Acil serviste mekanik göğüs kompresyon cihazı eşliğinde kardiyopulmoner resüsitasyon uygulanan hastalarda pasif bacak elevasyonu manevrasının prognoza etkisi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada hastanemiz acil servisine kardiyopulmoner arrest (KPA) olarak getirilen veya acil servis takibinde KPA gelişen hastalara Mekanik Göğüs Kompresyon Cihazı (MGKC) eşliğinde hastaların her iki bacağı eleve edilerek Kardiyopulmoner resüsitasyon (KPR) uygulanmasının sağkalım ve prognoza etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmamız prospektif gözlemsel bir çalışmadır. Çalışmamıza 15/02/2022-15/08/2022 tarihleri arasında Bolu Abant İzzet Baysal Üniversitesi Eğitim ve Araştırma Hastanesi Acil Servisi'ne travma dışı nedenlerle kardiyak arrest olarak getirilen veya acil serviste takibi sırasında travma dışı nedenlerden kardiyak arrest gelişen hastalar dahil edilmiştir. Hastalara MGKC eşliğinde ve bacaklar eleve edilerek KPR uygulandı. Spontan Dolaşımın Geri Döndürülmesi (SDGD) sağlanan hastaların arrest yeri-etyolojisi, KPR süresi, kan gazı incelenerek sağkalım ve prognoza etkileri karşılaştırlmıştır. Elde edilen verilerin istatistiksel analizinde SPSS™ (Statistical Package for the Social Sciences) 28.0 versiyon programı kullanıldı. Bulgular: Çalışma 84 hasta üzerinden değerlendirildi. Hastaların yaş ortalaması 74,44±13,53 iken, kadın ve erkek sayısı eşit 42 idi. Hastaların %32,14 'ünde hastane dışı kardiyak arrest (HDKA) gelişirken, %67,86'sında hastane içi kardiyak arrest (HİKA) gelişti. Arrest etyolojisinde hastaların %42,86'sında kardiyak nedenler, %57,14'ünde kardiyak dışı nedenler saptandı. KPR süresi <10dk olan hastaların KPR süresi >30dk olan hastalara göre 1 aylık sağkalımı anlamlı düzeyde yüksekti (p:0,000). HİKA vakalarında SDGD oranı istatistiksel anlamlı düzeyde daha yüksekti (p=0,002). HDKA vakalarının sağkalım süresi 24 saatten kısa olması HİKA vakalarına kıyasla istatistiksel anlamlı düzeyde yüksekti (p=0,029). Kardiyak nedenli arrestlerde 1 aylık sağkalım istatistiksel anlamlı düzeyde yüksekti (p=0,009). Sonuç: Çalışmada MGKC ve bacak elevasyonu birlikte uygulandığında KPR etkinliğini arttırdığı buna bağlı olarak SDGD ve prognozu olumlu yönde etkilediğini bulduk.
Objective: In this study, it was aimed to investigate the effect of cardiopulmonary resuscitation (CPR) on survival and prognosis by elevating both legs of the patients with Mechanical Chest Compression Device (MCCD) in patients who were brought to the emergency department of our hospital as cardiopulmonary arrest (CPA) or who developed CPA in the emergency department follow-up. Materials and Methods: Our study is a prospective observational study. Patients who were admitted to Bolu Abant İzzet Baysal University Training and Research Hospital Emergency Service as non-traumatic cardiac arrest between 15/02/2022-- 15/08/2022 or who developed cardiac arrest due to non-traumatic causes during follow-up in the emergency department were included in our study. CPR was applied to the patients with MGCC and elevating the legs. Arrest site-etiology, duration of CPR, blood gas were examined in patients with Spontaneous Circulatory Recovery (ROS) and its effects on survival and prognosis were compared. SPSS™ (Statistical Package for the Social Sciences) version 28.0 program was used for statistical analysis of the data obtained. Results: The study was evaluated on 84 patients. While the mean age of the patients was 74.44±13.53, the number of men and women was equal to 42. While out-ofhospital cardiac arrest (OHCA) developed in 32.14% of the patients, in-hospital cardiac arrest (IHCA) developed in 67.86%. In the etiology of arrest, cardiac causes were found in 42.86% of the patients and non-cardiac causes were found in 57.14% of the patients. Patients with a CPR time of <10 minutes had a significantly higher 1-month survival than patients with a CPR time of >30 minutes (p:0.000). The rate of ROSC was statistically significantly higher in IHCA cases (p=0.002). The survival time of OHCA cases shorter than 24 hours was statistically significantly vi higher compared to HICA cases (p=0.029). 1-month survival in cardiac arrests was statistically significantly higher (p=0.009). Conclusion: In the study, we found that when MCCD and leg elevation were applied together, it increased the effectiveness of CPR, and accordingly, it positively affected ROSC and prognosis.
Objective: In this study, it was aimed to investigate the effect of cardiopulmonary resuscitation (CPR) on survival and prognosis by elevating both legs of the patients with Mechanical Chest Compression Device (MCCD) in patients who were brought to the emergency department of our hospital as cardiopulmonary arrest (CPA) or who developed CPA in the emergency department follow-up. Materials and Methods: Our study is a prospective observational study. Patients who were admitted to Bolu Abant İzzet Baysal University Training and Research Hospital Emergency Service as non-traumatic cardiac arrest between 15/02/2022-- 15/08/2022 or who developed cardiac arrest due to non-traumatic causes during follow-up in the emergency department were included in our study. CPR was applied to the patients with MGCC and elevating the legs. Arrest site-etiology, duration of CPR, blood gas were examined in patients with Spontaneous Circulatory Recovery (ROS) and its effects on survival and prognosis were compared. SPSS™ (Statistical Package for the Social Sciences) version 28.0 program was used for statistical analysis of the data obtained. Results: The study was evaluated on 84 patients. While the mean age of the patients was 74.44±13.53, the number of men and women was equal to 42. While out-ofhospital cardiac arrest (OHCA) developed in 32.14% of the patients, in-hospital cardiac arrest (IHCA) developed in 67.86%. In the etiology of arrest, cardiac causes were found in 42.86% of the patients and non-cardiac causes were found in 57.14% of the patients. Patients with a CPR time of <10 minutes had a significantly higher 1-month survival than patients with a CPR time of >30 minutes (p:0.000). The rate of ROSC was statistically significantly higher in IHCA cases (p=0.002). The survival time of OHCA cases shorter than 24 hours was statistically significantly vi higher compared to HICA cases (p=0.029). 1-month survival in cardiac arrests was statistically significantly higher (p=0.009). Conclusion: In the study, we found that when MCCD and leg elevation were applied together, it increased the effectiveness of CPR, and accordingly, it positively affected ROSC and prognosis.
Açıklama
Tıp Fakültesi, Acil Tıp Ana Bilim Dalı
Anahtar Kelimeler
Acil Tıp, Emergency Medicine
