Ali İhsan UYSAL, Eylem YAFİAR, SEMRA DEMİRBİLEK

ARTER KAN GAZI VE VENÖZ KAN GAZI KORELASYONUNA APACHE II SKORU VE İNOTROP KULLANIMININ ETKİSİ

Amaç: Kan gazı analizi, solunumsal ve metabolik hastalığı olan, kritik hastaların tedavilerinin yönetiminde önemli birrol oynar. Çalışmadaki amacımız arter ve santral venöz kan gazı analizleri arasındaki ilişkiyi göstermek, bu ilişkiye inotropik ajankullanımının ve APACHE II değerinin etkisinin olup olmadığını ortaya koymaktır. Yöntem: Çalışmaya Yoğun Bakım Ünitesinde mekanik ventilatör desteğiyle takip edilen sepsis tanılı 65 hasta dahil edildi.Tüm hastalardan arteryel ve venöz kan gazları eş zamanlı olarak alındı. Kan gazı analizlerinde pH, pO2, pCO2, HCO3-, laktat veSpO2değerleri, APACHE skoru ve inotropik ajan desteği alıp almadığı kaydedildi.Bulgular: Ortalama arteryel ve venöz pH değerleri arasında korelasyon saptanırken pO2değerleri aralarında korelasyonbulunamadı. Ortalama arteryel ve venöz pCO2arasında korelasyon gösterilemedi. Ancak inotropik ajan ihtiyacı olmadığında,arteryel ve venöz pCO2değerleri arasında istatistiksel olarak anlamlı bir korelasyon saptandı. Ortalama arteryel ve venöz HCO3ve laktat değerleri arasında yüksek korelasyon saptandı. Sonuç: Oksijenizasyonun yakın takip edilmesi gereken hasta gruplarında arter kan gazı altın standart olmaya devam etmektedir.Ancak arter kan örneğinin alınamadığı durumda inotropik ajan ihtiyacı yoksa ve pCO2takibi daha önemliyse venöz kan gazıanalizinin faydalı olabileceğine inanmaktayız.

THE EFFECT OF APACHE II SCORE AND INOTROPIC AGENT ON ARTERIAL AND VENOUS BLOOD GAS ANALYSIS

Objective: Blood gas analysis has an important role in management of critically ill patients with respiratory and metabolicdiseases. In this study, our aim is to show correlation between arterial and venous blood gas analysis and determine effects ofinotropic agent consumption and APACHE II scores on this correlation. Method: Sixty-five patients followed with sepsis in intensive care unit with mechanical ventilation support were conducted inthe study. Ph, pO2, pCO2, HCO3, lactate and SpO2levels of blood gas analysis, APACHE scores and consumption of inotropicagents were recorded. Results: A strong correlation between mean arterial and venous pH levels was detected, whereas correlation for pO2levelscouldn't be found. There was no correlation between mean arterial and venous pCO2levels, but when no need for inotropic agents, astatistically significant correlation could be detected. There was a strong correlation between mean arterial and venous HCO3and lactate levels. Conclusion: Arterial blood gas analysis continues to be gold-standart for patients who need close monitorization of oxygenation. But we believe venous blood gas analysis may be useful in case arterial blood sample can not be provided when there is noneed for inotropic agent and pCO2follow-up is more important.

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