Akademik Veri Yönetim Sistemi
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi, cilt.13, sa.2, ss.73-78, 2007 (Scopus)
In recent years, differences in clinical outcomes due to use of pressure data obtained by pulmonary artery catheterization have been questioned. In this study, we retrospectively compared the effect of hemodynamic monitoring using pulmonary artery catheters (PAC) or central venous catheters(CVC) on intraoperative and postoperative morbidity and mortality (dysrhythmias, use of inotropic agents, myocardial ischemia, use of intraaortic balloon pump, return to cardiopulmonary bypass) of patients with poor left ventricular function during off-pump coronary artery bypass surgery (OPCAB). Charts of patients undergoing OPCAB between January 2003 and March 2005 were reviewed. Of 88 patients with EF <30 % and undergoing OPCAB via general anaesthesia and median sternotomy, 59 patients had PAC (Group PAC) and 29 patients had CVC (Group CVC). Standard anesthetic and surgical techniques were used. The number of grafted vessels were 2.3 in Group PAC and 2.1 in Group SVC. Duration of anesthesia, duration of operation, the mean dose of fentanyl, number of patient using antiarrhythmics and inotropic agents were not significantly different between groups (p>0.05). Also, the time to extubation, length of ICU stay, rate of myocardial infarction, use of intraaortic balloon and occurrence of perioperative myocardial infarction were similar between the two groups. The rate of conversion to CPB were 8 % in Group PAC and 6 % in CVC (p>0.05). In-hospital mortality was similar in the two study groups. Three patients in Group PAC and one patient in Group CVC died due to organ failure and ARDS secondary to low cadiac output. In conclusion, morbidity and mortality was not significantly different in patients with compromised left ventricular function undergoing OPCAB when the type of hemodynamic monitoring (PAC vs. CVC) was taken into account.