Objectives. The aim of this study is to compare the effects of the minimal extracorporeal circulation (MiECT) on postoperative systemic inflammatory response and the need for transfusion in patients undergoing open heart surgery with cardiopulmonary bypass. Methods. Patients were divided into two groups; Group M (n=31) included the patients operated via using the MiECT system and Group C (n=27) included the patients operated via using conventional cardiopulmonary bypass (CPB). Perioperative markers of inflammation after cardiopulmonary bypass in both groups were tested by measuring the levels via chemiluminescent immunometric assay. Blood samples were taken consecutively after anesthesia induction, 30th minute of CPB, on the 6th, 24th, and 48th hours after cardiopulmonary bypass. Results. The mean amount of priming solution was significantly lower in Group M when compared to Group C (802.60 ± 48.26 and 1603.71 ± 49.85 ml). The mean hematocrit (Hct) value taken immediately after cardiopulmonary bypass was found to be significantly higher in the MiECT patients with respect to the other group (% 32.71 ± 3.98 and % 28.82 ± 4.39). The transfused amounts of erythrocyte suspension and fresh frozen plasma were found to be significantly lower in patients in Group M when compared to those in Group C. Postoperative mediastinal drainage was also significantly lower in patients in Group M with respect to the other group. There was no significant difference between markers of inflammation. Conclusion. Our results show that MiECT seems to be more advantageous in terms of priming volume, perioperative hematocrit levels, need for blood and blood product transfusion, and mediastinal drainage with respect to the conventional approach after coronary artery bypass grafting.
Objective: The incidence of upper limb deep vein thrombosis is rising in parallel with more frequent invasive vascular procedures. In this study we aimed to evaluate the upper limb deep vein thrombosis (ULDVT) cases retrospectively according to risk factors, symptoms, diagnosis and clinical course.
Methods:Between January 2012 and May 2014, we studied 23 deep vein thrombosis cases which were confirmed with Doppler ultrasound. The patients were questioned about risk factors and underlying diseases and were examined with upper extremity venous Doppler ultrasonography. 15 cases had (65.2%) central venous catheter being the most common ULDVT reason.Results: Protocol included low molecular weight heparin in the acute phase and then oral anticoagulant for 6 months. All patients were followed at outpatient clinic with 2 month intervals for a year. Before completing the followup, 5 patients (21.7%) died of other reasons and we didn't see any pulmonary embolus complication and recurrent DVT. None of the cases had post-thrombotic syndrome during follow-up.
Conclusion:We suggest that LMWH must be preferred to standard heparin therapy because of its effectiveness, rare hemorrhage risk and easy usage to relieve symptoms, prevent recurrences, shorten the therapy period and decrease the costs. Sonuç: Tedavide amaçlanan; semptomları giderme, nüksleri önleme ve tedavi süresi ile maliyetleri sınırlama amacıyla DMAH'ların uygulama kolaylığının yanısıra etkinliği ve kanama riskinin azlığı nedeniyle standart heparine tercih edilerek yüz güldürücü sonuçlar alınacağı kanaatindeyiz.Anahtar kelimeler: Derin venöz tromboz, üst ekstremite, düşük molekül ağırlıklı heparin
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