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Öğe A new center: First six months analysis of adult cardiac surgery(2012) Gürkan, Selami; Gür, Özcan; Arar, Makbule Cavidan; Ege, TuranObjective: Cardiac surgery centers are developing and growing in recent years. We aimed to evaluate the first six months results of cardiac surgery operations that performed in our clinic which built new. Material and Methods: One hundred seven (73 men, 34 women; mean age 58.35±11.15 years) consecutive patient operated between October 2011 and March 2012 were analyzed retrospectively. While hypertension (43.9%) was the most common disease followed by diyabetes (39.2%), hyperlipidemia (35.5%) and chronic obstructive pulmonary disease (21.4%). Coronary artrey bypass graft operation was applied to 86 (80.3%) patients. The other procedures were; valve operation, atrial septal defect repair and Benthall. Results: Hospital mortality was 2.8% with 3 cases. Two of the patients were acute myocardial infarction, the other one was with left ventricular aneurysm. One of these patients diagnosed with acute myocardial infarction was taken to operation accompanied by cardiopulmonary resuscitation because of cardiopulmonary arrest. Postoperative wound infection was seen in 5 patiens. Saphenous vein wound infection in 3 and sternal wound infection in 2 patients was seen. Postoperative atrial fibrillation was seen in 28% of patients. Sinusal rhythm restored in all postoperative atrial fibrillations by medikal treatment. Revision operation for bleeding in 3 and for resistant ventricular fibrillation in 1 patient were performed. Conclusion: We thought that cardiac surgery operations that started at October 2011 in our clinic could be performed with acceptable mortality and morbidity rates. Copyright © 2012 by Türkiye Klinikleri.Öğe Büyük safen ven yetmezliğinde manuel 980 nm lazer çıplak-uçlu fiber ile otomatik geri çekme sistemli 1470 nm radial fiber lazerin karşılaştırılması: Erken dönem etkinlik ve komplikasyonlarin analizi(2013) Gürkan, Selami; Gür, Özcan; Arar, Makbule Cavidan; Donbaloğlu, Mehmet Okan; Ege, TuranAmaç: Endovenöz lazer ablasyon, variköz ven tedavisinde en çok kabul gören tedavi seçeneklerinden biridir. Bu retrospektif çalışmanın amacı manuel 980 nm çıplak fiber lazer ile otomatik geri çekme sistemli 1470 nm radial fiber lazerin erken dönem etkinliklerinin karşılaştırılması. Gereç ve Yöntemler: Ekim 2011 ile Ocak 2013 arasında büyük safen ven yetmezliği sebebiyle endovenöz lazer ablasyon ile tedavi edilen 78 hasta ve 89 ekstremite incelendi. 980 nm lazer ve çıplak fiber ile tedavi edilen 40 hasta ve 45 ekstremite Grup 1 olarak tanımlandı. 1470 nm lazer radial fiber ve otomatik geri çekme sistemi ile tedavi edilen 38 hasta ve 44 ekstremite Grup 2 olarak tanımlandı. Ağrı, ekimoz, endurasyon, parestezi gibi lokal komplikasyonlar postoperatif 3, 7 ve 30. günlerde klinik olarak ve Doppler ultrasonografi ile değerlendirildi. Bulgular: Grup 1 ve grup 2de erken kapanma oranları sırasıyla %91 (n=41) ve %93 (n=41) idi. Bir aylık takipler sonunda her iki grupta da venöz klinik şiddet skorlarında belirgin derecede azalma oldu. Postoperatif ekimoz, endurasyon parestezi ve analjezik ihtiyacı grup 1de anlamlı derecede yüksek olmasına rağmen, major komplikasyonlar her iki grupta da görülmedi. Sonuç: Her iki tip lazer ile yapılan endovenöz lazer ablasyon işleminin erken dönem sonuçları tatmin ediciydi. Otomatik geri çekme sistemli 1470 nm dalga boyunda radial fiber kullanılarak yapılan büyük safen venin endovenöz lazer ablasyonunun etkili ve güvenli bir tedavi seçeneği olduğu söylenebilir.Öğe Can Ultrasound-Guided Regional Anesthesia Techniques For Tracheostomy Be An Alternative To General Anesthesia?