Erișkin Akut Kardiyojenik Șoklu Hastalarda Veno-Arteriyel Ekstra-korporeal Membran Oksijenasyon Desteği: Retrospektif Analiz

Yıl 2017, , 111 - 117, 20.08.2017

A.rüçhan Akar

https://doi.org/10.1501/Tipfak_0000000974

Öz

Amaç: Ekstrakorporeal Membran Oksijenatör Sistemi (ECMO), respiratuar, kardiyak veya kombine yetmezliği olan hastalarda, hayat kurtarıcı bir teknik olarak kullanılmaktadır. Bu çalıșmada, refrakter kardiyojenik șok (RKS) nedeniyle veno-arteriyel ekstrakorporeal membran oksijenasyon (VA-ECMO) desteği gereken hastaların sonuçlarını değerlendirmek amaçlanmıștır.

Gereç ve Yöntem: Kliniğimizde, “Mart 2010 - Kasım 2016” yılları arasında, RKS nedeniyle VA-ECMO desteğine alınan hastaların sonuçları retrospektif olarak analiz edildi. Toplam 189 hastaya RKS nedeniyle (127’i erkek, yaș ortalaması = 56.6 ± 12.0; BSA ortalaması=1,85 ± 0,19) VA-ECMO implantasyonu yapıldı. Tüm hastaların demografik ve klinik dataları incelendi.

Bulgular: Ortalama VA-ECMO desteği süresi, 172.8 ± 234.2 saat (4-1920 saat) olarak hesaplandı. VAECMO desteğinden ayrılabilme (n=92; 48.6 %), toplam survey (n=74, 39.2 %) ve ECMO desteği sırasında görülen vasküler (n=21, 11.1%) ve nörolojik (n=11, 5.8%) komplikasyon oranlarının literatür ile benzerlik gösterdiği tespit edildi.

Sonuç: ECMO desteğindeki hastalar çoğunlukla multi-sistemik komplikasyonlara bağlı kaybedilmektedir. ECMO sistemlerindeki ve tekniklerindeki gelișim ile birlikte, mevcut hasta populasyonundaki sağkalım oranları artmakta ve olușabilecek komplikasyon oranları azalmaktadır. Özellikle son on yılda, hibrid ECMO sistemlerinin ve adjuvan kateter aracılı girișimlerin kullanılması, VA-ECMO desteğindeki hastaların hızlı ve güvenli bir șekilde düzelmesine katkı sağlamaktadır. Ülkemizde, daha fazla merkezde, ECMO ile ilgili deneyimin artması, bu tedaviden faydalanan hasta sayısında belirgin artıș olmasını sağlayacaktır. 

Anahtar Kelimeler

Ekstrakorporeal Membran Oksijenatörü, Refrakter Kardiyojenik Ș ok, Respiratuar Yetmezlik, Kalp Yetmezliği

Kaynakça

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