Hizir KAZDAL, Şule BATÇIK, Leyla KAZANCIOĞLU, İlkay BAHÇECİ, Remzi AKDOĞAN

Sedasyon Uygulanan Gastroskopik Girişimlerde Aneminin Integrated Pulmonary Index (IPI ) Skoruna Etkisi

Amaç: Endoskopik prosedürlerde sedasyon uygulamalarında çeşitli komplikasyonlar morbiditenin önde gelen nedenidir ve kılavuzlar dolaşım, solunum fonksiyonu ve ventilasyonun sürekli izlenmesini önerir. Bu izlemede kullanılabilen yöntemler den biri olan Integrated Pulmonary Index (IPI), Oksijen satürasyonu, End-tidal karbondioksit konsantrasyonu, solunum sayısı ve kalp hızı değerlerinin sürekli ve eş zamanlı ortak matematiksel analiziyle elde edilen, tek bir rakamsal değer verir ve bu girişimlerde iyi bir monitorizasyon ve takip sağlar. Bu çalışmada gastroskopi girişimlerinde sedasyon uygulanan anemik hastalarda IPI’nın solunumsal komplikasyonların tanı ve takibindeki yerini belirlemeyi amaçladık. Gereç ve Yöntem: Gastroskopi girişimi için sedasyon uygulanan hastalar çalışma için iki gruba ayrıldı. Anemisi bulunan hastalar 1. Grup (n:155 ) olarak, anemisi bulunmayan hastalar 2. Grup (n:158- kontrol grubu ) belirlendi. Hastaların yaş, cinsiyet, BMI, ASA fiziksel durum sınıflaması, yandaş hastalıkları, kullanılan ilaç dozları ile işlem öncesi bazal(0) ve 5. ,10. dakika ortalama arteryal kan basıncı(OAB), kalp hızı, SpO2, solunum sayısı, EtCO2, IPI değerleri tespit edildi. Takip edilen bu parametreler üzerinden solunumsal komplikasyonlar belirlenerek iki grup karşılaştırıldı. Bulgular: Çalışmaya alınan 313 hastanın % 49’u erkek olup yaş ortalaması 53±16.5 idi. İki grup arasında 0,5 ve 10. dk’lar için IPI skoru, IPI skorunu oluşturan diğer bileşenler ( SpO2, solunum hızı ve EtCO2) ve OAB açısından anlamlı fark yoktu (p>0.05).Ancak 2. Grup hastaların, kalp hızı tüm ölçüm zamanları için 1.gruptan daha yüksek bulundu (p0.05). Sonuç: Gastroskopik girişimlerde sedasyon uygulamalarında anemi, solunumsal komplikasyonların ortaya çıkması açısından bir risk oluşturmamaktadır. IPI monitorizasyonu, Gastroskopi girişimlerinde sedasyon uygulanan anemik hastalarda, anemisi olmayan diğer hastalar gibi doğru ve güvenli bir monitorizasyonla hastaların takibini sağlamaktadır.

Anahtar Kelimeler:

Anemi, gastroskopi, IPI (ıntegrated pulmonary ındex)

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