Turkiye Klinikleri Journal of Medical Sciences

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Noninvaziv İzlem Cihazlarının Açık Kalp Cerrahisi Sonrası Erişkin Hasta Takibinde Kullanımının Güvenilirlik Değerlendirmesi
SAFETY EVALUATION OF THE USE OF NON-INVASIVE MONITORIZATION DEVICES FOLLOWING OPEN-HEART SURGERY IN ADULT PATIENTS
Murat MERTa, Serdar ÇELEBİb, Cenk Eray YILDIZa, Ferdi MENDAb, Kaya SÜZERa
aKalp-Damar Cerrahisi AD, bAnesteziyoloji-Reanimasyon AD, İstanbul Üniversitesi, Kardiyoloji Enstitüsü, İSTANBUL
Turkiye Klinikleri J Med Sci. 2005;25(3):387-92
Article Language: TR
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Amaç: Açık kalp cerrahisini takip eden yoğun bakım dönemi, invaziv arteriyal monitörizasyon sistemlerinin yaygın olarak kullanıldığı alanların başında gelmektedir. Ancak son yıllarda sözü geçen değerlerin alternatif olarak sunulan noninvaziv cihazlarla da izlenmesi gündeme gelmektedir. Gereç ve Yöntemler: Açık kalp cerrahisi geçiren 45 erişkin hastada sistolik, diyastolik ve ortalama kan basıncı değerleri ile arteriyal oksijen ve karbondioksit değerlerinin invaziv ve noninvaziv yöntemlerle eşzamanlı olarak izlenmesi, tespit edilen değerler arasındaki ilişkinin belirlenmesi amaçlandı. Bu amaçla her üç kan basıncı değerleri postoperatif 1., 6., 12., 18. ve 24. saatlerde invaziv ve noninvaziv olarak tespit edildi. Arteriyal oksijen satürasyonu ve karbondioksit değerlerinin de her iki ölçüm sonuçları verilere dahil edildi. Bulgular: İnvaziv ve noninvaziv yöntemlerle yapılan ölçüm sonuçları karşılaştırıldığında diyastolik kan basıncı, arteriyal oksijen satürasyonu ve parsiyel karbondioksit basınçları için yapılan noninvaziv ölçüm değerleri ile invaziv ölçüm değerleri arasında tüm ölçüm zamanlarında anlamlı bir fark saptanmadı. Sistolik ve ortalama kan basıncının noninvaziv ölçüm değerlerinin ise 1., 6., 12. ve 18. saatlerde invaziv değerlerden anlamlı derecede düşük olduğu saptandı (p< 0.05). Sonuç: Açık kalp cerrahisi sonrası arteriyal kan basıncı, arteriyal oksijen ve karbondioksit seviyelerinin noninvaziv cihazlarla takip edilmesinin gerektiği durumlarda elde edilen arteriyal oksijen satürasyonu, karbondioksit seviyesi ve diyastolik kan basıncı değerleri invaziv yöntemlerle tam bir uyum göstermekle beraber sistolik ve ortalama kan basıncı değerleri invaziv değerlere göre daha düşük olarak gözlemlenmektedir. Bu veriler ışığında, açık kalp cerrahisi sonrası noninvaziv izlem cihazlarının hasta takibinde önemli bir alternatif oluşturduğu görüşündeyiz.

Anahtar Kelimeler: Noninvaziv, arter basıncı, pulsoksimetri,end-tidal karbondioksit
ABSTRACT
Objective: The intensive care unit period following open-heart surgery is one of the most widely-used areas of invasive monitorization systems. However, new non-invasive monitorization systems are being offered as an alternative to these patients. Material and Methods: The goal of the study was to determine the relations between invasive and non-invasively acquired values of systolic, diastolic and mean blood pressure mesurements, arterial oxygen saturation and partial arterial carbon dioxide pressure by comparing corresponding recordings of them. To this end, these values were recorded simultaneously by both methods in the post-operative 1st, 6th, 12th, 18th and 24th hours. Results: It was observed that non-invasive values for diastolic blood pressure, arterial oxygen saturation and partial carbon dioxide pressure were in accordance with invasive measurements. However, non-invasive values of systolic and mean blood pressure were significantly lower than invasively obtained values at the 1st, 6th, 12th and 18th hours postoperatively. Conclusion: In cases where non-invasive monitorization systems are preferred following cardiac surgery, the diastolic arterial pressure, the arterial oxygen saturation and carbon dioxide levels are in accordance statistically with corresponding invasive values. Non-invasive monitorization systems offer a viable alternative for patients who have undergone open-heart surgery, keeping in mind that recorded systolic and mean arterial pressure values are somewhat lower than those values recorded with invasive systems.

Keywords: Lithotripsy, pressure, oximetry, carbon dioxide

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