Kadir BABAOĞLU, Selim ÖNCEL, Gürkan ALTUN, Murat SERİNGEÇ, Ayşe ARISOY ENGİN

Erken doğmuş bebeklerde göbek ven kateterinin aritmi ve kalp hızı değişkenliği üzerine etkileri

Amaç: Yenidoğanlarda göbek veni kateterizasyonu ile ilişkili ritm bozuklukları olgu sunumları ile sınırlıdır. Bu çalışma erken doğmuş bebeklerde göbek ven kateterizasyonunun, aritmi ve kalp hızı değişkenliği üzerindeki etkisini araştırmak amacıyla yapılmıştır. Gereç ve Yöntem: Çalışma erken doğmuş bebeklerden oluşan iki grupta yapılmıştır. Grup I: Göbek ven kateteri takılı olan 26 bebek; grup II: göbek ven kateteri takılı olmayan 26 bebekten oluşmaktadır. Bütün bebeklerin cinsiyet, doğum haftası, doğum kilosu ve klinik değerlendirme puanları (SNAP-II ve SNAPPE-II) kaydedildi. Bebeklerin hepsine 24 saatlik Holter elektrokardiyografi takıldı. Kalp hızı değişkenliği zaman alanlı ve frekans alanlı değişkenler kullanılarak çalışıldı. Bulgular: Çalışmaya alınan bebeklerin ortalama doğum haftası grup 1’de 30,63±2,67, grup 2’de ise 31,60±2,45 idi. Gruplar arasında doğum haftası, doğum ağırlığı, SNAP-II ve SNAPPE-II puanları arasında istatistiksel olarak anlamlı fark saptanmadı. Aritmi açısından karşılaştırıldığında iki grup arasında istatistiksel olarak fark bulunmadı. Atriyal erken vuru grup 1’de 11 hastada (%42,3), grup 2’de 7 hastada (%26,9) saptandı. Ventriküler erken vuru grup 1’de 3 hastada (%11,5), grup 2’de bir hastada saptandı. Sinüs taşikardisi ise sadece grup 1’de yer alan üç hastada bulundu. Kalp hızı değişkenliği iki grup arasında istatistiksel olarak farklı bulunmadı. Çıkarımlar: Çalışmamızda, göbek ven kateterinin erken doğmuş yenidoğanlar da aritmi veya kalp hızı değişkenliği üzerinde anlamlı bir etkisinin olmadığı gösterilmiştir.

Effects of umbilical venous catheters on arrhythmia and heart rate variability in premature newborns

Aim: Cardiac rhythm abnormalities associated with umbilical venous catheters in newborns are limited to anecdotal case reports. The present study intended to evaluate association between umbilical venous catheter, arrhythmic potential, and changes in heart rate variability. Material and Method: The study consisted of two groups; 26 preterm newborns with a umbilical venous catheter (group 1), and 26 control group without (group 2). The following parameters were recorded prospectively: gender, gestation at birth, birth weight, and clinical assessment scores (SNAP-II and SNAPPE-II). Holter recordings were fitted in all newborns. The heart rate variability study was performed by utilizing time-domain and frequency-domain analyses. Results: The study population consisted of group 1 (30.63±2.67 weeks of gestation) and group 2 (31.60±2.45 weeks of gestation). There was no statistical difference between the two groups for gestational age, birth weight, SNAP-II and SNAPPE- II scores. When compared for arrhythmia there was no statistical difference in any parameters between the two study groups. Premature atrial contraction was noted in 11 babies (42.3%) in group 1 and in 7 babies (26.9%) in group 2. Premature ventricular contraction was noted in 3 babies (11.5%) in group 1 and in one baby in group 2. Sinus tachycardia detected in 3 patients in only the group 1. None of the heart rate variability parameters were found to be statistically different between the two groups. Conclusions: Our study reassuringly demonstrated that umbilical venous catheter does not have any significant effect on arrhythmia or heart rate variability in preterm newborns.

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