Umut PAYZA, Omay SORGUN, Adnan YAMANOĞLU

HASTANE DIŞI KARDİYAK ARREST İLE ACİL SERVİSE BAŞVURAN HASTALARDA MORTALİTE VE MORBİDİTENİN KAN GAZI PARAMETRELERİYLE BELİRLENMESİ

Giriş: Kardiyopulmoner arrest (KPA), herhangi bir nedenle kişinin solunum ve/veya dolaşımının ani ve beklenmedik bir şekilde durmasıdır. Bu çalışmada hastane dışı KPA ile acil servise başvuran hastalarda morbidite ve mortalitenin kan gazı parametreleriyle belirlenmesinin mümkün olup olmayacağını araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmamız gözlemsel amaçlı, tek merkezli ve retrospektif olup1 Ocak-2018 ile 1 Ocak 2019 tarihleri arasında hastanemiz acil servisine 112 acil sağlık hizmetleri ya da yakınları tarafından getirilen KPA vakaları dahil edildi. Hastaların demografik özellikleri, başvuru şikayetleri, gelişteki kan gazı sonuçları ve YBÜ’nde yatış durumları çalışma formuna kaydedildi. Veriler dijital ortama aktarıldıktan sonra istatistiksel analiz yapıldı. Tüm istatistikler için anlamlılık sınırı p

DETERMINATION OF MORTALITY AND MORBIDITY WITH BLOOD GAS PARAMETERS IN PATIENTS WHO APPLY TO EMERGENCY SERVICE WITH NON-HOSPITAL CARDIAC ARREST

Introduction: Cardiopulmonary arrest (CPA), sudden and unexpected stop of the person's breathing and / or circulation for any reason; cardiopulmonary resuscitation (CPR) is an attempt to restore spontaneous cardiac and / or respiratory functions of these patients. In this study, it was aimed to investigate whether it is possible to determine morbidity and mortality by blood gas parameters in patients admitted to the emergency department with out-of-hospital CPA. Materal and Method: Our study is observational, single-center and retrospective, and CPA cases brought to the emergency department of our hospital by 112 emergency health services or their relatives between 1 January 2018 and 1 January 2019 were included. Demographic characteristics of the patients, complaints on admission, blood gas results on arrival and hospitalization in the ICU were recorded in the study form. Statistical analysis was performed after the data were transferred to digital media. The limit of significance was chosen as p

