Pınar ÜNVERİR, Özgür KARCIOĞLU, Cüneyt AYRIK

Ani kalp durmasında ileri kardiyovasküler yaşam desteği ilaçlarının kullanımı

Ani kalp durması tüm dünyada her yıl birkaç milyon insanın ölümüne neden olan bir sendromdur. Bu olguların çoğunda koroner arter hastalığı bulunur. Kardiyak arrest ile acil servise getirilen hastaların yaklaşık %70’inde ilk kaydedilen ritm ventriküler fibrilasyondur (VF). Daha az oranda nabızsız elektriksel aktivite (pulseless electrical activity, PEA), bradiaritmiler, asistoli ve ventriküler taşikardi (VT) ilk ritmler olarak belgelenir. Ani kalp durması durumunda olan hastaların, ileri kardiyovasküler yaşam desteği (Advanced Cardiovascular Life Support, ACLS) kılavuzuna göre ilk değerlendirme ve yönetimlerinin yapılması gerekir. Ani kalp durması olan olgularda ilaçların uygun endikasyon ve uygun dozda kullanılmasına özen gösterilmelidir. Hekimler morbidite ve mortalitenin azaltılmasında her bir ilacın etki mekanizması, endikasyonu, dozu ve dikkat edilmesi gereken bazı noktaları iyi bilmelidirler. Bu sayede daha fazla hastada spontan dolaşımın geri dönmesi sağlanabilir. Bu derleme acil servis ortamında major kardiyak durumu olan hastaların resüsitasyonunda yararlı olan ilaçların özelliklerini anlatmaktadır.

Anahtar Kelimeler:

Kardiyopulmoner canlandırma, Yaşam tarzı, Canlandırma, Ölüm, ani, kardiyak

Usage of the advanced cardiovascular life support drugs in sudden cardiac

Sudden cardiac death (SCD) is an entity which causes a few million deaths per se all over the world each year. Many patients with SCD are already known to harbor coronary heart disease. The initial recorded rhythm in these patients is ventricular fibrillation in 70%, and the remaining entities are pulseless electrical activity, bradyarrhythmias, asystole and ventricular tachycardia. Initial evaluation and management of patients with SCD should proceed in accordance with Advanced Cardiovas¬cular Life Support (ACLS) principles. Usage of the drugs should be based on appropriate indication and dosage in patients with SCD. The physician should master the mechanisms of action, indications, dose and precautions of each drug in order to decrease morbidity and mortality. This paper reviews main properties of some essential agents utilized in resuscitation of major cardiac events in the emergency setting.

Keywords:

Cardiopulmonary Resuscitation, Life Style, Resuscitation, Death, Sudden, Cardiac,

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