The effect of dobutamine treatment on salvage of digital replantation and revascularization

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dc.contributor.authorInce, Bilsev
dc.contributor.authorUyanik, Orkun
dc.contributor.authorIsmayilzade, Majid
dc.contributor.authorYildirim, Mehmet Emin Cem
dc.contributor.authorDadaci, Mehmet
dc.date.accessioned2024-02-23T13:43:29Z
dc.date.available2024-02-23T13:43:29Z
dc.date.issued2023
dc.departmentNEÜen_US
dc.description.abstractPurposeOne 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.en_US
dc.identifier.doi10.1007/s00068-023-02312-x
dc.identifier.endpage2120en_US
dc.identifier.issn1863-9933
dc.identifier.issn1863-9941
dc.identifier.issue5en_US
dc.identifier.pmid37367969en_US
dc.identifier.scopus2-s2.0-85163401733en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage2113en_US
dc.identifier.urihttps://doi.org/10.1007/s00068-023-02312-x
dc.identifier.urihttps://hdl.handle.net/20.500.12452/10827
dc.identifier.volume49en_US
dc.identifier.wosWOS:001021038700001en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringer Heidelbergen_US
dc.relation.ispartofEuropean Journal Of Trauma And Emergency Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectReplantationen_US
dc.subjectSalvage Surgeryen_US
dc.subjectNo Reflowen_US
dc.subjectDobutamine Infusionen_US
dc.titleThe effect of dobutamine treatment on salvage of digital replantation and revascularizationen_US
dc.typeArticleen_US

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