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1. Winship C, Williams B, Boyle M. Cardiopulmonary resuscitation before defibrillation in the out-of-hospital setting. Emerg Med J 2011; 22.
2. Friedlander ED HJ. Basic Cardiopulmonary Resuscitation. In: Tintinalli JE SJ, Ma OJ, Cline DM, Cybulka RK, Meckler GM, editor. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide.7 ed. 2010; p.63-73.
3. Turedi S, Gunduz A, Mentese A, Dasdibi B, Karahan SC, Sahin A et al. Investigation of the possibility of using ischemiamodified albumin as a novel and early prognostic marker in cardiac arrest patients after cardiopulmonary resuscitation. Resuscitation 2009; 80(9): 994-9.
4. Scolletta S, Donadello K, Santonocito C, Franchi F, Taccone FS. Biomarkers as predictors of outcome after cardiac arrest. Expert Rev Clin Pharmacol 2012; 5(6): 687-99.
5. Shinozaki K, Oda S, Sadahiro T, Nakamura M, Hirayama Y, Abe R et al. S-100B and neuron-specific enolase as predictors of neurological outcome in patients after cardiac arrest and return of spontaneous circulation: a systematic review. Critical Care 2009; 13(4): R121.
6. Calderon LM, Guyette FX, Doshi AA, Callaway CW, Rittenberger JC. Combining NSE and S100B with clinical examination findings to predict survival after resuscitation from cardiac arrest. Resuscitation 2014; 85(8): 1025-9.
7. Callaway CW, Donnino MW, Fink EL, Geocadin RG, Golan E, Kern KB et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015; 132(18 Suppl 2): 465-82.
8. Hare GM, Kavanagh BP, Mazer CD, Hum KM, Kim SY et al. Hypercapnia increases cerebral tissue oxygen tension in anesthetized rats. Canadian Journal of Anaesthesia 2003; 50(10): 1061-8.
9. Hino JK, Short BL, Rais-Bahrami K, Seale WR. Cerebral blood flow and metabolism during and after prolonged hypercapnia in newborn lambs. Critical Care Medicine 2000; 28(10): 3505-10.
10. Zhou Q, Cao B, Niu L, Cui X, Yu H et al. Effects of permissive hypercapnia on transient global cerebral ischemia-reperfusion injury in rats. Anesthesiology 2010; 112(2): 288-97.
11. Nolan JP, Zideman DA, Zideman DA, Biarent D, Bossaert LL, Deakin DC et al. European Resuscitation Council Guidelines for resusitation 2010. Resuscitation 2010; 81:1219-76.
12. Berdowski J, Berg RA, Tijssen JGP, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation 2010; 81(11):1479–87.
13. Bertoia ML, Allison MA, Manson JE, Freiberg MS, Kuller LH, Solomon AJ et al. Risk factors for sudden cardiac death in post-menopausal women. J Am Coll Cardiol 2012; 60(25): 2674–82.
14. Adabag AS, Luepker RV, Roger VL, Gersh BJ. Sudden cardiac death: epidemiology and risk factors. Nat Rev Cardiol 2010; 7(4): 216–25.
15. Kim Y-J, Lee YJ, Ryoo SM, Sohn CH, Ahn S, Seo D-W et al. Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: Medicine (Baltimore). 2016; 95(25): e3960.
16. Sarıaydın T, Çorbacıoğlu ŞK, Çevik Y, Emektar E. Effect of initial lactate level on short-term survival in patients with out-ofhospital cardiac arrest. Turk J Emerg Med 2017; 17(4): 123–7.
17. Dadeh A, Nuanjaroan B. Using initial serum lactate level in the emergency department to predict the sustained return of spontaneous circulation in nontraumatic out-of-hospital cardiac arrest patients. Open Access Emerg Med 2018; 10:105–11.
18. Williams TA, Martin R, Celenza A, Bremner A, Fatovich D, Krause J et al. Use of serum lactate levels to predict survival for patients with out-of-hospital cardiac arrest: A cohort study. Emerg Med Australas 2016; 28(2): 171–8.
19. Umei N, Shingo I, Ujike Y, Yumoto T, Ida A, Hirayama T et al. Predicting the return of spontaneous circulation after out-ofhospital cardiac arrest through blood gas analysis. Intensive Care Med Exp [Internet]. 2015 Oct 1 [cited 2018 Dec 19];3(Suppl 1).
20. Anil M, Kose E, Kose S, Anil AB, Yorukbay Kaplan S, Baris M et al. Early mortality predictors for children receiving advanced life support in emergency department. Turk J Pediatr Emerg Intensive Care Med 2014; 1(1): 17–24.
21. Spindelboeck W, Gemes G, Strasser C, Toescher K, Kores B, Metnitz P et al. Arterial blood gases during and their dynamic changes after cardiopulmonary resuscitation: A prospective clinical study. Resuscitation 2016; 106: 24–9.
22. Fusada T, Shiraishi A, Suzuki T, Fudoji J. Blood gas analysis can poorly predict subsequent recovery of spontaneous circulation in patients with out of hospital cardiac arrest: A retrospective observational study. Resuscitation. 2017; 118: e87.
23. Choi DS, Ro Young Sun, Shin Sang Do. The relationship of serum potassium level and the survival outcomes in out-ofhospital cardiac arrest patients. Circulation 2018; 134(suppl-1): 17601.