ABSTRACT
ABSTRACT Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe disease treated with pulmonary endarterectomy. Our study aims to reveal the differences in liquid modalities and operation modifications, which can affect the patients' mortality and morbidity. Methods: One hundred twenty-five patients who were diagnosed with CTEPH and underwent pulmonary thromboendarterectomy (PTE) at our center between February 2011 and September 2013 were included in this retrospective study with prospective observation. They were in New York Heart Association functional class II, III, or IV, and mean pulmonary artery pressure was > 40 mmHg. There were two groups, the crystalloid (Group 1) and colloid (Group 2) liquid groups, depending on the treatment fluids. P-value < 0.05 was considered statistically significant. Results: Although the two different fluid types did not show a significant difference in mortality between groups, fluid balance sheets significantly affected the intragroup mortality rate. Negative fluid balance significantly decreased mortality in Group 1 (P<0.01). There was no difference in mortality in positive or negative fluid balance in Group 2 (P>0.05). Mean duration of stay in the intensive care unit (ICU) for Group 1 was 6.2 days and for Group 2 was 5.4 days (P>0.05). Readmission rate to the ICU for respiratory or non-respiratory reasons was 8.3% (n=4) in Group 1 and 11.7% (n=9) in Group 2 (P>0.05). Conclusion: Changes in fluid management have an etiological significance on possible complications in patient follow-up. We believe that as new approaches are reported, the number of comorbid events will decrease.
ABSTRACT
ABSTRACT Objective: To determine the factors related to quadriceps weakness, to evaluate electromyo-graphic changes in the quadriceps and to attempt to determine the neuromuscular restoration period after anterior cruciate ligament (ACL) repair. Methods: A total of 30 patients (28 males and 2 females) who underwent surgery conducted by two surgeons were reviewed prospectively. All ACLs were reconstructed arthroscopically with anterior tibial tendon allograft, using an anteromedial portal. The patients' quadriceps muscles' neuromuscular activity was determined with electromyography at early and late periods (1-3 months and 6-12 months, respectively). Results: A significant difference was observed (p < 0.01) in the quadriceps circumference between the operated extremities (average, 48.4 cm) and the healthy limbs (average, 50.6 cm), according to measurements obtained on the sixth month after surgery. The tourniquet time was greater than 50 minutes in patients with quadriceps atrophy. A significant elongation was observed in the motor unit potential duration of the operated ipsilateral side, compared to the contralateral side (p < 0.001) at the early-term period. Differences were observed between the ipsilateral MUP amplitude and the durations of early- and late-term patients, but were not significant. Conclusion: Our study demonstrated that atrophies are significantly overcome in the first year after surgery. The electromyographic examinations indicated that tourniquet use not only caused functional harm in the quadriceps muscle but it also caused structural damage. However, these structural injuries did not result in negative effects on the clinical success.