KONJENİTAL KALP CERRAHİSİNDE PERİFERİK VENÖZ BASINÇ SANTRAL VENÖZ BASINCA ALTERNATİF OLABİLİR Mİ?
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Tarih
2014
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info:eu-repo/semantics/openAccess
Özet
Öz: Amaç: Biz bu çalışma ile konjenital kalp cerrahisinde periferik venöz basınç (PVB) ölçümünün santral venöz basınç (SVB) ölçümüyle korrelasyonununu ve SVB’ye alternatif olup olamayacağını araştırmayı amaçladık. Yöntem: Etik kurul raporu alındıktan sonra, tam düzeltim operasyonu geçiren toplam 35 infant ve pediatrik kardiyak hastanın kalp cerrahisi yoğun bakım yatışları boyunca alınan SVB ve PVB ölçümleri prospektif olarak değerlendirildi. Çalışmamızdaki hastalar sıvı açığı, ateş, taşikardi, triküspit yetmezliği olup olmadığına göre 4 gruba, branül çapına göre, yaş gruplarına göre ayrıldı ve gruplar arası PVB ile SVB korelasyonu arandı. Hastaların yaşı, cinsiyeti, kilolaları, vücut yüzey alanı, konjenital kalp hastalığı tanıları, periferik venöz yol olarak kullanılan branül çapı, postoperatif transtorasik ekokardiyografi tetkikindeki triküspit yetmezliği derecesi, kalp hızı, ateş, sıvı dengesi, SVB ve PVB ölçümleri postoperatif yoğun bakım döneminde yapıldı. Bu ölçümler entübe1 (1.saat), entübe2 (2.saat), ekstübe1 (1.saat), ekstübe2 (2.saat) olmak üzere 4 farklı randomize zamanda yapıldı. Entübe ölçümler ekspirasyon periyodunun sonunda pozitif basınçlı ventilasyon periyodunda yapıldı. Kava pulmoner şant operasyonu yapılan hastalar, prematür hastalar, palyatif operasyon yapılan hastalar çalışma dışı bırakıldı: Bulgular: PVB ve SVB nin dört farklı zamanda korele olduğu saptandı. Hastaya yapılan ameliyat, hastaların yaş grupları ve vücut kitle indeksleri, taşikardinin olup, sıvı dengesi, ateş, ve triküspit yetmezlik derecesi SVB ile PVB korelasyonunu etkilemedi. Sonuç: Pediatrik kardiyak yoğun bakımda ameliyat öncesi dönemde ve diğer pediatri kliniklerinde volüm yükünün değerlendirilmesinde ve SVB takip edilmesi gereken olgularda daha az invazif olması nedeniyle antekübital bölgeden PVB ölçümünün tercih edilebileceği kanısındayız.
Abstract: 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 CVPand PVPcorrelation. 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.
Abstract: 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 CVPand PVPcorrelation. 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.
Açıklama
Anahtar Kelimeler
Kaynak
Anestezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
22
Sayı
2
Künye
IŞIK O,ŞAHUTOĞLU C,DİŞLİ Z. K,AYTAÇ İ,DİŞLİ O. M,KUTSAL A (2014). KONJENİTAL KALP CERRAHİSİNDE PERİFERİK VENÖZ BASINÇ SANTRAL VENÖZ BASINCA ALTERNATİF OLABİLİR Mİ?. Anestezi Dergisi, 22(2), 105 - 109.
