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Hemodilüsyon serebral kan akımını artırarak nöroprotektif etki göstermekte. Bu etkinin kısa ve uzun vadedeki sonuçlarını vasomotor reaktivite testi ve serebral oksimetre ile test etmeyi amaçladık. Gereç ve yöntemler: İskemik stroklu hastalar ardışık sistemle hemodilüsyon ve kontrol grubuna kabul edildi. Hemodilüsyon ilk 24 sa içinde uygulandı. Hematokrit düzeyine göre hipervolemik, izovolemik ya da hipovolemik hemodilüsyon uygulandı. Hemodilüsyon öncesi, sonrası 5.gün ve 90.gün transkranial doppler ile vasomotor reaktivite (VMR) testi, INVOS 3100 Cerebral Oximeter ile oksijen dağımı ve klinik değerlendirmeleri yapıldı. Klinik değerlendirmede Glaskow koma skalası, Bartel, Rankın, SSS, MCANS, HSS kullanıldı. Sonuçlar descriptive statistics, varyans analizi ve t- test ile değerlendirildi. Bulgular: Hemodilüsyon grubunda 21, kontrol grubunda 20 hasta vardı. Yaş ortalaması 61,2 idi. VMR testinde ve oksimetride oksijen değerlerinde iki grup birbiri ile ve günlere göre karşılaştırmada anlamlı bir farklılık bulunmamıştır. Klinik değerlendirmede 90. Günde hemodilüsyon grubunda SSS ve MCANS değerleri daha iyi bulunmuştur. Hemodilüsyon WMR testinde ve oksijen dağılımında anlamlı bir etki göstermemiştir. Uzun dönemde klinik iyileşmede etkili bulunmuştur.
Hemodylusion has a neuroprotective effect by increasing brain blood flow. We intended to test the short and long-term results of this effect with a vasomotor reactivity test and a brain oxymeter. Instruments and methods: Patients with ischemic stroke were admitted to the hemodylusion and control group with a consecutive system. Hemodilusion was applied in the first 24 hours. According to the level of hematocrit, hypervolemic, isovolemic or hypovolemic hemodylusion was applied. The test of vasomotor reactivity (VMR) with transcranial doppler before, after and on the 5th and 90th day of hemodylusion was conducted with INVOS 3100 Cerebral Oximeter for oxygen dissemination and clinical assessments. In clinical assessment, the Glaskow coma scale, Bartel, Rankin, SSS, MCANS, HSS were used. The results were evaluated by descriptive statistics, variance analysis and t-test. Results: In the hemodylusion group there were 21 patients, in the control group 20 patients. The average age was 61.2. In the VMR test and in the oxymetry, there was no significant difference in the oxygen values between the two groups and the day-by-day comparison. The clinical assessment is 90. The SSS and MCANS values were better found in the daily hemodylusion group. Hemodylusion did not show a significant effect on the WMR test and oxigen distribution. It has been effective in clinical healing for a long time.
Hemodilution (HD) which increases cerebral blood flow has a neuroprotective effect. We aim to test short and long term results of this effect with vasomotor reactivity test and cerebral oximetry Materials and Methods: Patients who had an ischemic stroke were included in the study consecutively. Hemodilution was performed hipervolemic, isovolemic and hypovolemic according to hematocrit levels and performed within first 24 hours. Patients underwent vasomotor reactivity test (VMR) with transcranial doppler ultrasonography, distribution of oxygen was measured with INVOS 3100 Cerebral Oximeter and simultaneous clinical assessments were done with Glascow Coma Scale, Bartel Index, Rankın Score, MCA Neurological Scale, Scandinavian Stroke Scale and Hemispheric Stroke Scale. These assessments were done in the first day, 5 days and 90 days after HD. The results were analyzed by descriptive statistics, variant analysis and t-test Result: We enrolled 21 patients whom hemodilution was performed and 20 control subjects in our study. Mean age of all subjects was 61.2 years. There was no significant difference between the two groups oxygen levels cerebral oximetry and results of vasomotor reactivity test. Hemodilution group had better clinical recovery in the third month. Hemodilution had no effect in VMR test and distribution of oxygen but it contributed to clinical recovery in long term.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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