(Sage Publications Inc, 2021) Şahin, Ayhan; Baran, Onur; Gültekin, Ahmet; Gücer Şahin, Gülcan; Ersözlü, Tolga; Arar, Makbule CavidanIntroduction The cervical plexus block (CPB) has been used for a long time for both analgesia and anesthesia in carotid endarterectomy and thyroid operations. To be unfamiliar with the technique and its perceived difficulty, potential risks, and possible adverse effects such as intravascular injection has limited broader use before the practical use of ultrasound. We hypothesize that the cervical plexus block can provide adequate anesthesia in tracheostomy cases and provide excellent anesthesia comfort when combined with a translaryngeal block. Methods This double-blinded, randomized 29 patients undergoing primary tracheostomy operation to receive either CPB (Group S) or CPB with translaryngeal block (Group ST). The primary outcome was cumulated analgesic consumption during the first 24 postoperative hours. Secondary outcomes were as follows: pain related to incision, patient tolerance as assessed by tracheostomy cannula comfort score, cough and gag, pain at rest, nausea and vomiting, and time to first analgesic demand. Results The patient tolerance for tracheostomy was higher in Group ST than Group S. The median tracheostomy cannula comfort score was 4.0 in Group S. In contrast, the median score was significantly lower in group ST (P<.001). The cough and gag reflex scores were significantly lower in Group ST than Group S (1.0 vs 4.0, P<.001). Conclusion This trial supported the hypothesis that the CPB combined with the translaryngeal block yields excellent anesthesia for tracheostomies. The technique we briefly described, in a way, is the equivalent of awake fiberoptic intubation to awake tracheostomy with minimal sedation adjusted according to airway patency.Öğe Combined spinal-epidural anesthesia or local anesthesia + Sedoanalgesia in abdominal aortic Aneurism Repair?(Turkish Anaesthesiology and Intensive Care Society, 2015) Arar, Makbule Cavidan; Sezen, Ü.; Yüksek, A.; Sarıkaya, H.; Turan, F.; Turan, C.; Mordeniz, C.; Baran, O.; Günkaya, M.; Gür, O.; Saraçoğlu Varol, GamzeObjective: Anesthesia for the repair of abdominal aortic aneurism can be performed with different modalities of anesthesia or their combinations. The risk level for the morbidity and mortality of the patients, is increased in geriatric patients with the existence of accompanying pathology. To compare two different anesthesia methods (local anesthesia and sedation vs combined spinal and epidural anesthesia) for the repair of endovascular aneurism in a geriatric patient. Material and Methods: 16 high risk geriatric patients were included in the study. The parameters of 16 high risk patients who underwent elective or emergency treatment for endovascular aneurism were included. Group-I (n:8) was given local anesthesia and sedation, Group-II (n:8) was given combined spinal and epidural anesthesia. Intraoperative and postoperative hemodynamic parameters were reviewed and analyzed. The demographic data of the two groups ressembled each other. Results: The complication rate was calculated at an average of 6.25%, which was considered insignifcant (p>0.05). There was no signifcant difference between the duration of hospital and intensive care unit stay for the two groups (p>0.05). Conclusion: Combined spinal and epidural anesthesia requires much more experience, but it is safer than local anesthesia and sedation for endovascular aneurism patients.Öğe Combined suprascapular nerve block and axillary nerve block approach vs. peri-articular infiltration analgesia for postoperative pain management following arthroscopic shoulder surgery: a randomized clinical trial(Verduci Publisher, 2022) Şahin, Ayhan; Baran, Onur; Çetin, Mehmet Ümit; Gültekin, Ahmet; Arar, Makbule Cavidan- OBJECTIVE: Postoperative pain following shoulder surgery is a devastating sit-uation. Several approaches, including region-al nerve blocks such as combined supras-capular nerve block and axillary nerve block (SSNB+ANB) and peri-articular infiltration (PÖğe Effect of waist circumference and body mass index on the level of spinal anesthesia(Springer, 2022) Gunkaya, Mustafa; Arar, Makbule Cavidan; Mordeniz, Cengiz; Baran, Onur; Topçu, BirolBackground: We aimed to determine the effects of waist circumference and body mass index on spinal anesthesia levels. In total, 120 surgical patients who were between 18 and 65 years old and in the American Society of Anesthesiologists' (ASA) I-III risk groups enrolled in this study. Patients were classified into three groups, depending on their weight. After a spinal block, we noted the time needed for the sensory block to reach the T10 level, the maximum sensory block level, the time needed for the sensory block to reach the maximum sensory block level, the time needed before the start of the motor block, and the Bromage scale for each