Vedat BAKUY, Tarık DEMİR, Faruk HÖKENEK, Füsun GÜLCAN, Barbaros KINOĞLU, Mete GÜRSOY, Ali Aycan KAVALA

An evaluation of renal functions in pulsatile and non-pulsatile cardiopulmonary bypass in the elderly

Amaç: Bu çalışmada yaşlı hastalarda pulsatil ve non- pulsatil kardiyopulmoner baypas tekniklerinin böbrek fonksiyonları üzerindeki etkileri değerlendirildi. Çalışm a planı: Ocak 2011 - Haziran 2011 tarihleri arasında kliniğimizde koroner arter baypas greftleme (KABG) yapılan 70 yaş üzeri 41 hasta çalışmaya alındı. Hastalar uygulanan perfüzyon tekniğine göre randomize olarak pulsatil ve non-pulsatil akım gruplarına ayrıldı. Hastaların ameliyat öncesi, kardiyopulmoner baypas sonrası ve ameliyat sonrası 3. gün kreatinin, sistatin C, kan üre azot değerleri, kardiyopulmoner baypas sırasında idrar çıkış miktarı ve akut böbrek hasarı görülme sıklığı kaydedildi. Bulgular: Hastaların ameliyat sonrası 3. gün sistatin C, kreatinin ve kan üre azot değerleri pulsatil akım grubunda anlamlı derecede daha düşüktü. Kardiyopulmoner baypas süresince hastaların idrar çıkışı ve akut böbrek hasarı görülme sıklığı gruplar arasında anlamlı düzeyde farklı bulundu. Sonuç: Pulsatil akımlı kardiyopulmoner baypas yaşlı has- talarda akut böbrek hasarını önleyebilen basit ve güvenli bir yöntemdir.

Yaşlılarda pulsatilvenonpulsatilkardiyopulmoner baypastaböbrek fonksiyonlarının değerlendirilmesi

Background: This study aims to evaluate the effects of pulsatile and non-pulsatile cardiopulmonary bypass techniques on renal functions in elderly. Methods: Between January 2011 and June 2011, 41 patients aged above 70 years who underwent coronary artery bypass grafting (CABG) in our clinic were enrolled in the study. Patients were randomly divided into two groups according to the perfusion technique: pulsatile and non-pulsatile flow. Preoperative, post-cardiopulmonary bypass and at third day following surgery, creatinine, cystatin C, blood urea nitrogen values, urine output during cardiopulmonary bypass and the incidence of acute kidney injury were recorded. Results: At third day following operation, cystatin C, creatinine and blood urea nitrogen values were significantly lower in pulsatile flow group. A significant difference was observed between the groups in terms of urine output during cardiopulmonary bypass and the incidence of acute kidney injury. Conclusion: Pulsatile flow cardiopulmonary bypass is a simple and safe method which may prevent acute kidney injury in elderly.

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