Amir NASERİ, İsmail ŞEN, Kürşat TURGUT, Hasan GUZELBEKTES

Doğal Gelişen Şiddetli Sepsisli ve Septik Şoklu Buzağılarda Pıhtılaşma Bozuklukları ve Kardiyak Biyomarkırlarının Değerlendirilmesi

Sepsis sırasında pıhtılaşma anormallikleri ve miyokardiyal hasarı sıklıkla ortaya çıkmaktadır. Bu çalışmanın amacı septik neonatal buzağılarda pıhtılaşma parametrelerini ve kardiyak spesifik biyobelirteçleri belirlenen aralıklarla değerlendirmekti. 20 adet sepsisli buzağı ve 10 adet sağlıklı buzağı dahil edildi. Pıhtılaşma parametreleri için prothrombin zamanı (PT), active edilmiş parsiyel tromboplastin zamanı (APTT), D-dimer, fibrinojen, antitrombin III (AT III), trombosit ve kardiyak biyobelirteçler için kardiyak troponin (cTn) I, T ve kreatin kinaz-MB (CK-MB) sepsisli buzağılarda tedavi öncesi, 24. ve 72. saatlerinde iki sefer ve sağlıklı buzağılarda tek sefer olarak değerlendirildi. Pıhtılaşma parametrelerinin sonuçları, PT ve APTT sürelerinde tedavi öncesinden 72. saate kadar önemli bir artış ve AT III ve fibrinojende tedavi öncesinden 72. saate kadar önemli biraz azalma belirlendi. Sepsisli buzağılarda kardiyak troponin T ve CK-MB 72 saatte anlamlı olarak yükseldiği tespit edildi. PT, APTT, fibrinojen ile kardiyak troponin T arasında korelasyon olduğu belirlendi. Sonuç olarak, kardiyak hasar, yaygın damar için pıhtılaşmanın (YDP) hiperkoagülasyon aşamasında gelişebilir ve bu durum cTn T ve CK-MB yükselmesine ve prognozun kötü olmasına yol açabilmektedir.

Anahtar Kelimeler:

sepsis, Biyobelirteçler, Miyokard, Yaygın damar içi pıhtılaşma

Evaluation of Coagulation Abnormalities and Cardiac Biomarkers in Calves with Naturally Occurring Severe Sepsis or Septic Shock

Coagulation abnormalities and myocardial injury frequently occur during sepsis. The aim of the present study was to evaluate the coagulation parameters and cardiac-specific biomarkers at set intervals in septic neonatal calves. Ten healthy calves and 20 septic calves were included in the study. For detecting coagulation parameters prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, fibrinogen, antithrombin III (AT III), thrombocyte and, for cardiac biomarkers cardiac troponin (cTn) I, T, and creatine kinase-MB (CK-MB) were evaluated on admission, 24 and 72 hours later in septic calves and once in healthy calves. The results of coagulation parameters showed a significant elevation of PT and APTT times from the time of admission until the 72nd hour and a significant reduction of AT III and fibrinogen from the time of admission until the 72nd hour. Cardiac troponin T was high in the 72nd hour, and CK-MB was high in the time of admission, 24th and 72nd hours in septic calves compare to the healthy calves. There was a correlation between PT, APTT, fibrinogen with cardiac troponin T. In conclusion, cardiac damage can develop during the hypercoagulable state of disseminated intravascular coagulation (DIC), and maybe it is responsible for the elevation of cTnT and CK-MB and worse outcome in neonatal septic calves.

Keywords:

sepsis, Biomarker, Disseminated intravascular coagulation, Myocardium,

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