Year 2019, Volume 58 , Issue 3, Pages 251 - 256 2019-09-20

The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes
Preoperatif hiponatreminin sol ventrikül ejeksiyon fraksiyonu üzerine etkileri ve klinik sonuçlarla ilişkisi

Çağatay Bilen [1] , Gökmen Akkaya [2] , Tuğra Gençpınar [3] , Sadık Kıvanç Metin [4]


Aim: In this study, we aim to investigate the relation between preoperative serum sodium levels and postoperative clinical follow-up; moreover, to compare the left ventricular ejection fraction increment in hyponatremic and normonatremic cases. Herein, we present one-year results of our clinic in open cardiac surgery performed patients.

Materials and Methods: This is a retrospective study of cases who underwent open cardiac surgery between February 2014-2015 in our clinic. Transplantation assist device implanted cases and hemodialysis receiving patients by reason of chronic renal failure were excluded.

Patients were divided into two groups according to blood serum sodium levels on admission day as normonatremic (135–145 mEq/L) or hyponatremic <135 mEq/L. The demographic characteristics of the patients, duration of intubation and length of intensive care unit (ICU) stay, need for inotropic support, mediastinal drainage amount, alteration in left ventricular ejection fraction (LVEF), intraaortic balloon pump (IABP) usage ratio, occurrence of acute renal failure, cardiopulmonary bypass time, cross clamping time and differences in clinical outcomes were examined.

Results: Hyponatremia was observed in 31,3% of patients and those had higher NYHA classification score. There was no statistical difference between groups in LVEF alteration was determined (p=0.756). Postoperative duration of intubation (p=0.003), need of blood products transfusion(p=0.033), vasoactive inotropic support (p=0.021) and postoperative amount of drainage was statistically higher in hyponatremic cases surplus(p=0.018). Peroperatively, both aortic cross clamping time (p=0.018) and cardiopulmonary bypass durations (p=0.026) were higher in hyponatremic group. Furthermore, postoperative mortality was also significantly higher (p=0.001).

Conclusion: We suggest that being hyponatremic has a prognostic importance in patients who undergo open cardiac surgery.

Amaç: Bu çalışmamızda preoperatif serum sodyum değeri ile postoperatif klinik durum arasındaki ilişkiyi saptamayı ve hiponatremik hastaların operasyon sonrasında sol ventrikül ejeksiyon fraksiyonundaki artışın normonatremik olgularla karşılaştırmayı amaçladık.

Gereç ve Yöntem: Şubat 2014 – 2015 tarihleri arasında kliniğimize başvuran ve açık kalp cerrahisi operasyonu olan, transplantasyon, yapay kalp implantasyonu yapılan olgular ve hemodiyaliz gerektiren kronik böbrek yetmezlik olguları dışındaki tüm hastalar çalışmamıza dahil edildi. Hastalar kan serum sodyum değerlerine göre operasyon öncesi iki gruba ayrıldı. Demografik veriler, entübasyon süreleri, yoğun bakım süreleri, inotrop kullanımı, oluşan komplikasyonlar, sol ventrikül ejeksiyon fraksiyonu değişimi, intraaortik balon pompası kullanımı, kardiyopulmoner baypas süreleri, kross klemp süreleri ve klinik sonuçlar arasındaki fark değerlendirildi.

Bulgular: Hiponatreminin postoperatif EF değişimi üzerine etkisi saptanmamıştır. Olguların serum sodyum değerine göre NYHA sınıflaması karşılaştırıldığında olguların hiponatremik hastalarda yüksek NYHA sınıfında olma arasında anlamlı fark saptanmıştır. Hiponatremik grupta postoperatif dönemde entübasyon süreleri, kullanılan kan ürünü ve postop drenaj miktarı anlamlı derecede fazladır. Hiponatremik hastalarda postoperatif akut böbrek yetmezliği görülme sıkılığı artmıştır. Hiponatremik hastalarda postoperatif mortalite oranları anlamlı derecede yüksektir.   

