Karbonmonoksit Zehirlenmesinde Oksijen Tedavilerinin Rolü

Ülkemizde iklimsel ve sosyoekonomik nedenlerle, özellikle kış aylarında karbonmonoksit (CO) zehirlenmesi vakalarıyla sık karşılaşılmaktadır. CO zehirlenmesinde ortamdaki gazın miktarına, maruziyet süresine ve CO kaynağının tipine bağlı olarak farklı klinik formlar ortaya çıkmaktadır. CO gazı vücutta birçok sistemi etkilemektedir. Kalp ve beyin gibi oksijen gereksinimi yüksek olan organlar daha çok etkilenmektedir. Tedavide temel hedef, CO'nun eliminasyonu ve toksik etkilerinin azaltılmasıdır. Bu amaçla normobarik ve hiperbarik koşullarda uygulanan oksijen tedavileri kullanılmaktadır. Normobarik oksijen (NBO) tedavisi kolay ulaşılabilen, yaygın olarak kullanılan ve göreceli olarak maliyeti düşük olan bir tedavidir. Hiperbarik oksijen (HBO) tedavisi ise özgül cihazların kullanıldığı, eğitimli personele ihtiyaç duyulan ve az sayıda merkezde uygulanabilen bir tedavi yöntemidir. CO zehirlenmesinin tedavisinde HBO tedavisinin NBO tedavisine oranla üstünlükleri vardır. HBO tedavi merkezlerinin yeterli sayıda olmaması HBO tedavisi uygulanacak hastaları seçerken bazı kriterlerin aranmasını zorunlu kılmaktadır. Hekimlerimizin ve sağlık çalışanlarının CO zehirlenmesinde kullanılan oksijen tedavileri konusunda bilgilendirilmesi, hastaların etkin bir şekilde değerlendirilmesi ve tedavi edilmesinde kritik bir öneme sahiptir. Bu derleme ile önemli bir halk sağlığı problemi olan CO zehirlenmesi vakalarında uygulanabilecek oksijen tedavileri konusunda bilgi vermek ve HBO tedavisi için hasta seçiminde kullanılabilecek kriterleri belirlemek amaçlanmıştır

[The Role of Oxygen Therapies in Carbon Monoxide Poisoning]

Due to climate and socio-economic issues in Turkey, the incidence of carbon monoxide (CO) poisoning is high, especially in winter. Clinical manifestations may vary depending on the type of CO source, concentration and duration of exposure. The symptoms of CO poisoning predominantly manifest in lots of organs and systems with high oxygen utilization, especially the brain and the heart. The primary aim in oxygen therapy is to eliminate CO and to reduce its toxic effects. In this context, normobaric and hyperbaric oxygen therapy are used to achieve these goals. Normobaric oxygen (NBO) treatment is an easily accessible and relatively not expensive modality, where hyperbaric oxygen (HBO) therapy requires specific equipment, certified staff and is available only in some centers. Additionally, HBO treatment has several additional advantages over NBO treatment. Despite its benefits, it is compulsory to search for some criteria in selecting patients to be treated because of the limited availability and access of hyperbaric facilities. For an effective evaluation and an optimal treatment, advanced education of the healthcare professionals on the use of oxygen delivery modalities in the management of CO poisoning is imperative. In this review, it has been aimed to outline the significance of oxygen treatment modalities and to determine patient selection criteria for HBO treatment in the management of CO poisoning which continues to be an important threat to community health care

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TSK Koruyucu Hekimlik Bülteni-Cover
  • ISSN: 1303-734X
  • Yayın Aralığı: Yılda 8 Sayı
  • Başlangıç: 2002
  • Yayıncı: Gülhane Askeri Tıp Akademisi Halk Sağlığı AD.
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