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Sağ ve sol torakotominin kardiyak outputa etkisinin noninvaziv olarak karşılaştırılması

Noninvasive comparison of the effects of right and left thoracotomies on cardiac output

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Abstract (2. Language): 
In this study, we aimed to compare noninvasively the effects of right and left thoracotomies on cardiac output in the patients who would undergo thoracotomy. Forty male patients in the Group of ASA I who were planned to undergo elective thoracotomy were included in the study. Right thoracotomy and left thoracotomy were performed in Group I (n=20) and Group II (n=20), respectively. All cases were monitorized with noninvasive cardiac output monitor, and values of cardiac output, cardiac index, stroke volume and endtidal CO 2 were measured. The data were recorded before and after induction at lateral decubitus position two, one and again two lung ventilation, and the last supine position. In intra-group comparisons in Groups I and II, statistically significant differences were detected in mean arterial pressure, heart rate, endtidal CO 2 and peripheral oxygen saturation values before induction among two lung ventilations in supine position and lateral decubitis positon, and one lung ventilation (p<0.001). The differences among the values of cardiac output, cardiac index and stroke volume were statistically significant in right thoracotomies whereas they were not in left thoracotomies. There were not any statistically significant differences between the inter-group comparisons. In conclusion, statistically significant differences detected between right and left thoracotomies regarding mean arterial pressure, heart rate, endtidal CO 2 , peripheral oxygen saturation, cardiac output, cardiac index and stroke volume suggest that noninvasive cardiac output monitor can be used as a noninvasive monitor in thoracotomy operations.
Abstract (Original Language): 
Bu çalışmada torakotomi operasyonu geçirecek olgularda, sağ ve sol torakotomilerin kardiyak outputa etkilerini noninvaziv olarak karşılaştırmayı amaçladık. Çalışmaya elektif torakotomi planlanan ASA I grubu 40 erkek olgu dahil edildi. Grup I (n=20) olgulara sağ torakotomi, Grup II (n=20) olgulara ise sol torakotomi uygulandı. Olgular entübasyondan sonra noninvaziv kardiyak output monitörü ile izlendiler ve kardiyak output, kardiyak indeks, stroke volüm ve endtidal CO 2 değerleri ölçüldü. Tüm veriler indüksiyondan önce ve sonra, süpin pozisyonunda çift akciğer ventilasyonunda, lateral dekübitis pozisyonunda önce çift, sonra tek, en son yine çift akciğer ventilasyonunda, süpin pozisyona çevrilen olgularda çift akciğer ventilasyonunda kaydedildi. Sağ ve sol torakotomilerde grup içi karşılaştırmalarda ortalama arter basıncı, kalp atım hızı, endtidal CO 2 ve periferik oksijen satürasyonu değerlerinde indüksiyondan önce, süpin pozisyonunda çift akciğer ventilasyonunda, lateral dekübitis pozisyonunda çift ve tek akciğer ventilasyonu arasında istatistiksel olarak anlamlı farklılıklar saptandı (p<0.001). Sağ torakotomilerde kardiyak output, kardiyak indeks ve stroke volüm değerleri arasındaki farklılıklar istatistiksel olarak anlamlı iken, sol torakotomilerde anlamlı değildi. Her iki grup karşılaştırmasında ise hiç bir parametre arasında istatistiksel olarak anlamlı farklılık saptanmadı. Sonuç olarak sağ ve sol torakotomilerde ortalama arter basıncı, kalp atım hızı, endtidal CO 2 , periferik oksijen satürasyonu, kardiyak output, kardiyak indeks ve stroke volüm değerleri arasında saptanan anlamlı farklılıklar, noninvaziv kardiyak output monitörünün torakotomi operasyonlarında noninvaziv bir monitör olarak kullanılabileceğini düşündürmektedir.
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