Ayhan ŞAHİN, İlker YILDIRIM, Onur BARAN, Mustafa GÜNKAYA, Cavidan ARAR, Ercan GÜNERİ

Kardiyopulmoner Bypass Hastalarında Pulsatil ve Pulsatil Olmayan Ekstra Korporeal Perfüzyonun Serebral Oksijen Satürasyonuna Etkisi

Amaç: Kalp akciğer makinesi tarafından oluşturulan akım türü kardiyopulmoner bypassta önemlidir. Kardiyopulmoner bypass sırasında pulsatil akıma karşı pulsatil olmayan akımın kullanılması klinisyenler arasında bir tartışma konusu olmuştur. Kardiyopulmoner bypass sırasında pulsatil olmayan ve pulsatil akımın serebral oksijenasyon üzerindeki etkisini karşılaştırdık.Yöntem: Üniversite hastanemizde koroner arter bypass greft cerrahisi yapılan 50 erişkin hastanın pulsatil ve pulsatil olmayan akım tipi arasındaki serebral oksijenasyon farklarını karşılaştırmak için kullanılan yakın kızılötesi spektroskopi ile retrospektif bir çalışma yaptık.Bulgular: Pulsatil ve pulsatil olmayan akımın SpO2, pO2, pCO2 üzerindeki etkileri arasında anlamlı bir fark yoktu. Yakın Kızılötesi Spektroskopisi verilerinde her iki akım türü arasında anlamlı bir fark yoktu.Sonuç: Erişkin hastalarda kalp-akciğer makinesi (pulsatil veya pulsatil olmayan) tarafından üretilen akım tipinin serebral oksijenasyona etkisi yoktu.

Anahtar Kelimeler:

pulsatil, kardiyopulmoner bypass, perfüzyon

The Effect of Pulsatile and Non-Pulsatile Extra Corporeal Perfusion on Cerebral Oxygen Saturation in Cardiopulmonary Bypass Patients

Objective: The flow type generated by a heart-lung machine is important in cardiopulmonary bypass. The use of pulsatile flow versus non-pulsatile flow during cardiopulmonary bypass has been a controversy among clinicians. We compared the effect of non-pulsatile and pulsatile flow during cardiopulmonary bypass on cerebral oxygenation. Method: We conducted a retrospective study of 50 adult patients who underwent coronary artery bypass graft surgery at our university hospital, with near infrared spectroscopy used to compare differences in cerebral oxygenation between the pulsatile and non-pulsatile flow type.Result: There was no difference between the effect of pulsatile and non-pulsatile flow on the saturation of hemoglobin (SpO2), nor on the partial pressure of oxygen (pO2) and carbon dioxide (pCO2). The near infrared spectroscopy results were not different between the two flow types. Conclusion: There was no effect of the flow type generated by a heart-lung machine (pulsatile or non-pulsatile) on cerebral oxygenation in adult patients.

Keywords:

pulsatile, cardiopulmonary bypass, perfusion,

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