ÖZET

Amaç:

Kardiyopulmoner baypas prosedürünün etkileri, antikoagülan uygulanması, kanama diyatezi, kan ürünü transfüzyonu ve hipotermi gibi çeşitli risk faktörleri kalp cerrahisi hastalarını trombositopeniye yatkın hale getirmektedir. Kalp cerrahisi sonrası erken trombositopeninin klinik ve prognostik önemi ise önceki çalışmalarda daha az incelenmiştir ve çalışmamızın temel konusunu oluşturmaktadır.

Gereç ve Yöntem:

Bu kesitsel çalışmada 6 ay içerisinde hastanemizde elektif olarak kalp cerrahisi uygulanan hastalar incelendi. Trombosit sayısının 150.000/μL altında olması trombositopeni olarak kabul edildi. Peroperatif değişkenler, Ardışık Organ Yetmezliği Değerlendirmesi’ne (SOFA) göre prognostik skorlar, yatış süresi, hastane yatışı sırasındaki mortalite ve ek olaylar incelendi.

Bulgular:

Hastaların %33,05’inde trombositopeni görüldü. Trombositopeni grubunda ortalama kros klemp süresi uzamış ve toplam mediastinal drenaj miktarı artmıştı. Bu grupta tüm nedenlere bağlı enfeksiyonlar, pulmoner ve renal disfonksiyon oranları fazla, SOFA skorları 24. ve 48. saatlerde yüksek, yoğun bakım ve hastane yatış süreleri daha uzun olmuştu.

Sonuç:

Kalp cerrahisi sonrası erken dönemde trombositopeninin, multiorgan yetmezliği, gelişebilecek enfeksiyonlar, kötü prognoz ve uzamış yatış süresiyle ilişkili olabileceği gözlenmiştir. Çalışmamızda kanama ve uzamış kros klemp süresinin trombositopeniyle ilişkili anlamlı risk faktörleri olduğu saptanmıştır. Bu nedenle uygun hemostatik yaklaşım ve kros klemp süresinin kısa tutulmasının kalp cerrahisi sonrası trombositopeniyi azaltabilecek önlemler olabileceğini düşünmekteyiz.

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Kardiyak Cerrahi Sonrası Erken Postoperatif Trombositopeni

ÖZET

References