PEROPERATIVE INVAZIVE HEMODYNAMIC MONITORIZATION-IN HIGH RISK SURGICAL PATIENTS
ATİLA KORKMAZ, E OKAN HAMAMCI, HASAN BESİM, YAŞAR ÖĞÜNÇ, MUHİTTİN SONIŞIK, HALUK GÜMÜŞ
Ankara Numune Hastanesi, 6.Cerrahi Anestezioloji Kliniği, ANKARA
The aim of this study is to advocate the efficacy of hemodynamic monitorization with pulmonary artery catheterization in high risk patients during the operative period. Conventional intraoperative monitorization in high risk patients undergoing non-cardiac surgery cannot adeguately reflect the circulatory changes. Pre-operative Swar-Ganz catheterization was performed in 26 high risk patients undergoing surgery. 5 groups were formed according to the results of intraoperative measurements and the effects of intraoperative monitorization on operative safety, morbidity and mortality was investigated. In 6 patients the hemodynamic and O2 transport parameter changes due to intraabdominal pressure depletion or elevations was evaluated. In half of the cases (n=13) preoperative and intraoperative diagnosis were correlated. In the rest of the patients pre and intraoperative diagnosis was different and treatment changes had to be done. Intraabdominal pressure depletions during the operative period resulted with changes in hemodynamic parameters and treatments of the patients. Pulmonary artery catheterization leads to accurate estimation of cardiopulmonary functions. In these 26 critically ill patients, no mortality was seen during the early postoperative period and we believe that this was due to the accuracy of the evaluation of cardiopulmonary functions with invasive hemodynamic monitorization.
Keywords: HEMODYNAMICS, CRITICAL ILLNESS, HEMODYNAMIC MONITORIZATION, SWAN-GANZ CATHETERIZATION, INTRAABDOMINAL PRESSURE