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Journals / Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi / 2017 / Cilt: 23 - Sayı: 4

Factors Affecting Thrombocytopenia During Extracorporeal Life Support Used After Open Heart Surgery

Açık Kalp Cerrahisi Sonrası Ekstrakorporeal Yaşam Desteği Kullanımında Trombositopeniye Etki Eden Faktörler

Cüneyt ARKAN
Mehmet YANARTAŞ
MURAT BÜLENT RABUŞ
Halide OĞUŞ
Adile Ece ALTINAY
Rezan AKSOY
Ömer Faruk ŞAVLUK
Emre GÜRCÜ
Deniz ÇEVİRME
Pages
121–125
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It has been thought that to prevent severe thrombocytopenia during ECLS usage after open heart surgery, instead of central approach, peripheral approach is more appropriate for cannulation.

📌 3 Key Takeaways

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Objective & Hypothesis:clinical outcomes after Extracorporeal Life Support (ECLS).
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Key Findings & Data:The patients were grouped as severe, moderate and mild cases with thrombocytopenia according to their platelet levels.
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Conclusion & Impact:It has been thought that to prevent severe thrombocytopenia during ECLS usage after open heart surgery, instead of central approach, peripheral approach is more appropriate for cannulation.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

clinical outcomes after Extracorporeal Life Support (ECLS). ECLS procedure aggravates thrombocytopenia after open heart surgery. The purpose of this study is to explore the possible causes which might contribute to thrombocytopenia developed in patients with ECLS after open heart surgery. Material and Methods: All the patients underwent open heart surgery. ECLS support was provided for the patients who developed low cardiac output syndrome. The patients were grouped as severe, moderate and mild cases with thrombocytopenia according to their platelet levels. Possible risk factors for cardiopulmonary bypass were included in the study. Results: Total number of patients was thirty five. Thirteen (37.1%) of them were women, and twenty- two (62.9%) of them were men. Before ECLS, all of them had undergone cardiopulmonary bypass. Considering preoperative platelet levels, mean (range) platelet count was found as (57-387) 175.97±75.53x103 /µL. Twelve patients (34.3%) with moderate thrombocytopenia had a mean platelet count as 94.0±19.36x103 /µL. Twenty three (65.7%) patients had mild and normal thrombocytopenia with a mean platelet count as 218.73±55.26x103 /µL. There are no patients who had severe thrombocytopenia. A significant decrease occurred in platelet counts during the postoperative first five days when compared with preoperative counts (p<0.05). Conclusion: Extracorporeal circulation is a risk factor for thrombocytopenia. It has been thought that to prevent severe thrombocytopenia during ECLS usage after open heart surgery, instead of central approach, peripheral approach is more appropriate for cannulation.

Özet

Amaç: Trombositopeni Ekstrakorporeal Yaşam Desteği (ECLS) kullanımı sonrası klinik olumsuzluklara neden olmaktadır. Açık kalp cerrahisi uygulandıktan sonra ECLS uygulanması trombositopeniyi daha da derinleştirmektedir. Bu çalışmanın amacı, açık kalp cerrahisi sonrasında ECLS kullanılan hastalarda oluşan trombositopeninin oluşumuna katkıda bulunabilecek olası nedenleri incelemektir.Gereç ve Yöntem: Tüm hastalara açık kalp cerrahisi uygulanmış olup, düşük debi gelişenlere ECLS desteği sağlanmıştır. Hastalar trombositopeni türlerine göre şiddetli, orta, hafif veya normal olarak 3 gruba ayrılmıştır. Kardiyopulmoner baypas için olası risk faktörleri çalışmaya alınmıştır. Bulgular: Toplam hasta sayısı 35'tir. On üç (%37.1) kadın, 22 (%62.9) erkek hasta mevcuttur. ECLS öncesi tamamı kardiyopulmoner baypas altında opere edilmiştir. Ameliyat öncesi (preoperatif) değerlerine bakıldığında trombosit ortalaması 175.97±75.53x103/µL olarak bulunmuştur. Preoperatif dönemde orta seviye trombositopeniye sahip 12 hasta (%34.3) trombosit ortalaması 94.0±19.36x103/µL, hafif veya normal trombositopeni seviyeye sahip 23 hasta (%65.7) trombosit ortalaması 218.73±55.26x103/µL bulunmuştur. Şiddetli trombositopeniye sahip hasta bulunmamaktadır. Preoperatif dönemden ilk 5 günlük takipte trombosit değerlerindeki düşme anlamlıdır (p<0.05).Sonuç: Ekstrakorporeal dolaşım trombositopeni için risk faktörüdür. Açık kalp cerrahisi sonrası ECLS kullanımında derin trombositopeniden kaçınmak için santral yerine periferal yerleşim tekniğinin yeğlenmesinin uygun olduğu düşünülmektedir

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Cite This Article

ARKAN, C., YANARTAŞ, M., RABUŞ, M. B., OĞUŞ, H., ALTINAY, A. E., AKSOY, R., ŞAVLUK, Ö. F., GÜRCÜ, E., ÇEVİRME, D. (2017). Factors Affecting Thrombocytopenia During Extracorporeal Life Support Used After Open Heart Surgery. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, Cilt: 23 - Sayı: 4, 121–125. https://ajindex.com/articles/167573

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