Koroner anjiyografi yapılan hastalarda iohexolün solunum fonksiyon testi parametrelerine etkisi
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Tarih
2004
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info:eu-repo/semantics/openAccess
Özet
Amaç: Damar içine uygulanan anjiyografik kontrast ajanlara bağlı olumsuz yan ekilerin varlığı daha önceki çalışmalarda bildirilmiştir. Bu çalışmanın amacı günlük uygulamada “iohexolün”ün koroner anjiyografi sırasında kullanımına bağlı solunumsal etkilerini incelemektir. Materyal ve Metod: Koroner arter hastalığı ön tanısıyla koroner anjiyografi yapılan 30 hasta çalışmaya alındı. Kronik obstruktif akciğer, bronşiyal astım, miyokard infarktüsü ve ekokardiyografik olarak saptanmış sol ventrikül sistolik disfonksiyonu olan hastalar çalışmaya alınmadı. Koroner anjiyografiden hemen önce ve sonra solunum fonksiyon testi yapıldı ve kan gazı bakıldı. Hastalar anjiyografide koroner arter hastalığı olanlar (Grup1) ve olmayanlar (Grup2) şeklinde ikiye ayrıldı. Koroner anjiyografi işlemi tek deneyimli bir operatör tarafından yapıldı. Protokol gereği hastaların hiç birine sol ventrikülografi yapılmadı. Bulgular:Koroner anjiyografi öncesi ve sonrası sonuçlar karşılaştırıldı. İşlem sonrası bakılan birinci saniye sonu forse orta ekspiryum volüm (FEV1), maksimum mid-ekspiryum akım hızı (MMFR) 25-75, arteriyel oksijen basıncı (PaO2),bikarbonat (HCO3) değerleri tüm hastalarda anlamlı derecede düşük bulundu ( p 0.01). İşlem sonrası bakılan FEV1 ve PaO2 Grup1’de diğer gruplara göre anlamlı derecede daha düşük bulundu ( p 0.01) Sonuç: Bilinen bir akciğer hastalığı olmayan hastalarda iohexol kullanılarak yapılan tanısal koroner anjiyografi, solunum fonksiyon testi parametrelerinde küçük, ama önemli bir bozulmaya yol açmaktadır. Bundan dolayı bilinen akciğer hastalığı olanlarda opak madde kullanımında dikkatli olunması gerekli olduğu sonucuna varıldı.
Background:Adverse respiratory reactions have been reported with intravascular radiographic contrast media. The aim of the present study was to assess the effects of iohexol on pulmonary functions in patients undergoing diagnostic coronary angiography. Methods: Thirty patients diagnosed as coronary artery disease undergoing diagnostic coronary angiography were enrolled in the study. Subjects with chronic obstructive pulmonary disease, asthma, allergic bronchitis, myocardial infarction and documented systolic dysfunction by transthoracic echocardiography were excluded. The respiratory functions of the patients before and immediately after the coronary angiography were measured and arterial blood gas analyses were performed. The subjects were divided into two groups according to results of angiography as having coronary artery disease (Group 1) and without significant coronary artery disease (Group 2). The angiography procedures were performed by a single, experienced angiographer. Left Ventriculography was not performed on any patient Results: The results gathered before and after angiography procedure were compared. Forced expiratory volume in the first second (FEV1), maximum mid-expiratory flow rate, (MMFR) 25-75, arterial oxygen pressure (PaO2) and bicarbonate (HCO3) were significantly reduced ( p < 0.01), where as forced vital capacity (FVC), pH, oxygen saturation and arterial carbondioxide pressure were not changed. The comparison between two groups resulted that FEV1 and PaO2 were significantly decreased after angiography in Group 1. Conclusions: Diagnostic coronary angiography using iohexol decreases ventilatory functions in a small but significant extent in patients without any overt pulmonary disease. Therefore they should be used cautiously in patients with chronic lung disease.
Background:Adverse respiratory reactions have been reported with intravascular radiographic contrast media. The aim of the present study was to assess the effects of iohexol on pulmonary functions in patients undergoing diagnostic coronary angiography. Methods: Thirty patients diagnosed as coronary artery disease undergoing diagnostic coronary angiography were enrolled in the study. Subjects with chronic obstructive pulmonary disease, asthma, allergic bronchitis, myocardial infarction and documented systolic dysfunction by transthoracic echocardiography were excluded. The respiratory functions of the patients before and immediately after the coronary angiography were measured and arterial blood gas analyses were performed. The subjects were divided into two groups according to results of angiography as having coronary artery disease (Group 1) and without significant coronary artery disease (Group 2). The angiography procedures were performed by a single, experienced angiographer. Left Ventriculography was not performed on any patient Results: The results gathered before and after angiography procedure were compared. Forced expiratory volume in the first second (FEV1), maximum mid-expiratory flow rate, (MMFR) 25-75, arterial oxygen pressure (PaO2) and bicarbonate (HCO3) were significantly reduced ( p < 0.01), where as forced vital capacity (FVC), pH, oxygen saturation and arterial carbondioxide pressure were not changed. The comparison between two groups resulted that FEV1 and PaO2 were significantly decreased after angiography in Group 1. Conclusions: Diagnostic coronary angiography using iohexol decreases ventilatory functions in a small but significant extent in patients without any overt pulmonary disease. Therefore they should be used cautiously in patients with chronic lung disease.
Açıklama
Anahtar Kelimeler
Cerrahi, Kalp ve Kalp Damar Sistemi
Kaynak
Türk Göğüs Kalp Damar Cerrahisi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
12
Sayı
4
