The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass
Yıl: 2019 Cilt: 27 Sayı: 2 Sayfa Aralığı: 165 - 172 Metin Dili: İngilizce DOI: 10.5606/tgkdc.dergisi.2019.16851 İndeks Tarihi: 27-05-2020
The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass
Öz: Background: This study aims to investigate the effects of partial pressure ofvenous-arterial carbon dioxide changes in the early period after cardiopulmonarybypass in patients who did or did not receive inotropic support therapy and theeffect of these changes on tissue perfusion.Methods: A total of 100 consecutive patients (70 males, 30 females; meanage 61.8±2.3 years; range, 20 to 75 years) who underwent open heart surgerywere divided into two groups as those who did not receive any inotropic agent(group 1, n=50) and those who received at least one inotropic agent (group 2, n=50)during the early postoperative period. Heart rate, blood oxygen saturation level,mean arterial pressure, central venous pressure and urine volume, lactate and baseexcess levels were recorded during the postoperative first 24 hours. At the sametimeframe, partial pressure of venous-arterial carbon dioxide level was calculatedfrom central venous and peripheral blood samples.Results: In both groups, partial pressure of venous-arterial carbon dioxide weresignificantly higher in the postoperative fourth hour compared with basal values.This significant difference continued for the postoperative first 24 hours. Partialpressure of venous-arterial carbon dioxide in group 2 was significantly higher atthe 12th-hour measurement (p=0.002). Lactate levels at zeroth and eighth hourswere significantly higher in group 2 (p=0.012 and p=0.017, respectively). Fourthhoururine excretion volumes were significantly lower in group 1 (p=0.010). Meanarterial pressure at zeroth, 12th and 20th hours was significantly higher in group 2(p=0.001, p=0.016, and p=0.027, respectively). At the eighth-hour measurement,a positive weak relationship was detected between partial pressure of venousarterialcarbon dioxide and lactate levels (r=0.253 and p=0.033).Conclusion: This study demonstrated that partial pressure of venous-arterial carbondioxide increased in the first few hours and remained to be high for 24 hours aftercardiopulmonary bypass independently of the use of inotropic support. However, inthe postoperative period, even after lactate and base excess levels return to baselinevalues, partial pressure of venous-arterial carbon dioxide may continue to remain athigh values, which may indicate impaired perfusion in some tissues.
Anahtar Kelime: Konular:
Kardiyopulmoner baypas sonrasında inotropik destek tedavisi ve santral parsiyel venö-arteriyel karbondioksit basıncı arasındaki ilişki
Öz: Amaç: Bu çalışmada kardiyopulmoner baypas sonrası erken dönemde inotropik destek tedavisi alan veya almayan hastalarda parsiyel venö-arteriyel karbondioksit basıncı değişikliklerinin etkileri ve bu değişikliklerin doku perfüzyonu üzerindeki etkisi araştırıldı. Çalışma planı: Açık kalp cerrahisi geçiren toplam 100 hasta (70 erkek, 30 kadın; ort. yaş 61.8±2.3 yıl; dağılım, 20-75 yıl) ameliyat sonrası erken dönemde herhangi bir inotropik ajan almayanlar (grup 1, n=50) ve en az bir inotropik ajan alanlar (grup 2, n=50) olmak üzere iki gruba ayrıldı. Ameliyat sonrası ilk 24 saatte kalp atım hızı, kan oksijen satürasyonu düzeyi, ortalama arteriyel basınç, santral venöz basınç ve idrar hacmi, laktat ve baz açığı düzeyleri kaydedildi. Aynı zaman diliminde, parsiyel venö-arteriyel karbondioksit basıncı düzeyi santral venöz ve periferik kan örneklerinden hesaplandı. Bulgular: Her iki grupta parsiyel venö-arteriyel karbondioksit basıncı ameliyat sonrası dördüncü saatte bazal değerlere göre anlamlı olarak daha yüksek idi. Bu anlamlı farklılık ameliyat sonrası ilk 24 saat boyunca devam etti. Grup 2’de parsiyel venö-arteriyel karbondioksit basıncı 12. saat