patient. Results: We observed no significant demographic differences in age, gender, or ASA risk class between the groups; however, we found a statistically significant difference between the groups' BMIs and waist circumferences. For the time needed for the spinal block to reach the T10 level, we observed a statistically significant difference between groups I, II, and III, and we also found a statistically significant difference between the groups' comparing Bromage scales. Moreover, we found a statistically significant difference between the groups' time needed (in minutes) for the block to reach the maximal upper dermatomal block level and, as BMIs and waist circumferences increased, the time needed to reach the maximal upper dermatomal block level. We also noted a statistically significant difference in waist circumference variability. Conclusions: This study shows that body mass index and waist circumference can be used and interpreted as independent parameters reflecting the increasing incidence of obesity.Öğe Endovasküler abdominal aortik anevrizma tamirlerinde erken dönem sonuçları (6 aylık takip)(2013) Gür, Özcan; Gürkan, Selami; Özkaramanlı Gür, Demet; Arar, Makbule Cavidan; Ege, TuranAmaç: Abdominal aort anevrizması, açık cerrahi teknikler ile tedavi edilebildiği gibi endovasküler olarak da tamir edilebilmektedir. Çalışmamızda, endovasküler aort tamiri yapılan olguların 6 aylık erken dönem sonuçlarını sunmayı amaçladık. Gereç ve Yöntemler: Kliniğimizde 2010-2012 mayıs tarihleri arasında endovasküler aort anevrizma tamiri yapılan 18 hasta çalışmaya alındı. Olgular işlem sonrası 1. ve 6. ay kontrollerine çağrılarak endoleak açısından değerlendirildi. Olguların komorbidite sebeplerine bakıldığında %38,9u diyabetik (n:7), %77,8 hipertansif (n:14), %55.6 kronik obstruktif akciğer hastalığı (n:10), %16,7 malignite (n:3), %22,2si koroner arter hastalığı (n:4), 1 olguda ise peritonit sebebiyle geçirilmiş batın cerrahisi mevcuttu. Bulgular: Olguların 4ü kadın, 14ü erkek toplam 18 hastaya endovasküler aort tamiri (EVAR) işlemi uygulandı. Hastaların yaş ortalaması 72,77±6,54 (min:62, max:82) olarak saptandı. Olguların 6 aylık takibinde mortalite gözlenmezken 1 olguda endoleak saptandı. Sonuç: EVAR işlemi açık cerrahi için yüksek riskli olgularda (ileri yaş, komorbidite varlığı, geçirilmiş batın cerrahisi) düşük mortalite ve morbidite oranları ile güvenli bir biçimde uygulanabilir. Daha kesin sonuçlar için uzun dönem takiplere ihtiyaç duyulmaktadır.Öğe Epicardial Lead Implantation for Failure of Transvenous Left Ventricular Lead Implantation in Patient with Dextrocardia(Elsevier Ireland Ltd, 2013) Gür, Özcan; Gürkan, Selami; Özkaramanlı Gür, Demet; Akkoyun, Dursun Çayan; Arar, Makbule Cavidan[No Abstract Available]Öğe Erector spinae plane block in laparoscopic cholecystectomy: a case report(Springer, 2020) Baran, Onur; Kir, Bünyamin; Şahin, Ayhan; Arar, Makbule CavidanBackground Ultrasound-guided erector spinae plane block has been reported to reduce postoperative pain following a laparoscopic surgery, which is one of the most common abdominal surgeries. The case reports and randomized controlled trials published previously mostly used bilateral erector spinae plane block; however, we report a case in which a unilateral erector spinae plane block was performed. Case presentation A 34-year-old male patient who underwent laparoscopic cholecystectomy was scheduled for a unilateral erector spinae plane block. The block was performed preoperatively, followed by the induction of general anesthesia. Conclusions The patient was comfortable and had a visual analog scale score of 2 for 12 h. Thus, we report successful pain management with the unilateral erector spinae plane block; however, more studies are needed for conclusive information.