Targeted Temperature Management in Postcardiac Arrest Syndrome: A Single-Center Experience with 47 Patients

Öz

Our aim in this study is to retrospectively analyze the results of Targeted Temperature Management (TTM) treatment in our intensive care unit. Following the ethics committee's approval, the demographic data, cardiac arrest history, the follow-up process, and the final status of patients who were applied TTM in Sakarya University Training and Research Hospital Anesthesia Intensive Care Unit between January 2017 and December 2019 were recorded. Then, the effect of these parameters on mortality was evaluated using regression analysis. Data of 47 patients who met the study criteria were analyzed. The mean age of the patients was 50 ± 16 and 14 (29.8%) patients were female. The duration of cardiopulmonary resuscitation (CPR) was 22.35 ± 16.08 minutes, 35 (74.5%) patients had a witness to arrest, 25 (53.2%) patients were arrested in the hospital, and 13 (27.7%) patients had shockable rhythm. It was determined that 60% of the patients died, 20% of them were care patients with poor neurological outcomes and 20% of them were discharged outpatient with good neurological outcomes. Age, development of acute renal failure, requiring vasopressor, high APACHE scores, and length of hospital stay were found to be independent risk factors for mortality.

Anahtar Kelimeler

• Cardiac arrest
• intensive care
• targeted temperature management
• mortality.

Postkardiyak Arrest Sendromunda Hedeflenen Sıcaklık Yönetimi: tek merkez deneyimi

Öz

Çalışmamızdaki amacımız yoğun bakım ünitemizde uygulanmış olan Hedeflenen Sıcaklık Yönetimi (HSY) tedavisinin sonuçlarını retrospektif olarak analiz etmektir. Bu amaçla etik kurul onayının ardından, Ocak 2017-Aralık 2019 tarihleri arasında Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi Anestezi Yoğun Bakım Ünitesi'nde HSY uygulanan hastaların demografik verileri, kardiyopulmoner resusitasyon öyküsü, yoğun bakım takip süreci ve yoğun bakım sonlanımları incelendi. Daha sonra bu parametrelerin mortalite üzerindeki etkisi regresyon analizi kullanılarak değerlendirildi. Çalışma kriterlerini karşılayan 47 hastanın verileri analiz edildi. Hastaların yaş ortalaması 50 ± 16 olduğu ve 14 (% 29,8) hastanın kadın olduğu saptandı. CPR süresi ortalama 22.35 ± 16.08 dakika idi ve 35 (% 74.5) hastada arreste tanıklık eden birinin olduğu, 25 (% 53.2) hastanın hastane içinde arrest olduğu ve 13 (% 27.7) hastada ilk muayenede şok verilebilir ritim olduğu gözlendi. Sonuç olarak hastaların % 60'ının ex olduğu, % 20'sinin bakım hastası olarak, %20'sinin de ayaktan taburcu edildiği belirlendi. Yaş, akut böbrek yetmezliği gelişimi, gerekli vazopressör, yüksek APACHE skorları ve hastanede kalış süresi mortalite için bağımsız risk faktörleri olarak bulundu.

Anahtar Kelimeler

• kardiyak arrest
• yoğun bakım
• hedeflenen sıcaklık yönetimi

Kaynakça

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