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    High postoperative serum levels of surfactant type b as novel prognostic markers for congenital heart surgery
    (Sociedade Brasileira de Cirurgia Cardiovascular, 2014) Isik O.; Disli O.M.; Bas T.; Aydin H.; Koç M.; Kutsal A.
    Objective: Congenital heart diseases are observed in 5 to 8 of every 1000 live births. The presence of a valuable biomarker during the surgical periods may aid the clinician in a more accurate prognosis during treatment. Methods: For this reason, surfactant protein B plasma levels may help to evaluate patients with cardiac problems diminishing the alveolocapillary membrane stability. In this study, plasma levels of this biomarker were measured in the preoperative and postoperative periods. This study was conducted to detect the differences between pulmonary hypertensive and normotensive patients. The differences before and after cardiopulmonary bypass were examined. Results: The differences in cardiopulmonary bypass time, cross-clamp time, inotropic support dose, and duration of intensive care of patients with and without pulmonary hypertensive were found to be statistically significant (P<0.05). The results revealed that this pathophysiological state was related to other variables that were studied. We believe that the differences in preoperative and postoperative SPB levels could be attributed to alveolocapillary membrane damage and alveolar surfactant dysfunction. We found that this pathophysiological condition was significantly associated with postoperative parameters. Conclusion: The findings of the current study showed that surfactant protein B was present in the blood of patients with a congenital heart disease during the preoperative period. Long by-pass times may exert damage to the alveolocapillary membrane in patients with pulmonary hypertension and preoperative heart failure, and it is recommended to keep the option of surfactant therapy in mind during the postoperative course at the intensive care unit before preparing the patients for extubation.
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    Peripheral venous pressure in congenital heart surgery may be an alternative to central venous pressure
    (Anestezi Dergisi, 2014) Işik O.; Sahuto?lu C.; Dişli Z.K.; Aytaç I.; Di?sli O.M.; Kutsal A.
    Objective: This study aims to investigate the correlation of peripheral venous pressure (PVP) measurement with central venous pressure (CVP) measurement in congenital cardiac surgery, and whether it can be an alternative to CVP. Method: After obtaining ethics committee report, CVP and PVP measurements taken during cardiac surgery intensive care hospitalization, of 35 infants and pediatric cardiac patients who underwent total correction surgery were prospectively assessed. The patients were divided into four groups according to their fluid balance, body temperature, cardiac rate, and the degree of tricuspid insufficiency, and into age groups considering their iv catheter diameter, and correlation of PVB and SVB between the groups was sought. Their ages, gender, weight, body surface area, congenital cardiac disease diagnoses, size of catheters used as peripheral venous lines, the degree of tricuspid insufficiency in postoperative transthoracic echocardiography examination, cardiac rate, body temperature, fluid balance, CVP and PVP measurements were taken in the postoperative intensive care period at four randomized times: CVP and PVP measurements were taken at four randomized times: intubated1 (1. hour), intubated2(1. hour), , extubated1(1. hour), , extubated2(2. hour), intragroup correlation was sought. Intubated measurements were taken at the end of expiration period, during the positive pressured ventillation period. Patients who underwent cava pulmonary shunt operations, premature patients, and patients who received palliative surgeries were excluded from the study. Results: PVP and CVP were found to be correlated at four different time points. The patients' surgeries, age groups, body surface areas, presence or absence of tachycardia, a negative or positive fluid balance, presence or absence of fever, and the tricuspid level of the patient had no effects on CVP and PVP correlation. Conclusion: The researchers concluded that being less invasive; PVP measurement in the antecubital region may be preferable during the preoperational period in pediatric cardiac intensive care, in assessing volume loading in other pediatric clinics, and in cases whose CVP measurements have to be followed.