p= 0.022). Conclusion: In pediatric patients undergoing open heart surgery with CPB, the use of intraoperative and postoperative theophylline may be effective in reducing postoperative inflammation, as demonstrated by lower white blood cell counts; but it does not significantly affect other clinical features.

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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