Bişar AMAÇ, AYDEMİR KOÇARSLAN, Mehmet Salih AYDIN, Nazım KANKILIÇ, Mahmut PADAK, Reşat DİKME

Kardiyopulmoner Bypass'ın Hemogram Parametreleri Üzerine Etkisi

Amaç: Bu çalışmada, kardiyopulmoner bypass yöntemi ile kardiyovasküler cerrahi geçiren hastaların farklı zamanlarda alınan hemogram örneklerinin değerlendirilmesi amaçlanmıştır. Materyal ve Metot: Prospektif olan çalışmamıza çeşitli sebeplerden dolayı kardiyovasküler cerrahi geçiren 30 hastadan preoperatif, anestezi indüksiyonu sonrası, aortik kross klemp sonrası, KPB çıkışından hemen sonra ve postoperatif 5.gün olmak üzere beş farklı zamanda hemogram tüpüne kan örnekleri alındı. Numuneler tam kan sayım cihazında çalışıldı ve istatistiksel analizleri yapıldı. Bulgular: Çalışmaya dahil edilen hastaların yaşları 49,57±14,25, boyları 165,33±0,06 cm, kiloları 71,00±12,98 kg, aortik kross klemp süreleri 75,23±28,45 dakika, total perfüzyon süreleri 112,50±46,23 dakika, hastanede kalış süreleri 13,53±10,18 gün, yoğun bakım kalış süreleri 1,9±2,04 gün, vücut yüzey alanları 1,78±0,17 m2, flow değerleri 4177,90±831,91 ml/dk/m2 bulundu. Lökosit, lenfosit, monosit, eoznofil, eritrosit, hematokrit ve platelet düzeylerindeki değişim istatistiksel olarak anlamlı bulundu (p<0,05). Nötrofil, bazofil ve hemoglobin düzeylerinde de ciddi düzeyde değişim vardı ancak istatistiksel olarak anlamlı değildi (p>0,05). Sonuç: Kardiyopulmoner bypass yöntemi ile kardiyovasküler cerrahisi sırasında uygulanan hemodilüsyon, heparinizasyon ve kanın endotel olmayan yüzeylerle teması neticesinde hasar ve enflamatuar yanıta bağlı olarak hemogram parametrelerinde ciddi düzeyde değişimler oluşmaktadır.

Anahtar Kelimeler:

Ekstrakorporeal dolaşım, hemogram parametreleri, kardiyopulmoner bypass, perfüzyon

The Effect of Cardiopulmonary Bypass on Hemogram Parameters

Objective: This study aims to evaluate the hemogram samples taken at different times from patients who underwent cardiovascular surgery with cardiopulmonary bypass method. Materials and Methods: In this prospective study, blood samples were taken from 30 patients who underwent cardiovascular surgery for various reasons at five different times: preoperatively, after anesthesia induction, after aortic cross clamp, immediately after CPB, and on the postoperative 5th day. Complete blood count was performed for the samples and statistical analysis was made. Results: The patients were found to have the following values: age 49.57±14.25 years, height 165.33±0.06 cm, weight 71.00±12.98 kg, aortic cross clamp time 75.23±28.45 minutes, total perfusion time 112.50±46.23 minutes, hospital stay 13.53±10.18 days, intensive care stay 1.9±2.04 days, body surface areas 1.78±0.17 m2, flow values 4177.90±831.91 ml/min/m2. The change in leukocyte, lymphocyte, monocyte, eosinophil, erythrocyte, hematocrit and platelet levels was statistically significant (p<0.05). There was also a significant change in neutrophil, basophil and hemoglobin levels, but it was not statistically significant (p>0.05). Conclusion: As a result of hemodilution, heparinization and blood contact with non-endothelial surfaces during cardiovascular surgery with cardiopulmonary bypass method, serious changes in hemogram parameters occur due to damage and inflammatory response.

Keywords:

Extracorporeal circulation, hemogram parameters, cardiopulmonary bypass, perfusion,

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