İnaortik Balon Pompasına Bağlı Damar Komplikasyonlarını Önlemede Dekstran 40 Kullanımı
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Date
2007
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Abstract
Amaç: Intraaortik balon pompası (IABP), dolaşım desteği sağlamak amacıyla, kardiyoloji ve kalp cerrahisinde yaygın olarak kullanılmaktadır. IABP kaynaklı tromboembolik damar komplikasyonlarını önlemek amacıyla, antitrombotik ajanlardan Dekstran 40 kullanılması araştırılmıştır. Gereç ve yöntemler: Kasım 2004 ile Ekim 2006 tarihleri arasında, koroner bypass operasyonu olan 37 hastaya IABP yerleştirilmiştir. Böbrek yetmezliği ve aşırı cerrahi drenaj tanısı alan hastalar dışındaki tüm hastalar, kateterin çekilmesinden 0.5 saat öncesine kadar Dekstran 40 infüzyonu almışlardır. Bu grupta heparin kullanılmamıştır. Bulgular: Olguların 26'sı (%70) erkek, 11'i (% 30) kadındır. Ortalama yaş, 63.4 + 8.4 yıl ve ortalama IABP kullanma süresi, 56.3 saat (6 ile 162 saat arası) bulunmuştur. Yirmidokuz hastaya (% 78.4) sadece koroner bypass operasyonu (CABG), 8 hastaya da (% 21.6) CABG'ye eşlik eden diğer açık kalp operasyonları uygulanmıştır. Hiçbir hastada Dextran 40 kullanımına bağlı yan etki görülmemiştir. Üç olguda (%8) bacak iskemisi gelişmiş olup, 2 olguda kateterin çekilmesi ile iskemi düzelmiş, I olguda Fogarty kateteri ile tromboembolektomi gerekli olmuştur. Hiçbir hastada büyük cerrahi girişim gereksinimi olmamıştır. Kateterin giriş yerinde belirgin kanama görülmemiştir. Olguların hiçbirinde trombositopeni gözlenmemiştir. Sonuç: Dekstran 40, IABP ilişkili damarsal yan etkileri azaltmak için güvenle kullanılabilir. Bu çalışma, IABP kaynaklı damar komplikasyonlarını önlemek açısından Dekstran 40 ile heparinin karşılaştırılacağı yeni çalışmalara öncülük edebilir.
Background: The intra- aortic balloon pump (IABP) is widely used to provide circulatory support in cardiology and cardiac surgery. To prevent thromboembolic vascular complications related to IABP, using of Dextran 40 that is one of the antithrombotic agents was studied. Methods: Between November 2004 and October 2006, an IABP was inserted in 37 patients who had coronary bypass surgery. All patients were received Dextran 40 infusion in postoperative period except patients who diagnosed renal failure and excessive surgical drainage and continued until 0.5 h before the removal of the balloon. Heparin was not used in this group. Results: There were 26 ( 70%) men and 11 ( 30%) women. The mean age was 63.4 8.4 years and the mean duration of IABP use was 56.3 h ( range 6-162 h). Twenty-nine patients (78.4%) had isolated coronary artery bypass grafting, 8 patients (21.6%) underwent coronary artery bypass grafting with associated procedures. Dextran 40- related side effect was not seen in any patients. 3 patients (8%) had limb ischemia; in 2 patients ischemia was reversed by IABP removal, one patients required thromboembolectomy with Fogarty catheter. No major surgical interventions were required in any patients. No major bleeding from insertion site was seen. None of patients was observed thrombocytopenia. Conclusion: Dextran 40 can be safely used to reduce IABP related vascular complications. This study could be led to further studies to compare the Dextran 40 with the heparin considering to prevent thromboembolic vascular complications related to IABP.
Background: The intra- aortic balloon pump (IABP) is widely used to provide circulatory support in cardiology and cardiac surgery. To prevent thromboembolic vascular complications related to IABP, using of Dextran 40 that is one of the antithrombotic agents was studied. Methods: Between November 2004 and October 2006, an IABP was inserted in 37 patients who had coronary bypass surgery. All patients were received Dextran 40 infusion in postoperative period except patients who diagnosed renal failure and excessive surgical drainage and continued until 0.5 h before the removal of the balloon. Heparin was not used in this group. Results: There were 26 ( 70%) men and 11 ( 30%) women. The mean age was 63.4 8.4 years and the mean duration of IABP use was 56.3 h ( range 6-162 h). Twenty-nine patients (78.4%) had isolated coronary artery bypass grafting, 8 patients (21.6%) underwent coronary artery bypass grafting with associated procedures. Dextran 40- related side effect was not seen in any patients. 3 patients (8%) had limb ischemia; in 2 patients ischemia was reversed by IABP removal, one patients required thromboembolectomy with Fogarty catheter. No major surgical interventions were required in any patients. No major bleeding from insertion site was seen. None of patients was observed thrombocytopenia. Conclusion: Dextran 40 can be safely used to reduce IABP related vascular complications. This study could be led to further studies to compare the Dextran 40 with the heparin considering to prevent thromboembolic vascular complications related to IABP.
Description
Keywords
Cerrahi, Intra-aortik balon pompası, Koroner arter bypass, Dekstranlar, Damar komplikasyonları, Intra- aortic balloon pumping, Coronary artery bypass, Dextrans, Vascular complications
Journal or Series
Damar Cerrahi Dergisi
WoS Q Value
Scopus Q Value
Volume
16
Issue
2
Citation
Narin, C., Özkara, A., Sarkılar, G., Can, İ., Ege, E., Sarıgül, A., Yeniterzi, M., (2007). İnaortik Balon Pompasına Bağlı Damar Komplikasyonlarını Önlemede Dekstran 40 Kullanımı. Damar Cerrahi Dergisi, 16(2), 1-8.
