How Important Are Arterial Blood Gas Parameters for Severe Head Trauma in Children?

Yıl 2022, Cilt: 12 Sayı: 2, 319 - 324, 15.03.2022

Murat Kayabaş Levent Şahin

https://doi.org/10.16899/jcm.1016696

Öz

Aim: Our aim in this study is to consider the relationship between arterial blood gas (ABG) parameters and prognosis in severe head trauma in children.
Material and Methods: Patients younger than 17 years of age with a Glasgow Coma Scale (GCS) of 8 and below with a history of head trauma were retrospectively analyzed. The relation of ABG parameters taken at the time of admission with mortality was examined. Independent sample T-test was used for pH, PCO2 and base extract (BE) parameters in ABG, and Mann Whitney U test was used for PO2 and lactate parameters.
Results: 48 patients were included in the study. Gender, age, admission blood pressure arterial values, GCS and Abbreviated Injury Scale (AIS) scores, length of stay in intensive care, and the surgical application did not differ statistically between the patient groups who died and survived (p> 0.05). Ph and PO2 values were lower, PCO2, lactate and BE values were found to be higher in the deceased patient group compared to the living patient group (p˂0.05). The presence of acidosis, hypercapnia, or hyperlactatemia according to ABG values in the patient group who died was statistically significantly higher (p˂0.05).
Conclusion: In our study, we found that the presence of acidosis, hypercapnia, and hyperlactatemia in patients according to ABG values increased mortality. In addition, according to the results of ROC analysis, we found that high PCO2 and lactate values could be specific indicators indicating poor prognosis. We think that PCO2 and lactate measured in arterial blood may be biomarkers that can determine the prognosis.

Anahtar Kelimeler

Traumatic brain injury, blood gas, child, lactate

Çocuklarda Ağır Kafa Travmalarında Arter Kan Gazı Parametreleri Ne Kadar Önemlidir?

Öz

Amaç: Bu çalışmadaki amacımız, çocuklarda şiddetli kafa travmasında arteriyel kan gazı (AKG) parametreleri ile prognoz arasındaki ilişkiyi ele almaktır.
Gereç ve Yöntem: Glasgow Koma Skalası (GKS) 8 ve altında olan ve kafa travması öyküsü olan 17 yaşından küçük hastalar geriye dönük olarak incelendi. Başvuru anında alınan AKG parametrelerinin mortalite ile olan ilişkisi incelendi. AKG'da pH, PCO2 ve baz ekstraktı (BE) parametreleri için bağımsız örnek T- testi, PO2 ve laktat parametreleri için ise Mann Whitney U testi kullanıldı.
Bulgular: Çalışmaya 48 hasta alındı. Ölen ve yaşayan hasta grupları arasında cinsiyet, yaş, başvuru tansiyon arter değerleri, GKS ve Kısaltılmış Yaralanma Skalası (AIS) skorları, yoğun bakımda kalış süresi ve cerrahi uygulama istatistiksel olarak farklılık göstermedi (p> 0.05). Ölen hasta grubunda yaşayan hasta grubuna göre Ph ve PO2 değerleri daha düşük, PCO2, laktat ve BE değerleri daha yüksek bulundu (p˂0.05). Ölen hasta grubunda AKG değerlerine göre asidoz, hiperkapni veya hiperlaktatemi varlığı istatistiksel olarak anlamlı derecede yüksekti (p˂0.05).
Sonuç: Çalışmamızda AKG değerlerine göre hastalarda asidoz, hiperkapni ve hiperlaktatemi varlığının mortaliteyi artırdığını bulduk. Ayrıca ROC analizi sonuçlarına göre yüksek PCO2 ve laktat değerlerinin kötü prognozu gösteren spesifik göstergeler olabileceğini saptadık. Arter kanında ölçülen PCO2 ve laktatın prognozu belirleyebilecek biyobelirteçler olabileceğini düşünüyoruz.

Anahtar Kelimeler

Travmatik beyin hasarı, kan gazı, çocuk, laktat

Kaynakça

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