Öğe Level Iv Renal Cell Carcinoma Detected During Cabg: A Case Report(Elsevier Ireland Ltd, 2013) Gürkan, Selami; Gür, Özcan; Akyuz, A.; Arar, Makbule Cavidan[No Abstract Available]Öğe Mantar Zehirlenmelerinde Silibinin ile Başarılı Tedavisi: Olgu Sunumu(Galenos Yayincilik, 2019) Yıldırım, İlker; Şahin, Ayhan; Baran, Onur; Arar, Makbule Cavidan; Sarıkaya, Hatice GülAlthough up to 100 of them known to be toxic, there are more than 5,000 mushroom species in the world. Of these, the most poisonous species belong to Amanita and Gallerina species. Alpha- and beta-amanita toxins which are associated with serious liver, kidney and central nervous system damage is produced by Amanita phalloides which is responsible for 90% of fatal mushroom poisoning in Turkey. Two cases that we aimed to present are two male patients aged 55 and 42 who collected and consumed mushrooms in the forest. The patients were admitted to the county state hospital with complaints of nausea, vomiting, diarrhea and fatigue after 18 and 24 hours. Patients with increased liver function tests were referred to our hospital for further examination and treatment, and they were discharged after successful treatment in our intensive care unit.Öğe Opinions of Operating Room and Surgical Ward Staff Toward Surgical Safety Checklist(2020) Önler, Ebru; Yıldız, Tülin; Arar, Makbule Cavidan; Horozoğlu, Fatih; Nair, FatmaAim: This research is aimed at evaluating operating room and surgical ward staff’s opinions regarding the WHO surgical safety checklist. Materials and Methods: The questionnaire includes questions about gender, age, job role, and years of experience. Every item on the checklist was evaluated, and responders were permitted to provide freehand comments on the subject. The researchers visited a hospital and collected data from December 2017 - January 2018. The sample population includes 27 surgeons, 34 anaesthetists, and 19 operating room and 38 surgical ward nurses at a university hospital in western Turkey. The collected data were analysed using SPSS 18.0 with frequencies, percentages, mean, and standard deviation. Results: Of the sample population 61% were women, 47% were under 30 years old, and 83.1% had over 1 year of job experience. The mean score of item importance varied from 4.25 to 4.79. The items “patient's identity, procedure, operation site verification” (4.79±0.50) and “preoperative fasting” (4.76±0.53) had the highest scores. “Blood glucose control” (4.25±1.08) and “team members introduced” (4.32±0.53) had the lowest scores. It was suggested that “allergy” and “prophylaxis of antibiotic and deep vein thrombosis” be transferred to the “before the patients leave the ward” section. It was also suggested to add a compact checklist for local and emergency surgeries and employ artificial intelligence, like chatbots, to prevent surgery from starting before the checklist is completed. Conclusion: All checklist items were considered necessary. However, “Patient’s identity, procedure and site verification” was perceived as the most important item on the checklist. It was also suggested to add a compact checklist for local and emergency surgeries.Öğe Perioperative Considerations in Urgent Surgical Care and Operating Room Practice and Guidance During COVID-19 Pandemic; Our Experiences(2020) Şahin, Ayhan; Gültekin, Ahmet; Yıldırım, İlker; Mordeniz, Cengiz; Arar, Makbule CavidanAim: The novel coronavirus SARS-CoV-2 (COVID-19) can infect healthcare workers. We developed an institutional algorithm to protect operating room team members during the COVID-19 pandemic and rationally conserve personal protective equipment (PPE). We aimed to review the latest data on the COVID-19 pandemic and essential information for practice in emergency surgery and the operating room.Materials and Methods: An interventional platform (operating room, interventional suite, and endoscopy) with our committee formed with our doctors consisting of different branches, we developed our guidelines based on potential patterns of spread, risk of exposure, and conservation of PPE. We aimed to share our experiences with 128 patients who were taken into operation in a 2-month period.Anesthetic management and infection control guidelines for emergency procedures for patients with suspected 2019-nCoV were drafted and applied in Medical Faculty of Namık Kemal University.Results: A decision tree algorithm describing our institutional guidelines for precautions for operating room team members was created. This algorithm is based on the urgency of operation, anticipated viral burden at the surgical site, the opportunity for a procedure to aerosolize virus, and the likelihood a patient could be infected based on symptoms and testing.Conclusion: Despite COVID-19 being a new threat, we have shown that by developing an easy-to-follow decision algorithm for the interventional platform teams, we can ensure optimal healthcare worker safety.