ölçümünde anlamlı olarak daha yüksek idi (p=0.002). Grup 2’de laktat düzeyleri sıfırıncı ve sekizinci saatte anlamlı olarak daha yüksek idi (sırasıyla, p=0.012 ve p=0.017). Grup 1’de idrar atılım hacimleri dördüncü saatte anlamlı olarak daha düşük idi (p=0.010). Grup 2’de ortalama arteriyel basınç sıfırıncı, 12. ve 20. saatte anlamlı olarak daha yüksek idi (sırasıyla, p=0.001, p=0.016 ve p=0.027). Sekizinci saat ölçümünde, parsiyel venö-arteriyel karbondioksit basıncı ve laktat düzeyleri arasında pozitif zayıf bir ilişki saptandı (r=0.253 ve p=0.033). Sonuç: Bu çalışma, kardiyopulmoner baypas sonrasında parsiyel venö-arteriyel karbondioksit basıncının inotropik destek kullanımından bağımsız olarak ilk birkaç saat yükseldiğini ve 24 saat yüksek kalmaya devam ettiğini gösterdi. Ancak ameliyat sonrası dönemde laktat ve baz açığı düzeylerinin normale dönmesinden sonra bile parsiyel venö-arteriyel karbondioksit basınç yüksek değerlerde kalmaya devam edebilir ve bu durum bazı dokularda bozulmuş perfüzyona işaret edebilir.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ERENLER F, Yapici N, KUDSİOĞLU Ş, ATALAN ÖZLEN N, acarel m, ORHAN G, KAVAKLİ A, Aykac Z (2019). The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. , 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| Chicago | ERENLER Ferhat,Yapici Nihan,KUDSİOĞLU ŞEFİKA TÜRKAN,ATALAN ÖZLEN NAZAN,acarel murat,ORHAN Gökçen,KAVAKLİ Ali Sait,Aykac Zuhal The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. (2019): 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| MLA | ERENLER Ferhat,Yapici Nihan,KUDSİOĞLU ŞEFİKA TÜRKAN,ATALAN ÖZLEN NAZAN,acarel murat,ORHAN Gökçen,KAVAKLİ Ali Sait,Aykac Zuhal The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. , 2019, ss.165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| AMA | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. . 2019; 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| Vancouver | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. . 2019; 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| IEEE | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z "The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass." , ss.165 - 172, 2019. 10.5606/tgkdc.dergisi.2019.16851 |
| ISNAD | ERENLER, Ferhat vd. "The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass". (2019), 165-172. https://doi.org/10.5606/tgkdc.dergisi.2019.16851 |
| APA | ERENLER F, Yapici N, KUDSİOĞLU Ş, ATALAN ÖZLEN N, acarel m, ORHAN G, KAVAKLİ A, Aykac Z (2019). The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 27(2), 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| Chicago | ERENLER Ferhat,Yapici Nihan,KUDSİOĞLU ŞEFİKA TÜRKAN,ATALAN ÖZLEN NAZAN,acarel murat,ORHAN Gökçen,KAVAKLİ Ali Sait,Aykac Zuhal The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi 27, no.2 (2019): 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| MLA | ERENLER Ferhat,Yapici Nihan,KUDSİOĞLU ŞEFİKA TÜRKAN,ATALAN ÖZLEN NAZAN,acarel murat,ORHAN Gökçen,KAVAKLİ Ali Sait,Aykac Zuhal The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.27, no.2, 2019, ss.165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| AMA | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2019; 27(2): 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| Vancouver | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2019; 27(2): 165 - 172. 10.5606/tgkdc.dergisi.2019.16851 |
| IEEE | ERENLER F,Yapici N,KUDSİOĞLU Ş,ATALAN ÖZLEN N,acarel m,ORHAN G,KAVAKLİ A,Aykac Z "The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 27, ss.165 - 172, 2019. 10.5606/tgkdc.dergisi.2019.16851 |
| ISNAD | ERENLER, Ferhat vd. "The relationship between inotropic support therapy and central partial pressure of venous-arterial carbon dioxide after cardiopulmonary bypass". Türk Göğüs Kalp Damar Cerrahisi Dergisi 27/2 (2019), 165-172. https://doi.org/10.5606/tgkdc.dergisi.2019.16851 |
