ANESTEZİ DOKTORLARININ PEROPERATİF END-TİDAL KARBONDİOKSİT MONİTÖRİZASYON UYGULAMALARI

AmaçKapnografi ile ekspiryum havasında karbondioksit ölçümü yapılmakta, solunum, dolaşım, ventilasyon, metabolizma değerlendirmesinde hayati önem taşımaktadır. Ancak bu monitörizasyon yöntemi yeteri kadar etkin kullanılmamaktadır. Bu anket çalışması ile anestezi doktorlarının peroperatif dönemde yapılan Endtidal karbondioksit (ETCO2 ) monitörizasyonu hakkında bilgi, deneyim, görüşlerinin sorgulanması amaçlanmıştır.Gereç ve YöntemBakırköy Dr. Sadi Konuk, Taksim Gazi Osmanpaşa, Sultan Abdülhamid Han Eğitim ve Araştırma Hastanesi anestezi kliniklerinde çalışan toplam 68 anestezi asistan veya uzman hekim anket çalışmasına katıldı. Sonuçlar değerlendirildi. Mesleki deneyim süresine göre verilen cevaplar karşılaştırıldı.BulgularHekimlerin yarıya yakını cihaz yetersizliği veya arızasından dolayı monitörizasyon yapamadan genel anestezi uygulamak durumunda kaldıklarını ifade etmişlerdir. Açık cerrahide kardiyak output göstergesi olarak, bronkospazm tanı ve tedavisinde, travmada mortalite göstergesi olarak ve sedasyonda ventilasyon takibinde hekimlerin ETCO2 monitorizasyon kullanımı düşük bulunmuştur. Kardiyak output göstergesi olarak ETCO2 monitörizasyonunu kullanımı ve pulmoner emboli tanısı konulmasında ETCO2 monitörizasyonunu kullanımı sorusuna verilen yanıtlarda mesleki deneyim yılları arasında anlamlı fark görülmüştür.SonuçAnket sonuçları incelendiğinde teknik yetersizlik dikkat çekmektedir. Ayrıca peroperatif dönemde ETCO2 monitörizasyonunun etkin kullanımı için eğitim toplantılarının daha sık yapılmasının faydalı olacağı kanaatindeyiz.

ANESTHESIOLOGISTS’ PERIOPERATIVE APPLICATIONS OF END-TIDAL CARBON DIOXIDE MONITORING

Objective By using capnography, carbon dioxide is measured in expiratory air and capnography plays a vital role in evaluation of breathing, circulation and ventilation.. However, this monitoring method is not used effectively enough. The aim of this study was to investigate the knowledge, experience, and opinions of anesthesiologists about the monitoring of end-tidal carbon dioxide (ETCO2 ) applied during the preoperative phase.Material and Method A total of 68 specialists or resident anesthesiologists from the anesthesia clinics of Bakırköy Dr. Sadi Konuk, Taksim Gazi Osmanpaşa, Sultan Abdülhamid Han Research and Education hospitals participated in the survey study. The results were analyzed. The responses were compared based on the years of professional experience. Results Nearly half of the physicians stated that they had to perform general anesthesia without monitoring due to a lack of equipment or equipment malfunction. The use of ETCO2 monitoring by physicians was found to be low as an indicator of cardiac output during an open surgery, in the diagnosis and treatment of bronchospasm, as a mortality indicator in trauma and in the respiratory monitoring of sedation. The responses regarding the application of ETCO2 monitoring as an indicator of cardiac output and application of ETCO2 in the diagnosis of pulmonary embolism were found to be significantly different between the participants who had varying years of professional experience. Conclusion When the survey results are analyzed, a lack of equipment was observed. We also believe that holding more training sessions could be beneficial for the effective use of ETCO2 monitoring during the preoperative phase.

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