Document Detail


The effects on cardiac functions and arterial blood gases of totally occluding nasal packs and nasal packs with airway.
MedLine Citation:
PMID:  20938948     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effects on cardiac functions and blood arterial gases of totally occluding nasal packs and nasal packs with airway.
STUDY DESIGN: Prospective, randomized trial.
METHODS: Thirty-nine adults without any comorbidities underwent septoplasty or septorhinoplasty and had nasal packs placed postoperatively; 19 nasal packs with airways and 20 totally occluding nasal packs. Twenty-four-hour Holter monitorization was done pre- and postoperatively. Arterial blood gas analysis was performed both before the operation and after application of nasal packs.
RESULTS: Application of packs with airway did not cause any significant changes in blood gas parameters. Packing with totally occluding nasal packs caused a significant decrease in HCO(3) and pCO(2), and insignificant changes in pO(2), O(2) saturation, and pH. No serious arrhythmias were observed in any patient. In both groups, nasal packing resulted in a significant increase in minimum heart rates, a significant decrease in maximum heart rates, and insignificant changes in the mean heart rates. Heart rate variability obtained from 24-hour Holter electrocardiography was analyzed by power spectral analysis. An increase in the high-frequency (HF) domain, a decrease in the low-frequency (LF) domain, and a decrease in the LF/HF ratio were observed after packing in both groups.
CONCLUSIONS: Nasal pack-induced cardiac complications may occur due to increased vagal stimuli secondary to nasal mucosa compression rather than obstruction-related hypoxia. The use of nasal packs in the elderly patients with cardiopulmonary disease warrants close observation. Nasals packs with airways should be preferred in patients susceptible to hypoxia.
Authors:
Ehab Zayyan; Ehab Zeyyan; Münir Demir Bajin; Kudret Aytemir; Taner Yılmaz
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2011-01-07     Revised Date:  2011-07-13    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2325-30     Citation Subset:  IM    
Affiliation:
Hacettepe University Department of Otorhinolaryngology, Hacettepe University Hospital, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anoxia / etiology*,  physiopathology
Arrhythmias, Cardiac / etiology,  physiopathology
Blood Gas Analysis
Electrocardiography
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Heart Function Tests
Heart Rate / physiology
Humans
Male
Middle Aged
Nasal Obstruction / physiopathology
Nasal Septum / surgery*
Oxygen / blood*
Postoperative Care / methods
Postoperative Complications / physiopathology
Prospective Studies
Reference Values
Rhinoplasty / adverse effects*,  methods
Risk Assessment
Tampons, Surgical / adverse effects*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Erratum In:
Laryngoscope. 2011 Jun;121(6):1351
Note: Zeyyan, Ehab [corrected to Zayyan, Ehab]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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