ÇOKLU BAŞARILI RESÜSİTASYON VE AKUT KORONER SENDROMLU HASTAYA YAKLAŞIM

Öz

Kardiyak nedenlere bağlı ölüm, ani ölümlerin önde gelen nedenidir. Dış merkez acil serviste kardiyak arrest sonrası 30 dk kardiyopulmoner resüsitasyon (KPR) uygulanan ve spontan dolaşımı geri dönen bilinci kapalı hasta tetkik ve yoğun bakım takibi için hastanemize gönderildi. Primer patolojinin erken tanınması ve acil tedavisi önemlidir. Sorun çözümlenmediği sürece, etkin ve başarılı yapılan resüsitasyona rağmen sağ kalım azalır. Bu olgu sunumunda; kardiyak arrest nedenleri ve KPR sonrası yoğun bakımda tedavi ve takip basamakları ele alınmıştır.

Anahtar Kelimeler

• Kalp durması
• Pnömotoraks
• Kardiyopulmoner resüsitasyon
• Miyokardiyal İnfarktüs
• Akut koroner sendrom

MULTIPLE SUCCESSFUL RESUSCITATION AND APPROACH TO PATIENT WITH ACUT CORONARY SENDROM

Öz

Cardiac death is the leading cause of sudden death. In this article an unconscious patient who came to the emergency department with cardiac arrest and underwent a CPR (Cardiopulmonary Resusitation) for 30 minutes and then followed up in the intensive care unit is discussed with the causes of cardiac arrest. Despite effective and successful resuscitation, failure to resolve the primary pathology causing the disease with urgent and effective treatment directly affects survival. In this case report; causes of cardiac arrest and follow-up steps in intensive care after CPR were discussed.

Anahtar Kelimeler

• Cardiac arrest
• Pneumothorax
• Cardiopulmonary resuscitation
• Myocardial infarction
• Acute coronary sendrom

Kaynakça

1. Chiota NA, Freeman WD, Barrett KM. Hypoxic-ischemic brain injury and prognosis after cardiac arrest. Continuum (Minneap Minn) 2011; 17: 1094-1118.
2. European Heart Network. European Cardiovascular Disease Statistics. 2012 edition.
3. Thygesen K, Alpert JS, Jaffe AS et all. Third universal definition of myocardial infarction. Eur Heart J 2012;33(20):2551–2567.
4. Roffi M, Patrono C, Collet JP et. all 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). Eur Heart J 2016;37(3):267–315.
5. Townsend N, Wilson L, Bhatnagar P, Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016;37(42):3232–3245
6. Larsen JM, Ravkilde J. Acute coronary angiography in patients resuscitated from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Resuscitation 2012;83(12):1427– 1433.
7. Twerenbold R, Neumann JT, Sorensen NA, et. all Prospective validation of the 0/1-h algorithm for early diagnosis of myocardial infarction. J Am Coll Cardiol 2018;72:620632
8. http://resusitasyon.org/tr/kilavuzlar-resusitasyon-rehberi/69-avrupa-resusitasyon-konseyi-2015-resusitasyon-rehberigenis-ozet.html

9. https://www.uptodate.com/contents/image?topicKey=CARD%2F963&search=overview%20of%20sudden%20cardiac%20t&imageKey=CARD%2F62184&rank=1~150&source=see_link
10. Lambert L, Brown K, Segal E, et. all Association between timeliness of reperfusion therapy and clinical outcomes in STelevation myocardial infarction. JAMA. 2010;303(21):2148
11. Kardiyak arrest sonrası hedeflenmiş sıcaklık yönetimi ulusal tedavi klavuzu. Eylül Ofset Matbaa ve Reklam Hizm.Sn.Tic.Ltd.Şti. 2020,1.Baskı, İstanbul, ISBN : 978-605-70043-0-7