Öğe Pre-emptive analgesia with preoperative oral gabapentin and pregabalin in lumbar narrow canal surgery(Pharmamed Mado Ltd, 2024) Mordeniz, Cengiz; Ozdemir, Fatma; Karaarslan, Numan; Yıldırım, Ilker; Demirkapu, Mahluga Jafarova; Arar, Makbule CavidanThe success of pre-emption depends on the strategy pertaining to the choice of agent and when and how, to use. This study was aimed to evaluate the efficacy of preemptive analgesia regarding the postoperative pain management in lumbar spinal stenosis surgery. The oral gabapentin 800 mg or pregabalin 225 mg or placebo were administered 1 h before surgery. The pain and sedation scores were measured through Visual Analogue Scale (VAS) and Ramsay Sedation Scale (RSS). Three groups of 30 patients each were included in the study. Group 1 was administered with gabapentin 800 mg, Group 2 with pregabalin 225 mg, and Group 3 with placebo 1 hour before the surgery. VAS scores at the 1st, 2nd, 4th, 6th, 8th, 10th, 12th, 14th, 16th, 18th, 20th, 22nd and 24th hours of surgery, and RSS scores and analgesic drug usage in the 1st to 24 hours of surgery were recorded. There were statistically significant differences between the 1st, 2nd and 4th hour VAS score averages. RSS scores changed among the three groups in postoperative period. The total analgesics employed in gabapentin and pregabalin groups were lower than those in placebo group. Pre-emptive analgesia of oral pregabalin or gabapentin minimized the postoperative pain in patients undergoing lumbar stenosis surgery. © 2024 The Author(s).Öğe Predictive Values of Inflammation Indexes in Predicting Mortality in Patients with COVID 19 Hospitalized in General Intensive Care Unit(2022) Engin, Mesut; Yıldırım, İlker; Arar, Makbule Cavidan; Amaç, Bişar; Alpsoy, Şeref; Aydın, Cihan; Gültekin, AhmetObjective: Causing a global pandemic, the coronavirus disease 2019 (COVID-19) has caused millions of people to become infected and many more to die. In this study we aimed to investigate whether routinely evaluated clinical and laboratory values ??can predict the mortality of patients with COVID-19 disease.Materials and Methods: In our study, routine laboratory parameters of 89 patients hospitalized in the general intensive care unit with the diagnosis of COVID 19 were retrospectively analyzed. The aggregate index of systemic inflammation (AISI) and other inflamatuar values were calculated from blood tests in patients with positive COVID-19 polymerase chain reaction test and with ground-glass opacity on lung tomography. Patients were divided into two groups as those who died (non-survivors) and those who were discharged (survivors)during the intensive care follow-ups. Results: In our study, in 48 patients who died during follow-up, the indexes of AISI, other inflamatuar paramaters and the biochemical parameters such as troponin I, d-dimer, ferritin and procalcitonin were significantly higher than in discharged patients. Hypertension and higher AISI and ferritin levels were statistically associated with reduced survival in Cox regression analysis (Hazard ration (HR): 3.176; 95% Confident interval (CI): 1.122-8.991, p=0.03, HR: 1.114; 95% CI: 1.060-1.348, p=0.042, HR=1.072;95% CI: 1.014-1.242, p=0.011, respectively.Conclusion: Inflammation indexes derived from blood tests and acute phase reactants such as ferritin can guide us in planning the treatment strategy and risk stratification in patients with COVID-19 in intensive care follow-ups.Öğe Serratus anterior plane block for tertiary revision rhinoplasty with rib cartilage harvest(Elsevier Science Inc, 2021) Şahin, Ayhan; Baran, Onur; Gültekin, Ahmet; Yıldırım, İlker; Arar, Makbule Cavidan; Günkaya, Mustafa[No Abstract Available]Öğe Sol Ön İnen Koroner Arter Anevrizması, Nadir Gözlenen Bir Olgu(2013) Gür, Özcan; Gürkan, Selami; Özkaramanlı Gür, Demet; Alpsoy, Şeref; Arar, Makbule CavidanSol ön inen koroner arter anevrizması nadir gözlenen bir koroner anomalidir. Bu yazıda efor anjinası sebebiyle koroner anjiyografi yapılan ve sol ön inen koroner arter anevrizması saptanan 72 yaşında erkek olguyu sunmayı amaçladık.