Mithat KAHRAMANOĞLU, Mehmet Akif YAŞAR, İsmail DEMİREL, Kürşat GÜL, Ayşe Belin ÖZER

Weaning Başarısızlığının Göstergesi Olarak Yüksek Serum C Reaktif Protein Düzeyi

Giriş: Weaning, yoğun bakımdaki hastada mekanik desteğin azaltılması ve solunum işinin hastaya bırakılması sürecidir. Weaningde uygulama şekli ve zamanı önemlidir. Weaningde solunumsal parametreler kadar biyokimyasal testler de önemlidir. C-Reaktif Protein (CRP) inflamasyonda artış gösteren bir akut faz reaktanıdır. Bu çalışma, weaning başarısında CRP düzeyinin yeni bir parametre olarak kullanılıp kullanılmayacağını göstermek amacıyla planlandı. Gereç ve Yöntem: Çalışmamız Fırat Üniversitesi Anesteziyoloji ve Reanimasyon AD Yoğun Bakım Ünitesi (AYBÜ)'nde Haziran 2005 - Ocak 2006 tarihleri arasında yatan hastalarda yapıldı. PEEP=5, FiO2: 0.4, f/Vt

Anahtar Kelimeler:

Weaning, C-reaktif protein

High Serum C-reactive Protein Level as a Indicator of the Weaning Failure

Objectives: Weaning is the period in which mechanic support in the intensive care unit is diminished and respiratory work is completely maintained by the patient. CRP is an acute phase reactant that increases in inflammation. Proper time and application way is important for the weaning. Biochemical tests are important as respiratory parameters at the weaning too. This study was planned to show whether the level of CRP can be used as a new parameter in the success of weaning. Material and Methods: This study was performed on patients hospitalized in Intensive Care Unit (ICU) between June 2005 and January in Firat University Department of Anesthesiology and Reanimation. 54 patients included weaning protocol who meeting PEEP=5, FIO2:0.4, f/Vt

Keywords:

-,

PDF

___

Walsh TS, Dodds S, McArdle F. Evaluation of simple criteria to predict successful weaning from mechanical ventilation in intensive care patients. Br J Anaesth. 2004; 92: 793-799.
Alia I, Esteban A. Weaning from prolonged mechanical ventilation. Crit Care. 2000; 4: 72-80.
Scheinhorn DJ, Chao DC. Post-ICU mechanical ventilation: treatment of 1,123 patients at a regional weaning center. Chest 1997; 111; 1654-1659.
Cano NJ, Pichard C, Roth H. C-Reactive Protein and Body Mass Index Predict Outcome in End-Stage Respiratory Failure. Chest 2004 Aug; 126: 540-546.
Kılıçturgay K. İmmünolojiye Giriş. Yargıçoğlu Basımevi, 1987: 84-85
Doç. Dr. Alper Kararmaz. Weaning. 13. Ulusal Yoğun Bakım Kongresi Kitapçığı, 170-171.
Pressac M, Vignoli L, Aymerd P, Ingenbleek Y.Usefulness of a prognostic inflammatory and nutritional index in pediatric clinical practice.Clin Chim Acta.1990 Apr 30; 188: 129-136.
Vehe KL, Brown RO, Kuhl DA at al. The prognostic inflammatory and nutritional index in traumatized patients receiving enteral nutritional support. J Am Coll Nutr 1991; 10: 355-363
Afessa B, Hogans L, Murph R. Predicting 3-day and 7 day outcomes of ‘weaning’ from mechanical ventilation. Chest 1999; 116: 456-461.
Maclntyre NR. Respiratory factors in weaning from mechanical ventilatory support. Respir Care 1995; 40: 244-248.
Suzana M. A. Lobo, Francisco R. C- Reactive Protein Levels Correlate With Mortality and Organ Failure in Critically Ill Patients. Chest. 2003; 123; 2043-2049.
Hall JB, Wood LDH. Liberation of the patient from mechanical ventilation. JAMA 1987; 257: 1621-1628.
Maclntyre NR. Evidence-based ventilatory weaning and discontinuation. Respir Care 2004; 49: 830-836.
Yang K, Tobin MJ, A Prospective study of indexes predicting the outcome of trials of trials from mechanical ventilation. N Engl J Med 1991; 324: 1445-1450.
Mariusz JA, Brant Rollin. Nonrespiratory predictor of mechanical ventilation dependency in intensive care unit patients. Critical Care Medicine 1996; 24: 601-607.
Schlossmacher P, Hasselmann M, Meyer N. The prognostic value of nutritional and inflammatory indices in critically ill patients with acute respiratory failure. Clin Chem Lab Med. 2002 Dec; 40: 1339-1343.
Dikmen Y. Ventilatörden Ayırma (Weaning). Yoğun Bakım Derneği Dergisi, Cilt: 68-72
Vallverdu I, Mancebo J. Approach to patients who fail initial weaning trials. Respir Care Clin N Am. 2000; 6: 365-384.
Kabul Tarihi: 29.09.2006