Sonuç: Çalışmamızda preoperatif hiponatreminin, kalp cerrahisi hastalarında prognostik önemi olduğunu düşünmekteyiz. 

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Primary Language en
Subjects Health Care Sciences and Services
Journal Section Research Articles
Authors

Orcid: 0000-0002-9158-5627
Author: Çağatay Bilen (Primary Author)
Institution: Ege University, Cardiovascular Surgery, Izmir
Country: Turkey


Orcid: 0000-0002-0509-1971
Author: Gökmen Akkaya
Institution: Ege University, Cardiovascular Surgery, Izmir
Country: Turkey


Orcid: 0000-0003-4438-7991
Author: Tuğra Gençpınar
Institution: Dokuz Eylül University, Cardiovascular Surgery, Izmir
Country: Turkey


Orcid: 0000-0001-9888-2141
Author: Sadık Kıvanç Metin
Institution: Dokuz Eylül University, Cardiovascular Surgery, Izmir
Country: Turkey


Dates

Publication Date : September 20, 2019

Bibtex @research article { etd607596, journal = {Ege Tıp Dergisi}, issn = {1016-9113}, eissn = {2147-6500}, address = {}, publisher = {Ege University}, year = {2019}, volume = {58}, pages = {251 - 256}, doi = {10.19161/etd.607596}, title = {The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes}, key = {cite}, author = {Bilen, Çağatay and Akkaya, Gökmen and Gençpınar, Tuğra and Metin, Sadık Kıvanç} }
APA Bilen, Ç , Akkaya, G , Gençpınar, T , Metin, S . (2019). The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes. Ege Tıp Dergisi , 58 (3) , 251-256 . DOI: 10.19161/etd.607596
MLA Bilen, Ç , Akkaya, G , Gençpınar, T , Metin, S . "The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes". Ege Tıp Dergisi 58 (2019 ): 251-256 <http://egetipdergisi.com.tr/en/issue/47742/607596>
Chicago Bilen, Ç , Akkaya, G , Gençpınar, T , Metin, S . "The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes". Ege Tıp Dergisi 58 (2019 ): 251-256
RIS TY - JOUR T1 - The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes AU - Çağatay Bilen , Gökmen Akkaya , Tuğra Gençpınar , Sadık Kıvanç Metin Y1 - 2019 PY - 2019 N1 - doi: 10.19161/etd.607596 DO - 10.19161/etd.607596 T2 - Ege Tıp Dergisi JF - Journal JO - JOR SP - 251 EP - 256 VL - 58 IS - 3 SN - 1016-9113-2147-6500 M3 - doi: 10.19161/etd.607596 UR - https://doi.org/10.19161/etd.607596 Y2 - 2018 ER -
EndNote %0 Ege Tıp Dergisi The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes %A Çağatay Bilen , Gökmen Akkaya , Tuğra Gençpınar , Sadık Kıvanç Metin %T The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes %D 2019 %J Ege Tıp Dergisi %P 1016-9113-2147-6500 %V 58 %N 3 %R doi: 10.19161/etd.607596 %U 10.19161/etd.607596
ISNAD Bilen, Çağatay , Akkaya, Gökmen , Gençpınar, Tuğra , Metin, Sadık Kıvanç . "The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes". Ege Tıp Dergisi 58 / 3 (September 2019): 251-256 . https://doi.org/10.19161/etd.607596
AMA Bilen Ç , Akkaya G , Gençpınar T , Metin S . The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes. Ege Tıp Dergisi. 2019; 58(3): 251-256.
Vancouver Bilen Ç , Akkaya G , Gençpınar T , Metin S . The effects of preoperative hyponatremia on left ventricular ejection fraction and relation with clinical outcomes. Ege Tıp Dergisi. 2019; 58(3): 256-251.