Kardiyopulmoner Resusitasyon Başarı Kriteri Olarak Baz Seviyesi ve Laktik Asit Düzeylerinin Değerlendirilmesi

Abstract

Amaç: Kardiyopulmoner arrest, mortalite ve morbiditesi yüksek bir durumdur. Hastane içi arrest vakalarında bile ölüm oranı yüksek iken, hastane dışında kardiyak arrest olgularında sağkalım oranı daha da düşüktür, bu nedenle arrest vakasının ciddiyetini öngörmek önemlidir. Kardiyak arrest mekanizmasını anlamak, önelemek ve müdahale kalitesini artırmak için birçok çalışma yapılmıştır.

Amaç: Bu çalışmada asidoz parametreleri ile kardiyopulmoner resüsitasyon başarısı arasındaki ilişkiyi analiz etmeyi amaçladık.

Yöntem: Hastane ışında kardiyak arrest geçiren, daha sonrasında ilk yardım ekiplerince ilk müdahalesi başlatılan ve hastaneye getirilen vakalar çalışmaya dahil edilmiştir.

Bulgular: Gruplar arasında kan laktat düzeylerinde anlamlı fark olduğu belirlendi.

Sonuç: Laktat ve Baz düzeyleri, kardiyopulmoner resüsitasyonun başarısını değerlendirmek için kullanılabilecek parametrelerdir.

Keywords

• Kardiyopulmoner Arrest,Laktik Asit,Baz Fazlalığı

Base Excess and Lactic Acid Levels as Success Criteria in Cardiopulmonary Resuscitation

Abstract

Background: Cardiopulmonary arrest a condition that causes high mortality and morbidity. While the mortality rate is high even in in-hospital arrest cases, the survival of patients undergoing cardiac arrest outside the hospital is lower, so it is essential to predict the severity of the case. Many studies have been performed to understand the mechanism of cardiac arrest, to improve its prevention, and to increase intervention quality.

Aim: In this study we aimed to analyze the relationship between acidosis parameters and cardiopulmonary resuscitation success.

Methods: We analyzed blood gas data in patients that underwent cardiopulmonary arrest out-of-hospital, had intervention by an ambulance first-aid team and were then brought to the emergency room for advanced life support.

Results: A significant difference in blood lactate levels between the groups was determined.

Conclusion: Lactate and Base excess levels are parameters that could be used to assess the success of cardiopulmonary resuscitation.

Keywords

• Cardiopulmonary Arrest,Lactic Acid,Base Excess

References

1. 1. Al B Zengin S, Kabul S, Güzel R, Sarcan E, Yıldırım C. Basic and advanced life support practices in out-of-hospital cardiopulmonary arrest developing patients: analysis of 27 months. Gaziantep Med J 2013;19:13-17.
2. 2. Oğuztürk H. TMG, Tekin Y.T., Sarıhan e. Acil Serviste Gerçekleșen Kardiyak Arrestler ve Kardiyopulmoner Resüsitasyon Deneyimlerimiz. Jounal of Medical Siences. 2001;1:114-117.
3. 3. Donnino MW, Miller J, Goyal N, Loomba M, Sankey SS, Dolcourt B, Sherwin R, Otero R and Wira C. Effective lactate clearance is associated with improved outcome in post-cardiac arrest patients. Resuscitation. 2007;75:229-34.
4. 4. Eisenberg MS and Mengert TJ. Cardiac resuscitation. The New Englan Journal of Medicine. 2001;344:1304-13.
5. 5. Rosamond W FK, Furie K, et al. Heart disease and stroke statistics—2008 update: report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2008;117:146.
6. 6. Vukmir RB. Survival from prehospital cardiac arrest is critically dependent upon response time. Resuscitation. 2006;69:229-34.
7. 7. Berdowski J, Berg RA, Tijssen JGP and Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010;81:1479-1487.
8. 8. Dunne RB, Compton S, Zalenski RJ, Swor R, Welch R and Bock BF. Outcomes from out-of-hospital cardiac arrest in Detroit. Resuscitation. 2007;72:59-65.

9. 9. Atwood C, Eisenberg MS, Herlitz J and Rea TD. Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation. 2005;67:75-80.
10. 10. Rea TD, Eisenberg MS, Sinibaldi G and White RD. Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation. 2004;63:17-24.
11. 11. Väyrynen T, Boyd J, Sorsa M, Määttä T and Kuisma M. Long-term changes in the incidence of out-of-hospital ventricular fibrillation. Resuscitation. 2011;82:825-829.
12. 12. Englehart MS and Schreiber MA. Measurement of acid-base resuscitation endpoints: lactate, base deficit, bicarbonate or what? Current opinion in critical care. 2006;12:569-74.
13. 13. Ditchey RV, Winkler JV and Rhodes CA. Relative lack of coronary blood flow during closed-chest resuscitation in dogs. Circulation. 1982;66:297-302.
14. 14. Bellamy RF, DeGuzman LR and Pedersen DC. Coronary blood flow during cardiopulmonary resuscitation in swine. Circulation. 1984;69:174-80.
15. 15. Davis JW, Shackford SR and Holbrook TL. Base deficit as a sensitive indicator of compensated shock and tissue oxygen utilization. Surgery, gynecology & obstetrics. 1991;173:473-6.
16. 16. Rutherford EJ, Morris JA, Jr., Reed GW and Hall KS. Base deficit stratifies mortality and determines therapy. The Journal of trauma. 1992;33:417-23.
17. 17. Takasu AS, T. Okada, Y. Arterial base excess after CPR: the relationship to CPR duration and the characteristics related to outcome. Resuscitation. 2007;73:394-9.
18. 18. Sloan EP, Koenigsberg M, Gens D, Cipolle M, Runge J, Mallory MN, Rodman Jr G and Group DTHSS. Diaspirin cross-linked hemoglobin (DCLHb) in the treatment of severe traumatic hemorrhagic shock: a randomized controlled efficacy trial. Jama. 1999;282:1857-1864.
19. 19. Prause G, Ratzenhofer-Comenda B, Smolle-Jüttner F, Heydar-Fadai J, Wildner G, Spernbauer P, Smolle J and Hetz H. Comparison of lactate or BE during out-of-hospital cardiac arrest to determine metabolic acidosis. Resuscitation. 2001;51:297-300.