İzole koroner arter bypass cerrahisi olacak hastalarda hba1c ve nt-probnp değerlerinin postoperatif sonuçlar üzerine etkileri
Küçük Resim Yok
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diyabetik hastalarda en önemli ölüm nedeni kardiyovasküler hastalıklardır. Günümüzde diyabet kardiyovasküler hastalıkla eşdeğer olarak kabul edilmektedir. Bu hastalarda kardiyovasküler hastalık gelişme riski preklinik diyabet döneminden önce başlamaktadır. Diyabetik hastalarda perioperatif ve postoperatif risk daha fazladır. Dolayısıyla gerek cerrahlar ve gerekse anesteziyolojistler diyabetle ilişkili ve diyabetik hastaların cerrahisi ve anestezisi hakkındaki risklerden haberdar olmalılardır. Diyabetik hastalarda kan glukoz kontrolü ve bu hastalarda kalp yetmezliği bulgularını ortaya koymak amacıyla preoperatif HbA1c ve NT-proBNP değerlerinin operasyon sonuçları üzerine etkilerini karşılaştırdık. Trakya Üniversitesi Tıp Fakültesi Hastanesi Kalp ve Damar Cerrahisi kliniğinde elektif izole koroner arter bypass cerrahisi uygulanan toplam 40 diyabetik hasta çalışmamıza rızaları alınarak dahil edildiler. Hastalardan preoperatif gönderdiğimiz NT-proBNP ve HbA1c değerlerini postoperatif sonuçlarla karşılaştırdık. HbA1c değeri yüksek olan hastaların üre, kreatinin değerleri daha yüksek, drenajı daha fazla, postoperatif inotrop ihtiyacının artmış, postoperatif yoğun bakımda kalış ve hastanede yatış sürelerinin daha uzun olduğunu bulduk. Mortalite oranı bu hastalarda anlamlı olarak çok yüksek bulundu. NT-proBNP ile HbA1c arasında korelasyon bulamadık Preoperatif EF'si düşük olan hastalarda ve yaş arttıkça NT-proBNP'nin yükseldiğini bulduk. Bu hastalarda inotrop ihtiyacı artmış ve postoperatif AF oranı daha yüksek seyretti. Daha az koroner damarı bypass yapılmasına rağmen aort klemp süresi NT-proBNP değeri yüksek olan grupta daha uzundu. Koroner arter bypass cerrahisi uygulanacak diyabetik hastalarda HbA1c ve NT-proBNP'nin postoperatif sonuçlar hakkında önemli öngörüler sunabildiği kanaatindeyiz. Anahtar Kelimeler: Diyabetes Mellitus, Koroner Arter Bypass Cerrahisi, HbA1c, NTproBNP
Cardiovascular diseases are the most substantial cause of death in diabetic patients. Recently diabetes is accepted in the same class with cardiovascular diseases. In these patients the risk of cardiovascular disorder progression starts in preclinic terms. Perioperative and postoperative risks are higher in diabetic patients. Therefore both anesthesiologists and surgeons should be aware of risks related with diabetes, surgery and anesthesia of diabetic patients. The effects of HbA1c and NT-proBNP levels were compared on postoperative outcomes to provide blood glucose control and to evaluate heart failure findings. A total of 40 diabetic patients undergoing elective isolated coronary bypass surgery in Trakya Universitesi Tıp Fakültesi Hastanesi Cardiovascular Surgery Clinique were enrolled with their informed consents. Preoperative NT-proBNP and HbA1c levels were compared with postoperative outcomes. The patients having higher HbA1c had higher ure, creatinin levels, drainage, inotropic needs and their stay in intensive care unit and hospital were longer. Mortality rate was significantly very high in those group. There were no correlation between HbA1c and NT-proBNP levels. Elder patients and patients with low ejection fractions had higher NT-proBNP levels. In patients with higher NT-proBNP levels, the need for inotropic agents and postoperative atrial fibrillation rates were higher. The aortic clamp times were longer in this group even less number of vessels were bypassed. We believe that HbA1c and NT-proBNP levels provide us important informations about postoperative outcomes for diabetic patients underwent coronary artery bypass surgery. Key Words: Diabetes Mellitus, Coronary Artery Bypass Surgery, HbA1c, NTproBNP
Cardiovascular diseases are the most substantial cause of death in diabetic patients. Recently diabetes is accepted in the same class with cardiovascular diseases. In these patients the risk of cardiovascular disorder progression starts in preclinic terms. Perioperative and postoperative risks are higher in diabetic patients. Therefore both anesthesiologists and surgeons should be aware of risks related with diabetes, surgery and anesthesia of diabetic patients. The effects of HbA1c and NT-proBNP levels were compared on postoperative outcomes to provide blood glucose control and to evaluate heart failure findings. A total of 40 diabetic patients undergoing elective isolated coronary bypass surgery in Trakya Universitesi Tıp Fakültesi Hastanesi Cardiovascular Surgery Clinique were enrolled with their informed consents. Preoperative NT-proBNP and HbA1c levels were compared with postoperative outcomes. The patients having higher HbA1c had higher ure, creatinin levels, drainage, inotropic needs and their stay in intensive care unit and hospital were longer. Mortality rate was significantly very high in those group. There were no correlation between HbA1c and NT-proBNP levels. Elder patients and patients with low ejection fractions had higher NT-proBNP levels. In patients with higher NT-proBNP levels, the need for inotropic agents and postoperative atrial fibrillation rates were higher. The aortic clamp times were longer in this group even less number of vessels were bypassed. We believe that HbA1c and NT-proBNP levels provide us important informations about postoperative outcomes for diabetic patients underwent coronary artery bypass surgery. Key Words: Diabetes Mellitus, Coronary Artery Bypass Surgery, HbA1c, NTproBNP
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Göğüs Kalp ve Damar Cerrahisi, Thoracic and Cardiovascular Surgery ; Kardiyoloji
