Erol ŞENER, Ezgi ERKILIÇ, Elvin KESİMCİ, Tuğba DULKADİROĞLU, Ferit ALAYBEYOĞLU, Cemile BALCI, Orhan KANBAK, Tülin GÜMÜŞ

Kalp ameliyatı sırasında nörolojik sonuçlar ile glisemik düzey arasındaki ilişki: Yakın kızılötesi spektroskopi çalışması

Amaç: Bu çalışmada kardiyopulmoner baypas yapılan hastalarda kan glukoz düzeyleri ve nörobilişsel fonksiyonlar arasındaki muhtemel ilişki araştırıldı. Çalışma planı: Aralık 2015 - Şubat 2016 tarihleri arasında elektif kardiyopulmoner baypas uygulanan toplam 54 hasta (42 erkek, 12 kadın; ort. yaş 59.6±11.6 yıl; dağılım 31-83 yıl) prospektif olarak çalışmaya alındı. Her hasta için bölgesel serebral oksijen satürasyon monitörizasyonu ile birlikte cerrahi hazırlığı, anestezi ve standart veri takibi yapıldı. Hastalar ameliyattan 24 saat önce ve sonra Mini-Mental Durum Değerlendirmesi’ne tabi tutuldu. Serebral oksimetre ve kan glukoz düzeyleri önceden belirlenen zamanlarda örneklendi (T0: anesteziden önce; T1: anesteziden sonra;sonrası)T.2: iskemi sonrası; T3: reperfüzyon sonrası ve T4: cerrahi Bulgular: Kardiyopulmoner baypasın farklı evrelerinde serebral oksijen satürasyon değerlerinde ve kan glukoz düzeylerinde görülen değişiklikler arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Diabetes mellitus varlığı veya testin zamanlaması açısından hastaların Mini -Mental Durum Değerlendirmesi skorları arasında da anlamlı bir fark yok idi. Sonuç: Çalışma bulgularımız, kardiyopulmoner baypas sırasında glisemik değişikliklerin bölgesel serebral oksijenasyonda değişikliğe neden olmadığını göstermektedir. Ayrıca, diğer değişkenler sabit tutulduğunda, kan glukoz düzeylerindeki değişiklikler ameliyat sonrası nörolojik fonksiyonları değiştirmemektedir.

The relationship of glycemic level with neurological outcomes during open cardiac surgery: A near-infrared spectroscopy study

Background: This study aims to investigate a possible relationship between blood glucose levels and neurocognitive functions in patients undergoing cardiopulmonary bypass.Methods: Between December 2015 and February 2016, a total of 54 patients (42 males, 12 females; mean age 59.6±11.6 years; range, 31 to 83 years) undergoing elective cardiopulmonary bypass were prospectively included. Preparation for surgery, anesthesia, and standard data monitoring were performed in each patient with additional regional cerebral oxygen saturation monitorization. The patients underwent the Mini-Mental State Examination 24 h before and after the operation. Cerebral oximetry and blood glucose levels were sampled at pre-defined time points (T0: before anesthesia; T1: after anesthesia; T2: after ischemia; T3: after reperfusion, and T4: after surgery).Results: No statistically significant relationship was found in the different stages of cardiopulmonary bypass between the altered cerebral oxygen saturation values and blood glucose levels. There was no significant difference between the Mini-Mental State Examination scores of the patients with respect to either presence of diabetes mellitus or timing of the test.Conclusion: Our study findings show that glycemic changes during cardiopulmonary bypass do not alter the regional cerebral oxygenation. In addition, when other variables are kept constant, changes in the blood glucose levels do not alter postoperative neurological functions.

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