HASTANE ÖNCESİ YAKLAŞIMI ETKİLEYEN BİR PARAMETRE: KAPİLLER LAKTAT ÖLÇÜMÜ

Laktat, genellikle anaerobik metabolizmanın yan ürünü olarak hipoperfüzyon durumlarında yükselen ve doku hipoksisini belirlemede kullanılan önemli bir parametredir. Günümüzde sağlık hizmeti veren kurumlarda özellikle de acil servislerde hastalardaki laktat düzeyinin belirlenmesi büyük önem taşımaktadır. Çünkü laktat seviyesindeki artış mortalite ve morbidite hakkında bilgi vermekte bu nedenle hastalara olan acil yaklaşımı önemli ölçüde etkilemektedir. Laktat seviyesi ölçümü hastane ortamında venöz veya arteriyel yapılmaktadır. Son yıllarda ise laktat seviyesini ölçmek basit ve hızlı bir hale gelmiştir. Portatif cihazlar ile parmak ucu kapiller laktat ölçümü yapılabilmektedir. Özel beceri gerektirmeden hastane öncesinde de laktat değerini belirlemeye olanak sağlayan portatif kompakt laktat analizörleri geliştirilmiştir. Bu analizörlerin hastane öncesi kritik durumdaki hastaların hızlı tespit edilmesine ve sağlık profesyonellerine triyajda doğru karar almalarına yol gösterici olabileceği bildirilmektedir. Ülkemizde henüz acil yardım ambulanslarında bu cihazlar kullanılmamaktadır. Yurt dışında ise portatif kompakt laktat analizörlerinin ambulanslarda bulunmasının ve laktatın uyarıcı ve yönlendirici bir biyobelirteç olarak kabul edilmesinin önemi vurgulanmaktadır.

Anahtar Kelimeler:

acil servis, ambulans, biyobelirteç, hastane öncesi, laktik asit

A PARAMETER AFFECTING THE PRE-HOSPITAL APPROACH: CAPILLARY LACTATE MEASUREMENT

Lactate is an important parameter that is used to determine tissue hypoxia, which is usually elevated in hypoperfusion situations as a product by anaerobic metabolism. Today, it is of great importance to determine the lactate level of patients in healthcare institutions, especially in emergency services. The increase in lactate level gives information about mortality and morbidity, therefore it significantly affects the emergency approach to patients. The measurement of lactate level is done venous or arterial in the hospital. In recent years, measuring lactate level has become simple and fast. Fingertip capillary lactate measurement can be made with portable devices. Portable compact lactate analyzers have been developed that allow determining the lactate value even before the hospital without special skills. It is reported that these analyzers can guide the rapid detection of patients in critical condition before the hospital and guide the healthcare professionals to make the right decision in triage. In our country, these devices are not being used in emergency ambulances yet and there is no study on the subject. On the other hand, the importance of having portable compact lactate analyzers in ambulances abroad and accepting lactate as a stimulating and directing biomarker is emphasized.

Keywords:

emergency department, ambulance, biomarker, prehospital, lactic acid,

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