Postoperative clinical course of pulsatile and non-pulsatile blood flow during extracorporeal circulation/ Ekstra korporeal dolasimda pulsatil ve non-pulsatil akim formlarinin postoperatif seyir uzerine etkisi

• Published in: Pamukkale Medical Journal Vol. 15; no. 1; p. 159
• Main Authors: Aykulteli, Mehmet, Degirmenci, Taner, Acikel, Unal
• Format: Journal Article
• Language: English
• Published: Pamukkale University 01.01.2022
• Subjects: Health aspects; Lactates; Mortality
• ISSN: 1309-9833
• DOI: 10.31362/patd.1015079

Purpose: In our study, we aimed to investigate the effects of extracorporeal circulation with pulsatile and nonpulsatile (np) flow forms on the hemodynamics, laboratory results, hospital stay, mortality and morbidity rates of cardiac surgery. Materials and methods: A total of 174 patients were enrolled, 96 (%55.2) of whom were male and 78 (%44.8) were female. The patients were divided into two groups, nonpulsatile (Group I) and pulsatile (Group II). Results: In our study, blood gas lactate and AST levels, which are indicators of perfusion deterioration in the pulsatile group. In pulsatile perfusion CPB, the duration of cross-clamp, tissue hypoperfusion, and hospital stays were found to be higher than nonpulsatile CPB. Conclusion: We think that this increase in the markers of perfusion deterioration in the pulsatile group is related to the cross clamp and the duration of the pump, which are prolonged from the pulsatile difference. The prolongation of clamp and pump time is usually related to the type of surgical procedure, the difficulty, and the characteristics of the patient, and this is the preferred reason for the pulsatile operation of the physician performing the surgical procedure in patients who are likely to have a long or long postoperative complication. In this study, it was considered unexpected that the difference in pulsatility caused this situation. There is a need to reduce the duration of CPB and to have large, prospective and randomized studies of pulsatile currents in selected eligible patients. Key words: Bypass, extra corporeal circulation, nonpulsatile perfusion, pulsatile perfusion. Amac: Calismamizda, kardiyak cerrahide uygulanan ekstra korporeal dolasim yontemleri olan pulsatil (p) ve nonpulsatil (np) akim formlarinin ameliyat sonrasi hemodinami, laboratuvar degerleri, hastanede kalis suresi, mortalite ve morbidite uzerine etkilerini arastirmayi amacladik. Gerec ve yontem: Calismamiza 96 (%55,2)'si erkek 78 (%44,8)'i kadin olmak uzere toplam 174 hasta alindi. Hastalar nonpulsatil (Grup I) ve pulsatil (Grup II) sekilde iki gruba ayrildi. Calismamizda kros klemp suresi de uzun olan pulsatil grupta perfuzyonun bozulma belirtecleri olan kan gazi laktat ve AST duzeyleri calisildi. Bulgular: Calismamiszda pulsatil grupta perfuzyonun bozulma belirtecleri olan kan gazi laktat ve AST duzeylerinde artis saptandi. Pulsatil akimli KPB'de nonpulsatil uygulamaya gore kros klemp suresi ve KPB suresinde uzamanin, doku hipoperfuzyonunun, hastanede yatis suresinin daha fazla oldugu saptandi. Sonuc: Kros klemp ve KPB surelerindeki uzama genellikle yapilan cerrahi islemin tipi, zorlugu ve hastanin ozelikleri ile iliskili olup bu uzama cerrahi islemi uygulayan hekimin, uzun surmesi olasi olan veya postoperatif komplikasyon beklentisi daha fazla olan hastalarda pulsatil calisma tercihi nedeniyledir. Bu calismada pulsatilite farkinin bu duruma yol acmasi beklenmeyen bir durum olarak dusunulmustur. KPB suresinin azaltilmasi ve pulsatil akimin secilmis uygun hastalarda yapilacak genis capli, prospektif ve randomize calismalara ihtiyac bulunmaktadir. Anahtar kelimeler: By-pass, ekstra korporeal dolasim, nonpulsatil perfuzyon, pulsatil perfuzyon.