Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?
Yıl: 2020 Cilt: 28 Sayı: 1 Sayfa Aralığı: 84 - 91 Metin Dili: İngilizce DOI: 10.5606/tgkdc.dergisi.2020.18685 İndeks Tarihi: 11-11-2020
Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?
Öz: Background: In this study, we aimed to investigate the effects of poorblood glucose control on the intraoperative cerebral system in patientsundergoing coronary artery bypass grafting using various neuromonitors.Methods: Between January 2 011 a nd D ecember 2 011, a t otal of 4 0 a dultpatients (31 males, 9 females; mean age 58.8±9.2 years; range, 38 to 78years) who were scheduled for elective coronary artery bypass grafting wereincluded in the study. The patients were divided into four groups accordingto hemoglobin A1c levels as follows: Group 1 including non-diabetic controls(n=11); Group 2 including those with a hemoglobin A1c value of <7%(n=10); Group 3 including those with a hemoglobin A1c value of 7 to 10%(n=11); and Group 4 including those with a hemoglobin A1c value of ≥10%(n=8). Cerebral monitoring was performed with near-infrared spectroscopyand transcranial Doppler. Measurement periods were defined as follows:Before anesthesia induction (period 1), 10 min after anesthesia induction(period 2), during cannulation (period 3), 10 min after cardiopulmonarybypass (period 4), at 32°C temperature during cardiopulmonary bypass(period 5), at 36°C temperature during cardiopulmonary bypass (period 6),and at the end of the operation (period 7).Results: There was a significant difference in the near-infraredspectroscopy values in the cannulation period for both right (p<0.001)and left (p=0.002) sides and the mean transcranial Doppler flow velocity(p=0.002) in Group 4, compared to Group 1. The heart rate was foundto be significantly lower in Group 4 in the cannulation period. Thenear-infrared spectroscopy values and transcranial Doppler blood flowvelocity decreased in Group 4 in all measurement periods.Conclusion: The results of our study show that, in patients with severediabetes undergoing open heart surgery, heart rate decreases in thecannulation period due to possible autonomic neuropathy, and cerebralblood flow and oxygenation decrease. For these patients, particularly inthe cannulation period, perfusion of both cerebral and other organs shouldbe closely monitored and necessary interventions should be performed.
Anahtar Kelime: Kalp cerrahisinde kontrolsüz diabetes mellitus serebral hemodinamikleri etkiler mi?
Öz: Amaç: Bu çalışmada, koroner arter baypas greftleme yapılan hastalarda çeşitli nöromonitörler ile kötü kan glukoz kontrolünün ameliyat sırası serebral sistem üzerine etkisi araştırıldı. Çalışma planı: Ocak 2011 - Aralık 2011 tarihleri arasında elektif koroner arter baypas greftleme planlanan toplam 40 erişkin hasta (31 erkek, 9 kadın; ort. yaş 58.8±9.2 yıl; dağılım, 38-78 yıl) çalışmaya alındı. Hastalar hemoglobin A1c düzeylerine göre şu şekilde dört gruba ayrıldı: Grup 1, diyabetik olmayan kontroller (n=11); Grup 2, hemoglobin A1c düzeyi <%7 olanlar (n=10); Grup 3, hemoglobin A1c düzeyi %7 ila %10 olanlar (n=11) ve Grup 4, hemoglobin A1c düzeyi ≥%10 olanlar (n=8). Yakın kızılötesi spektroskopi ve transkraniyal Doppler ile serebral monitörizasyon yapıldı. Ölçüm dönemleri şu şekilde belirlendi: Anestezi indüksiyonundan önce (periyod 1), indüksiyondan 10 dk. sonra (periyod 2), kanülasyon sırasında (periyod 3), kardiyopulmoner baypastan 10 dk. sonra (periyod 4), kardiyopulmoner baypas sırasında 32°C’de (periyod 5), kardiyopulmoner bypass sırasında 36°C’de (periyod 6) ve operasyon sonunda (periyod 7). Bulgular: Grup 1’e kıyasla Grup 4’te kanülasyon periyodunda yakın kızılötesi spektroskopi