The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting

Şen, Ahmet; TUĞCUGİL, Ersagun; koyuncu, tolga; ÖZDEMİR, Abdullah; Erdivanlı, Başar; Ergene, Saban

The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting

Başar ERDİVANLI, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Rize, Türkiye)

Ahmet ŞEN, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Rize, Türkiye)

Tolga KOYUNCU, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Rize, Türkiye)

Şaban ERGENE, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, Rize, Türkiye)

Abdullah ÖZDEMİR, (Recep Tayyip Erdoğan Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Rize, Türkiye)

Ersagun TUĞCUGİL (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Rize, Türkiye)

Türk Göğüs Kalp Damar Cerrahisi Dergisi

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Yıl: 2017 Cilt: 25 Sayı: 1 Sayfa Aralığı: 22 - 28 Metin Dili: İngilizce İndeks Tarihi: 07-11-2018

The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting

Öz:

Background: This study aims to investigate the effect of acute normovolemic hemodilution on reduced plasma levels of fibrinogen.Methods: We retrospectively evaluated data of a total of 101 adult patients (68 males, 33 females; mean age 61±8 years; range 46 to 84 years) who underwent elective coronary artery bypass grafting surgery between January 2014 and December 2015. A comparison was made between patients who received acute normovolemic hemodilution (ANH group, n=49) and patients who did not (control group, n=52) matched by predictors of mortality and postoperative bleeding.Results: The mean decline in fibrinogen in ANH group (27.4±13.8%) was significantly lower, compared to the control group (43.7±9.5%, 95% CI: -21.4 to -11.3, p<0.0001). The mean decline in platelet count in ANH group (33.1±10.1) was similar to control group (35.6±8.9) (p=0.21). The whole blood was not re-transfused to 10 patients (20.4%) in ANH group at the end of surgery and preserved to be used in the intensive care unit. During intensive care unit stay, only eight patients (16.3%) in ANH group received allogeneic red blood cell, while 41 patients (78.8%) in the control group (p<0.0001). Only 14 patients (28.6%) in ANH group received allogeneic fresh frozen plasma, while all patients in the control group received (p<0.0001). No mortality was seen in either group.Conclusion: Acute normovolemic hemodilution may preserve plasma levels of fibrinogen and reduce the need for allogeneic transfusion of blood products in patients with adequate preoperative fibrinogen level.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Koroner arter baypas greftlemede akut normovolemik hemodilüsyonun fibrinojen düzeyine etkisi

Öz:

Amaç: Bu çalışmada, akut normovolemik hemodilüsyonun, fibrinojen düzeylerindeki düşüşe etkisi araştırıldı. Çalışma planı: Ocak 2014 - Aralık 2015 tarihleri arasında elektif koroner arter baypas greftleme yapılan toplam 101 erişkin hastanın (68 erkek, 33 kadın; ort. yaş 61±8 yıl; dağılım 46-84 yıl) verileri retrospektif olarak incelendi. Akut normovolemik hemodilüsyon uygulanan hastalar (ANH grubu, n=49) ile uygulanmayan hastalar (kontrol grubu, n=52), mortalite ve ameliyat sonrası kanama belirteçlerine göre eşleştirilerek karşılaştırıldı. Bulgular: Fibrinojen düzeyinde ortalama düşüş ANH grubunda (27.4±13.8%), kontrol grubuna kıyasla (43.7±9.5%) anlamlı düzeyde düşüktü (%95 GA: -21.4 ve -11.3, p<0.0001). Trombosit sayısında ortalama düşüş ANH grubunda (33.1±10.1), kontrol grubu ile (35.6±8.9) benzerdi (p=0.21). Cerrahi sonunda ANH grubunda 10 hastaya (%20.4) tam kan yeniden transfüze edilmedi ve yoğun bakım ünitesinde kullanılmak üzere saklandı. Yoğun bakım ünitesinde yatış sırasında, ANH grubunda sadece sekiz hastaya (%16.3) allojenik kırmızı kan hücre verilirken, kontrol grubunda 41 hastaya (%78.8) verildi (p<0.0001). ANH grubunda yalnızca 14 hastaya (%28.6) allojenik taze donmuş plazma verilirken, kontrol grubunda tüm hastalara verildi (p<0.0001). İki grupta da mortalite izlenmedi. Sonuç: Akut normovolemik hemodilüsyon, yeterli ameliyat öncesi fibrinojen düzeyine sahip hastalarda, plazma fibrinojen düzeylerini koruyabilir ve allojenik kan ürünü transfüzyonuna olan ihtiyacı azaltabilir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Erdivanlı B, Şen A, koyuncu t, Ergene S, ÖZDEMİR A, TUĞCUGİL E (2017). The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. , 22 - 28.
Chicago	Erdivanlı Başar,Şen Ahmet,koyuncu tolga,Ergene Saban,ÖZDEMİR Abdullah,TUĞCUGİL Ersagun The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. (2017): 22 - 28.
MLA	Erdivanlı Başar,Şen Ahmet,koyuncu tolga,Ergene Saban,ÖZDEMİR Abdullah,TUĞCUGİL Ersagun The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. , 2017, ss.22 - 28.
AMA	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. . 2017; 22 - 28.
Vancouver	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. . 2017; 22 - 28.
IEEE	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E "The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting." , ss.22 - 28, 2017.
ISNAD	Erdivanlı, Başar vd. "The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting". (2017), 22-28.

APA	Erdivanlı B, Şen A, koyuncu t, Ergene S, ÖZDEMİR A, TUĞCUGİL E (2017). The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 25(1), 22 - 28.
Chicago	Erdivanlı Başar,Şen Ahmet,koyuncu tolga,Ergene Saban,ÖZDEMİR Abdullah,TUĞCUGİL Ersagun The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi 25, no.1 (2017): 22 - 28.
MLA	Erdivanlı Başar,Şen Ahmet,koyuncu tolga,Ergene Saban,ÖZDEMİR Abdullah,TUĞCUGİL Ersagun The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.25, no.1, 2017, ss.22 - 28.
AMA	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2017; 25(1): 22 - 28.
Vancouver	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2017; 25(1): 22 - 28.
IEEE	Erdivanlı B,Şen A,koyuncu t,Ergene S,ÖZDEMİR A,TUĞCUGİL E "The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 25, ss.22 - 28, 2017.
ISNAD	Erdivanlı, Başar vd. "The effect of acute normovolemic hemodilution on plasma fibrinogen level in coronary artery bypass grafting". Türk Göğüs Kalp Damar Cerrahisi Dergisi 25/1 (2017), 22-28.