Preoperatif hiponatreminin sol ventrikül ejeksiyon fraksiyonu üzerine etkileri ve klinik sonuçlarla ilişkisi

Abstract

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.