ÖZETAmaç: Çalışmamızın amacı, kardiyopulmoner baypas (KPB) uygulanan ve uygulanmayan (OPCAB) hastalarda intestinal iskemi ile intestinal yağ asidi bağlayıcı protein (I-FABP) arasında ilişki olup olmadığını belirlemektir. Yöntemler: Çalışma prospektif, gözlemsel olarak planlandı. Elektif koroner arter baypas greftleme cerrahisi uygulanacak 50-70 yaşları arasında hastalar ardışık olarak çalışmaya alındı. Kardiyopulmoner baypas uygulanan 35 hasta birinci grup (CPB), uygulanmayan 16 hasta ikinci grup (OPCAB) olarak kabul edildi. Gruplar arası ve grup içi karşılaştırmalar Student's t, Mann-Whitney U, Friedman ve Wilcoxon testleri ile analiz edildi. Bulgular: Kardiyopulmoner baypas uygulanan grubun I-FABP düzeylerinde operasyon sonunda, başlangıca göre anlamlı yükselme olurken (p<0.005), postoperatif 12. ve 24. saatlerde operasyon bitişine göre anlamlı düşme görüldü (sırasıyla p<0.001, p<0.001). Kardiyopulmoner baypas uygulanmayan grupta ise operasyon sonunda operasyon başlangıcına göre yükselme görülürken (p<0.001), postoperatif 24. saatte operasyon başlangıcına göre anlamlı düşme görüldü (p<0.001). Her iki grubun I-FABP düzeyleri cerrahi bitiminde preoperatif değerlere göre anlamlı şekilde yükseldi. Sonuç: Çalışmamız sırasında hiçbir hastamızda intestinal iskemi görülmezken, I-FABP düzeylerindeki değişiklik bize açık kalp cerrahisi geçiren hastalarda intestinal iskemi monitörizasyonunda I-FABP'nin kullanılabileceğini düşündürdü.
ABSTRACTObjective: The aim of this study was to determine whether serum levels of intestinal type fatty acid binding protein (I-FABP) are related to intestinal ischemia in patients undergoing coronary bypass surgery. Methods: The study was planned as prospective, observational. Elective coronary artery bypass candidate patients between ages of 50 and 70 were consecutively included in the study. Thirty-five patients scheduled for cardiopulmonary bypass (CPB) were identified as the CPB group and 16 patients not scheduled for CPB were identified as the off-pump coronary artery bypass surgery (OPCAB) group. The variables between and within the groups were analyzed with Student's t, Mann-Whitney U, Friedman and Wilcoxon tests respectively. Results: In both CPB and OPCAB groups, I-FABP level at the end of the operation was significantly higher than that noted at the beginning of the operation (p<0.005). In the CPB group, there was a significant drop in I-FABP from the end of the operation to each of the postoperative time points (12 th hour and 24 th hour) (respectively p<0.001, p<0.001). In the OPCAB group, the I-FABP levels at both postoperative time points were lower than that at the end of the operation (p<0.001), and the level at 24-hour post-surgery was significantly lower than at both the end-of-operation I-FABP value (p<0.001) and the 12-hour post-surgery I-FABP value. Conclusion: Since we have not observed any intestinal ischemia through our research, slight changes of I-FABP measurements make us believe that I-FABP would be a valuable way to monitor for intestinal ischemia in patients w...
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