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

Year 2018, Volume: 40 Issue: 1, 1 - 6, 31.01.2018

Engin Özakın Hakan Dolgun Ebubekir Aslan Nurdan Acar Kadir Uğur Mert Filiz Baloğlu Kaya Mustafa Emin Çanakçı

https://doi.org/10.20515/otd.371115

Abstract

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.

Keywords

invaziv koroner revaskülarizasyon, kardiyak arrest

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

Abstract

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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