2020 REHBERLERİNE GÖRE TOKSİKOLOJİ VE YAŞAM DESTEĞİ

Kardiyopulmoner resüsitasyon uygulamalarında standart oluşturmak, uygulama farklılıklarını engellemek, kanıta dayalı tıp temelli uygulamaları sağlamak amacıyla farklı alanlardaki dernekler ve eğitim kuruluşlarının bir araya gelerek 2000 yılında başlattıkları ortak resüsitasyon rehberleri her beş yılda bir (2005, 2010 ve 2015 yıllarında) yenilenerek yayınlanmıştır. Bu derleme makalesi 2020 yılı ekim ayında yayınlanan yeni rehberlerde önerilen yetişkin, pediatrik ve yeni doğan ileri kardiyak yaşam desteğindeki başta opioid aşırı dozu olmak üzere intoksikasyon durumlarında önerilen değişiklikleri özetlemek amacıyla hazırlanmıştır.

TOXICOLOGY AND LIFE SUPPORT ACCORDING TO THE 2020 GUIDELINES

In order to set standards in cardiopulmonary resuscitation practices, to prevent differences in practice, and to provide evidence-based medicine-based practices, joint resuscitation guidelines, which were initiated in 2000 by associations and educational institutions in different fields, were renewed and published every five years (in 2005, 2010 and 2015). This review article has been prepared in order to summarize the recommended changes in adult, pediatric and neonatal advanced cardiac life support in intoxication conditions, especially opioid overdose, in the new guidelines published in October 2020.

___

  • 1. Highlights of the 2020 American Heart Association (AHA) Guidelines for CPR and ECC.https://cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf. Erişim: 01.11.2020.
  • 2. Merchant RM, et al. Part 1: Executive Summary: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S337-S357.
  • 3. Panchal AR, et al. Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S366-S468.
  • 4. Topjian AA, et al. Part 4: Pediatric Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S469-S523.
  • 5. Aziz K, et al. Part 5: Neonatal Resuscitation: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2020 Oct 20;142(16_suppl_2):S524-S550.
  • 6. Chandler RK, Villani J, Clarke T, McCance-Katz EF, Volkow ND. Addressing opioid overdose deaths: The vision for the HEALing communities study. Drug Alcohol Depend. 2020 Dec 1; 217: 108329.
  • 7. Scholl L, et al. Drug and opioid-involved overdose deaths—United States, 2013-2017. MMWR Morb Mortal Wkly Rep. 2018;67:1419–1427.
  • 8. Clarke SF, et al. Naloxone in opioid poisoning: walking the tightrope. Emerg Med J. 2005;22:612–616.
  • 9. Zuckerman M, et al. Pitfalls of intranasal naloxone. Prehosp Emerg Care. 2014;18:550–554.
  • 10. Penninga EI, et al. Adverse Events Associated with Flumazenil Treatment for the Management of Suspected Benzodiazepine Intoxication–A Systematic Review with Meta-Analyses of Randomised Trials. Basic Clin Pharmacol Toxicol. 2016;118:37–44.
  • 11. Neal JM, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice advisory on local anesthetic systemic toxicity: executive summary 2017. Reg Anesth Pain Med. 2018;43:113–123.
  • 12. Harrigan RA, et al. ECG abnormalities in tricyclic antidepressant ingestion. Am J Emerg Med. 1999;17:387–393.
  • 13. Bebarta VS, et al. Incidence of Brugada electrocardiographic pattern and outcomes of these patients after intentional tricyclic antidepressant ingestion. Am J Cardiol. 2007;100:656–660.
  • 14. Parker-Cote JL, et al. Challenges in the diagnosis of acute cyanide poisoning. Clin Toxicol (Phila). 2018;56:609–617.
  • 15. Baud FJ, et al. Elevated blood cyanide concentrations in victims of smoke inhalation. N Engl J Med. 1991;325:1761–1766.
  • 16. Baud FJ, et al. Relation between plasma lactate and blood cyanide concentrations in acute cyanide poisoning. BMJ. 1996;312:26–27.