Büşra TEZCAN, Nejla Mendil ERDOĞAN, Özcan ERDEMLİ

Transfüzyon İkileminin Çözümü: Doku Oksijenasyonu ve Kritik Hemoglobin

Anemi hem perioperatif dönemde hem de yoğun bakım hastalarında sık karşılaşılan, mortalite, morbidite, hastanede kalım süreleri ve maliyeti arttıran ciddi bir sağlık sorunudur. İlk kan bankasının kurulduğu 1921 yılından beri sıklıkla transfüzyonla tedavi edilmekteyken transfüzyonun enfeksiyöz ve non enfeksiyöz komplikasyonlarının fark edilmesi, maliyeti arttırıcı etkisinin daha iyi anlaşılmasıyla birlikte gerçek transfüzyon endikasyonları çeşitli klinik durum ve hasta profillerinde sorgulanmaya başlamış ve bu konudaki çalışmalar son yıllarda hızla artmıştır. Akciğerlerle birlikte kardiyovasküler sistem ve özellikle kanın asıl görevi hücrelere aerobik metabolizma aracılığıyla enerji üretebilmeleri için oksijen taşımaktır. Dolayısıyla transfüzyon; ciddi komplikasyonları düşünülerek, perioperatif dönem ve yoğun bakımda anemi nedeniyle doku oksijenasyonu bozuluyorsa uygulanması gereken bir tedavi şekli olmalıdır. Yani doku oksijenasyon bozukluğunun tespiti bu hastalarda transfüzyon ve anemi ikilemini çözecek etkili bir anahtardır. Bu makalede bu ikilemin çözümünde doku oksijenasyonunun önemi, tespiti ve kritik hemoglobin değeri kavramları gözden geçirilecektir

The Solution To The Transfusion Dilemma: Tissue Oxygenation and Critical Hemoglobin

Anemia is a common and serious health problem both among patients undergoing surgery and among those in intensive care units. It is associated with increased patient morbidity and mortality, length of hospital stay and costs. However blood transfusion has been used to treat anemia since the establishment of the first blood donor service in 1921, real transfusion indications are indications are being questioned in various clinical conditions and patient profiles because of the infectious and noninfectious complications and cost increasing effects. Based on this knowledge, studies on this subject have increased rapidly in recent years. The Lungs and particularly the circulatory system are responsible for transporting oxygen to the cells to produce energy through the aerobic metabolism. Therefore, transfusion should be chosen as the treatment modality for decreased tissue oxygenation due to anemia in the perioperative period and intensive care. Determination of the disruption of oxygen supply to the tissues is the key point that may solve the critical dilemma of transfusion and anemia. In this article, the importance and determination of tissue oxygenation in solving this dilemma and the term ‘critical hemoglobin value’ will be reviewed

Keywords:

blood transfusion, tissue oxygenation,

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