ENGİN ÖZAKIN, Hakan DOLGUN, Ebubekir ARSLAN, NURDAN ACAR, KADİR UĞUR MERT, FİLİZ BALOĞLU KAYA, MUSTAFA EMİN ÇANAKÇI

Kardiyak Arrest Sonrası Spontan Dolaşımı Sağlanan ve Girişimsel Koroner Revaskülarizasyon Yapılan Hastaların Analizi

Çalışmamızın amacı hastanemiz acil servisine kardiyak arrest olarak getirilen ve acil koroner kateterizasyon yapılan hastalardaki mortalite ve morbiditeyi değerlendirmektir. 2011-2014 arası Eskişehir Osmangazi Üniversitesi Tıp Fakültesi acil servisine kardiyak arrest olarak nakli gerçekleştirilen ve kardiyopulmoner resüsitasyon sonrası spontan dolaşım sağlanan ve EKG’lerinde patoloji saptanıp acil kateterizasyona alınan hastalar incelendi. Değerlendirmeye 11’i erkek toplamda 15 hasta alındı. Yaş ortalamaları 57.80 (min:32, maks:85) idi. Hastaların tamamı 112 ambulans servisi ile getirildi. Hastaların ilk geliş EKG ritimlerinde 5’inde ventriküler fibrilasyon, 5’inde nabızsız elektriksel aktivite, 3’ünde asistoli ve 2’sinde nabızsız ventriküler taşikardi saptandı. Acil serviste yapılan KPR süresi ortalama: 18.60 dakika (min:10, maks: 40) idi. Post resüsüitasyon EKG değerlendirmelerinde 10’unda ST segment elevasyonu, 4’ünde ST-T değişiklikleri, 1’inde nodal ritim saptandı. Kapı anjiografi zamanı ortalama 60,73 dakika (min: 27, maks: 110) idi. Tedavileri sonrasında hastaların 9’u taburcu edilirken 6’sı eksitus kabul edildi. Acil serviste kardiyak arrest olarak getirilen, algoritmalara uygun şekilde müdahale edilen ve spontan dolaşım sağlanan hastalarda, acil servis hekimlerinin EKG değerlendirmelerini hızlıca yapmaları gerekir. Anormal EKG bulgusu saptanan hastaların acilen koroner girişimsel tedaviye alınmaları için acil servis ve Kardioloji bölümü ile ortak prtokoller hazırlanması mortalite ve morbiditeyi azaltması açısından önemlidir.

Anahtar Kelimeler:

invaziv koroner revaskülarizasyon, kardiyak arrest

Analysis of Patients Whose Return of Spontaneous Circulation Ensured and İnvasive Coronary Revascularization Performed Following Cardiac Arrest

The aim of this study was to evaluate mortality and morbidity in patients referred to our emergency department with cardiac arrest and whom emergency coronary catheterization was performed. Between 2012-2015, patients who were referred to the emergency department of Eskisehir Osmangazi University Medical Center, Eskisehir, TURKEY with cardiac arrest and on whom emergency catheterization was performed after return of spontaneous circulation following cardiopulmonary resuscitation and with determined pathology on ECG were analyzed. A total of 15 patients (11 males) were included. The average duration of cardiopulmonary resuscitation was 18,60 minutes. Post-resuscitation ECG revealed ST segment elevaiton in 10 patients, ST-T changes in 4 patients, and nodal rhythm in 1 patient. Mean door-to-balloon time was 60,73 minutes (min: 27, max: 110). Following treatment, 9 patients were discharged while the remaining 6 were declared as exitus. Emergency coronary catheterization increases survival in patients who were referred to the emergency department following cardiopulmonary resuscitation. In patients referred to the emergency department with cardiac arest and in whom management is performed in accordance with related algorithms and return of spontaneous circulation, Emergency physicians should evaluate ECG rather quickly. Joint protocols of the Emergency and Cardiology Departments is important in terms of decreased mortality and morbidity for emergency coronary invasive treatment in patients with abnormal ECG findings

Keywords:

invasive coronary revascularization, cardiac arrest,

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