değerlerinde hem sağ (p<0.001) hem de sol (p=0.002) taraflarda ve ortalama transkraniyal Doppler kan akış hızında (p=0.002) anlamlı fark bulundu. Kanülasyon periyodunda Grup 4’te kalp hızı anlamlı düzeyde düşüktü. Tüm ölçüm periyotlarında yakın kızılötesi spektroskopi değerleri ve transkraniyal Doppler kan akış hızı Grup 4’te azalmıştı. Sonuç: Çalışma sonuçlarımız, açık kalp ameliyatı geçiren ciddi diyabetli hastalarda kanülasyon periyodunda muhtemel otonom nöropati nedeniyle kalp hızının düştüğünü ve serebral kan akımı ve oksijenasyonun azaldığını göstermektedir. Bu hastalarda, özellikle kanülasyon periyodunda, hem serebral hem de diğer organların perfüzyonları yakından izlenmeli ve gerekli girişimler yapılmalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ÖZGÖK A, ULUS A, KARADENİZ Ü, DEMİR Z, ÖZTÜRK KAZANCI D, ÖZYALÇIN S, AYDIN Y, Ünal E (2020). Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. , 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| Chicago | ÖZGÖK Ayşegül,ULUS Ahmet Tulga,KARADENİZ Ümit,DEMİR Zeliha Aslı,ÖZTÜRK KAZANCI Dilek,ÖZYALÇIN Sertan,AYDIN Yasemen,Ünal Ertekin Utku Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. (2020): 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| MLA | ÖZGÖK Ayşegül,ULUS Ahmet Tulga,KARADENİZ Ümit,DEMİR Zeliha Aslı,ÖZTÜRK KAZANCI Dilek,ÖZYALÇIN Sertan,AYDIN Yasemen,Ünal Ertekin Utku Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. , 2020, ss.84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| AMA | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. . 2020; 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| Vancouver | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. . 2020; 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| IEEE | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E "Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?." , ss.84 - 91, 2020. 10.5606/tgkdc.dergisi.2020.18685 |
| ISNAD | ÖZGÖK, Ayşegül vd. "Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?". (2020), 84-91. https://doi.org/10.5606/tgkdc.dergisi.2020.18685 |
| APA | ÖZGÖK A, ULUS A, KARADENİZ Ü, DEMİR Z, ÖZTÜRK KAZANCI D, ÖZYALÇIN S, AYDIN Y, Ünal E (2020). Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. Türk Göğüs Kalp Damar Cerrahisi Dergisi, 28(1), 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| Chicago | ÖZGÖK Ayşegül,ULUS Ahmet Tulga,KARADENİZ Ümit,DEMİR Zeliha Aslı,ÖZTÜRK KAZANCI Dilek,ÖZYALÇIN Sertan,AYDIN Yasemen,Ünal Ertekin Utku Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. Türk Göğüs Kalp Damar Cerrahisi Dergisi 28, no.1 (2020): 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| MLA | ÖZGÖK Ayşegül,ULUS Ahmet Tulga,KARADENİZ Ümit,DEMİR Zeliha Aslı,ÖZTÜRK KAZANCI Dilek,ÖZYALÇIN Sertan,AYDIN Yasemen,Ünal Ertekin Utku Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. Türk Göğüs Kalp Damar Cerrahisi Dergisi, vol.28, no.1, 2020, ss.84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| AMA | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2020; 28(1): 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| Vancouver | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?. Türk Göğüs Kalp Damar Cerrahisi Dergisi. 2020; 28(1): 84 - 91. 10.5606/tgkdc.dergisi.2020.18685 |
| IEEE | ÖZGÖK A,ULUS A,KARADENİZ Ü,DEMİR Z,ÖZTÜRK KAZANCI D,ÖZYALÇIN S,AYDIN Y,Ünal E "Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?." Türk Göğüs Kalp Damar Cerrahisi Dergisi, 28, ss.84 - 91, 2020. 10.5606/tgkdc.dergisi.2020.18685 |
| ISNAD | ÖZGÖK, Ayşegül vd. "Does uncontrolled diabetes mellitus affect cerebral hemodynamics in heart surgery?". Türk Göğüs Kalp Damar Cerrahisi Dergisi 28/1 (2020), 84-91. https://doi.org/10.5606/tgkdc.dergisi.2020.18685 |
