The effect of dobutamine treatment on salvage of digital replantation and revascularization
Küçük Resim Yok
Tarih
2023
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Springer Heidelberg
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
PurposeOne of the most common causes of a failure after replantation and revascularization surgeries is 'no reflow' from proximal artery that occurs, especially following crush and avulsion injuries. In this study, we aimed to evaluate the effect of dobutamine treatment on salvage of replanted and revascularized digits.MethodsThe patients with no reflow phenomenon detected in the salvage operations of replanted/revascularized digits between the years 2017 and 2020 were included in the study. Dobutamine treatment was infused at a rate of 4 & mu;g & BULL;kg(-1)& BULL;min(-1) intraoperatively and of 2 & mu;g & BULL;kg(-1) min(-1) postoperatively. Demographic data (age, sex), digit survival rate, ischemia time, and level of injury were retrospectively analysed. Pre-infusion, intraoperative and postoperative values of cardiac index (CI), mean arterial pressure (MAP), and heart rate (HR) were recorded.ResultsThe phenomenon of 'no reflow' was encountered in 35 digits of 22 patients who underwent salvage surgery due to vascular compromise. The survival rate in the revascularization group was 75%, while it was 42.1% in the replanted digits. Metaphysis level of proximal phalanx was the most common localization for 'no reflow' phenomenon. The least values of CI, MAP and HR to obtain sufficient perfusion in salvaged digits were as follows: 4.2 l.min(-1).m(-2), 76 mm Hg, and 83 beat & BULL;min(-1), respectively.ConclusionsIt was demonstrated that dobutamine infusion at a rate of 4 & mu;g & BULL;kg(-1)& BULL;min(-1) intraoperatively and at 2 & mu;g & BULL;kg(-1)& BULL;min(-1) postoperatively has favorable effects on the vascular compromise derived from no reflow of proximal artery.
Açıklama
Anahtar Kelimeler
Replantation, Salvage Surgery, No Reflow, Dobutamine Infusion
Kaynak
European Journal of Trauma and Emergency Surgery
WoS Q Değeri
N/A
Scopus Q Değeri
Q2
Cilt
49
Sayı
5
