Diltiazemin hipotermik kardiyopulmoner bypass esnasında kardiyoprotektif etkinliği
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Tarih
2000
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info:eu-repo/semantics/openAccess
Özet
Koroner arter bypass greft (KABG) cerrahisi uygulanan 20 hasta üzerinde gerçekleştirilen çalışmamızda soğuk kan kardiyoplejisine ek olarak uygulanan diltiazem infüzyonunun miyokardı koruyucu etkinliginin ve antiperoksidan etkisinin araştırılması amaçlandı. Diltiazem grubunda (D grubu) indüksiyon sonrasında 0.3 mg/kg iv diltiazem uygulandı ve X-klemp kaldırılıncaya kadar 2 mg/kg/dk dozunda infüze edildi. K grubu kontrol grubu olarak izlendi. X-klemp kaldırıldığında, lipid peroksidasyonun bir ürünü olan malondialdehit (MDA) düzeyleri her iki grupta da bazal değerlere göre anlamlı yüksek bulundu ve iki grup arasında fark belirlenmedi. CPK, CK-MB ve LDH düzeyleri postoperatif 2. saatte her iki grupta da preoperatif düzeylere göre anlamlı artış gösterdi ve gruplar arasında anlamlı fark gözlenmedi. Hemodinamik ölçümlerde kardiyopulmoner bypass (KPB) sonrasında CI ve LSVWI, D grubunda K grubuna göre anlamlı yüksek bulundu. X-klemp kaldırıldığında D grubunda 6 hastada ventriküler fibrilasyon (VF) gözlendi (p<0.05). Çalışmamızın sonucunda diltiazemin lipid peroksidasyonunu engellemediği ve başka etki mekanizmalarıyla hiportermik koşullarda da kardiyoprotektif etkisi olduğu kanısına varıldı.
In our study, we aimed to investigate the myocardial protective and antiperoxidant effects of diltiazem infusion given during cardiopulmonary bypass (CPB) in addition to cold blood cardioplegia in 20 patients undergoing coronary artery bypass grafting surgery. In diltiazem group (group D) 0.3 mg kg-1 iv diltiazem was given after induction and infused at 2 mg.kg-1 min-1 until declamping the aorta. Group C was the control group. After declamping, the arterial and coronary sinus malondialdehyde levels, measured as a marker of lipid peroxidation incresed significantly in both groups when compared with the basal values and there was no difference between the preoperative levels but there was no significant difference between the groups. Hemodynamic measurement after CPB revealed significant increase in CI and LVSWI in group D with respect to group C. Ventricular fibrillation was observed in 1 patient in group D and 6 patients in group C (p<0.05). It has been concluded that diltiazem did not prevent lipid peroxidat ion but protected the myocardium under hypothermic conditions by other postulated mechanisms.
In our study, we aimed to investigate the myocardial protective and antiperoxidant effects of diltiazem infusion given during cardiopulmonary bypass (CPB) in addition to cold blood cardioplegia in 20 patients undergoing coronary artery bypass grafting surgery. In diltiazem group (group D) 0.3 mg kg-1 iv diltiazem was given after induction and infused at 2 mg.kg-1 min-1 until declamping the aorta. Group C was the control group. After declamping, the arterial and coronary sinus malondialdehyde levels, measured as a marker of lipid peroxidation incresed significantly in both groups when compared with the basal values and there was no difference between the preoperative levels but there was no significant difference between the groups. Hemodynamic measurement after CPB revealed significant increase in CI and LVSWI in group D with respect to group C. Ventricular fibrillation was observed in 1 patient in group D and 6 patients in group C (p<0.05). It has been concluded that diltiazem did not prevent lipid peroxidat ion but protected the myocardium under hypothermic conditions by other postulated mechanisms.
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Anestezi Dergisi
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8
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