Hızır KAZDAL, Şule BATÇIK, Leyla KAZANCIOĞLU, İlkay BAHÇECİ, Remzi Adnan AKDOĞAN

Gastroskopik girişimlerde sedoanaljezi uygulanan anemik hastalarda entegre pulmoner indeks ve solunum komplikasyonlarındaki değeri

Endoskopik prosedürlerde sedoanaljeziye bağlı komplikasyonlar morbiditenin önde gelen nedenlerindendir. Dolaşım, solunum fonksiyonu ve ventilasyonun izlenmesi önemlidir. Entegre pulmoner indeks, periferik oksijen satürasyonu, end-tidal karbondioksit konsantrasyonu, solunum sayısı ve kalp hızı değerlerinin eş zamanlı ortak analiziyle elde edilen bir parametredir. Entegre pulmoner indeks tek değer vererek iyi bir monitörizasyon ve takip yapmamızı sağlar. Çalışmamızda anemik hastalarda sedoanaljezi ile yapılan gastroskopik girişimlerde entegre pulmoner indeks skorlarınının tespiti ile meydana gelebilecek solunumsal komplikasyonların takibindeki önemini incelemeyi amaçladık. Gereç ve Yöntem: Gastroskopi girişimlerinde sedoanaljezi uygulanan hastalar iki gruba ayrıldı: Grup I (n: 155) anemisi bulunan, Grup II (n: 158) anemisi bulunmayan hastalar. Hastalara ait demografik veriler ile işlem öncesi bazal 0., 5. ve 10. dakika ortalama arteriyal kan basıncı, kalp hızı, periferik oksijen satürasyonu, solunum sayısı, end-tidal karbondioksit konsantrasyonu, entegre pulmoner indeks değerleri tespit edildi. Takip edilen bu parametreler üzerinden solunumsal komplikasyonlar belirlenerek iki grup karşılaştırıldı. Bulgular: Cinsiyet açısından 313 hastanın %49’u erkek, %51’i kadın olup yaş ortalaması 53±16.5’di. Gruplar arasında 0., 5. ve 10. dakikalar için entegre pulmoner indeks skoru, periferik oksijen satürasyonu, solunum sayısı, end-tidal karbondioksit konsantrasyonu ve ortalama arteriyal kan basıncı açısından anlamlı fark yoktu (p >0.05). Grup II için, kalp hızı tüm ölçüm zamanlarında Grup I’den yüksek bulundu (p 0.05). Sonuç: Gastroskopik girişimlerin sedoanaljezi uygulamalarında, anemi solunumsal komplikasyonların ortaya çıkması açısından önemli bir sorun oluşturmamıştır. Entegre pulmoner indeks monitörizasyonunun, gastroskopi girişimlerinde sedoanaljezi uygulanan anemik ve anemik olmayan hastalarda doğru ve güvenli bir monitörizasyon tekniği olduğu kanaatindeyiz.

Integrated pulmonary index and its value in respiratory complications in anemic patients undergoing sedoanalgesia in gastroscopic interventions

Complications due to sedoanalgesia are the leading cause of morbidity in endoscopic procedures. Thus, monitoring of circulation, respiratory function, and ventilation is important. integrated pulmonary index offers good monitoring and follow-up by providing the only value obtained by simultaneous joint analysis of peripheral oxygen saturation, end-tidal carbon dioxide concentration, and respiratory and heart rate values. The objective was to analyze the integrated pulmonary index score and its place in the follow-up of respiratory complications that may occur in anemic patients undergoing sedoanalgesia during gastroscopic procedures. Materials and Methods: Patients who underwent sedoanalgesia during gastroscopic procedures were divided into two groups: Group I (n: 155) with anemia and Group II (n: 158) without anemia. Based on the demographic data of the mean arterial blood pressure, heart rate, peripheral oxygen saturation, respiratory rate, and end-tidal carbon dioxide concentration of the patients, the integrated pulmonary index values were determined at the beginning and the 5th and 10th minutes of the procedure. Moreover, respiratory complications in both groups were compared using these parameters. Results: In this study, 49% of 313 patients were male, 51% of female and the mean age was 53±16.5. There was no substantial difference between the groups with respect to the integrated pulmonary index score, peripheral oxygen saturation, respiratory rate, end-tidal carbon dioxide concentration, and mean arterial blood pressure at the beginning and the 5th and 10th minutes of the procedure (p >0.05). In Group II, the heart rate was found to be higher than in Group I in all time frames (p 0.05). Conclusion: In sedoanalgesia applications of gastroscopic interventions, anemia did not pose a major problem in the emergence of respiratory complications. Integrated pulmonary index monitoring is known to be an accurate and safe monitoring technique in anemic and non-anemic patients undergoing sedoanalgesia in gastroscopic procedures.

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