Öğe Successful Replacement of Mitral Valve in a Patient with Antiphospholipid Syndrome(2016) Gürkan, Selami; Gür, Özcan; Gür Özkaramanlı, Demet; Arar, Makbule Cavidan; Ege, TuranElli bir yaşında mitral yetmezlik tanısı ile cerrahi tedavi için yatırılan bir hastayı sunduk. Dört yıl önce primer antifosfolipid tanısı almış ve trombositopeni hikayesi mevcut. Postoperatif titiz antikoagülan tedavi ile mitral kapak başarılı bir şekilde replase edildi ve postoperatif dönem olaysız geçti. Antifosfolipid sendromlu hastalarda kardiyak cerrahide yüksek mortalite ve morbidite oranları bildirilmiştir. Postoperatif dönemde hemen antikoagülan tedavinin başlanması trombozun önlenmesi açısından çok önemlidir.Öğe The Clinical Outcomes of Ultrasonography Usage in Percutaneous Dilatational Tracheostomy in the Intensive Care Unit(Galenos Publ House, 2023) Baran, Onur; Sahin, Ayhan; Arar, Makbule CavidanAim: Preprocedural ultrasonographic examination of the upper airway anatomy is an effective method for deciding on a tracheostomy procedure, such as percutaneous or surgical tracheostomy. We aimed to compare the effects of superficial cervical plexus block (CPB) with translaryngeal block with those of local anesthesia infiltration to the incision site for percutaneous tracheostomy in terms of hemodynamic parameters, gag reflex, and anesthetic requirement. In addition, we evaluated the effect of preprocedural ultrasonography assessment compared with that of anatomical landmark examination in terms of reducing the risk of procedure -related complications. Materials and Methods: A total of 148 patients aged at the range of 18-99 years, who were indicated for percutaneous tracheostomy in the intensive care unit, were enrolled in the study. The data intended for this study were obtained from the hospital's electronic patient database through retrospective scanning between 2018 and 2022. Patients who underwent ultrasonography for the evaluation of the related anatomical structures and superficial CPB with a translaryngeal block were assigned to the ultrasonography group (n=74), whereas those who underwent an anatomical landmark technique and local anesthetic infiltration to the procedure site were assigned to the traditional group (n=74). Results: The patients' age and sex distributions did not differ significantly between the traditional and ultrasonography groups (p>0.05). In the ultrasonography group, the preprocedural, midprocedural, and postprocedural heart rates were significantly higher than in the traditional group (p<0.05). In the ultrasonography group, the mean preprocedural arterial pressure decreased significantly during and after the procedure (p<0.05). The mean arterial pressure decreased during the procedure and the postprocedural arterial pressure was significantly higher (p<0.05) in the ultrasonography group than in the traditional group. Conclusion: Although ultrasonography-guided percutaneous tracheostomy takes more time to perform than traditional anatomical landmark percutaneous tracheostomy, we claim that the procedure is much safer and provides better clinical outcomes.Öğe The Effect of Pulsatile and Non-Pulsatile Extra Corporeal Perfusion on Cerebral Oxygen Saturation in Cardiopulmonary Bypass Patients (Flow Type on Cerebral Oxygenation)(2019) Şahin, Ayhan; Yıldırım, İlker; Baran, Onur; Günkaya, Mustafa; Arar, Makbule Cavidan; Güneri, ErcanAim:The flow type generated by a heart-lung machine is important in cardiopulmonary bypass. The use of pulsatile flow versus non- pulsatile flow during cardiopulmonary bypass has been a controversy among clinicians. We compared the effect of non- pulsatile and pulsatile flow during cardiopulmonary bypass on cerebral oxygenation.Materials and Methods:Weconducted a retrospective study of 50 adult patients who underwent coronary artery bypass graft surgery at our university hospital, with near infrared spectroscopy used to compare differences in cerebral oxygenation between the pulsatile and non-pulsatile flow type.Results:There was no difference between the effect of pulsatile and non-pulsatile flow on the saturation of hemoglobin (SpO2), nor on the partial pressure of oxygen (pO2) and carbon dioxide (pCO2). The near infrared spectroscopy results were not different between the two flowtypes.Conclusion:There was no effect of the flow type generated by a heart-lung machine (pulsatile or non-pulsatile) on cerebral oxygenation in adult patients.
