Karbon Monoksit Zehirlenmesi ve Mekanik Ventilasyon: Olgu Sunumu Literatür Derlemesi
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Dosyalar
Tarih
2010
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Karbon monoksit zehirlenmesi en ölümcül zehirlenmelerden biridir. Zehirlenmeden sağ kalanların yaklaşık %50-75’inde nörolojik veya psikiyatrik sekeller kalmaktadır. Karbon monoksit zehirlenmesi %100 oksijen veya hiperbarik oksijen ile tedavi edilebilir. Soba zehirlenmesi nedeniyle acil servisimize getirilen erkek hastanın geliş Glasgow Koma Skalası (GKS) 4’tü. Hastanın hiperbarik oksijen tedavisi verilen bir merkeze transferi düşünüldü ancak şartların uygun olmaması nedeniyle yoğun bakımda mekanik ventilatörle verilen %100 oksijen tedavisine başlandı. Spontan solunumu yeterli düzeye ulaşan hasta 5. gün mekanik ventilatörden ayrıldı ve ekstübe edildi. Takip süresi sonunda hasta 14. gün önerilerle taburcu edildi. Taburcu edilirken hastanın genel durumu iyi ve GKS 15 idi. Genel olarak çalışmalardaki ortak kanı ciddi zehirlenmesi olan hastalarda destek tedavisinin çok önemli olduğu yönündedir. Ülkemiz şartlarında her hastanın hiperbarik oksijen tedavisi veren bir merkeze transferi mümkün olmamaktadır. Bu vakada olduğu gibi iyi yapılan destek tedavisinin hayat kurtarıcı olduğu açıktır.
Carbon monoxide poisoning is one of the most common lethal poisonings. Neurological or psychiatric sequelae occur in approximately 50-75% of survivors. Carbon monoxide poisoning can be treated with 100% oxygen or hyperbaric oxygen. The Glasgow Coma Scale (GKS) of the male patient who was admitted to our emergency department with CO intoxication due to a heater was 4. The patient’s transport to a hyperbaric oxygen treatment center was considered but the conditions were not suitable for transport, so 100% oxygen treatment with mechanical ventilator was initiated. The patient was weaned from the mechanical ventilator at day 5 and he was extubated when his spontaneous breathing was adequate. He was discharged from hospital at the end of the follow-up period, day 14. His general condition was quite good and his GKS was 15 at discharge. Although most of the studies suggested that hyperbaric oxygen treatment was more efficacious in carbon monoxide poisoning, other studies stated that there was no difference between hyperbaric oxygen and 100% oxygen treatment.There is a general opinion that the supportive treatment is very important for survival.
Carbon monoxide poisoning is one of the most common lethal poisonings. Neurological or psychiatric sequelae occur in approximately 50-75% of survivors. Carbon monoxide poisoning can be treated with 100% oxygen or hyperbaric oxygen. The Glasgow Coma Scale (GKS) of the male patient who was admitted to our emergency department with CO intoxication due to a heater was 4. The patient’s transport to a hyperbaric oxygen treatment center was considered but the conditions were not suitable for transport, so 100% oxygen treatment with mechanical ventilator was initiated. The patient was weaned from the mechanical ventilator at day 5 and he was extubated when his spontaneous breathing was adequate. He was discharged from hospital at the end of the follow-up period, day 14. His general condition was quite good and his GKS was 15 at discharge. Although most of the studies suggested that hyperbaric oxygen treatment was more efficacious in carbon monoxide poisoning, other studies stated that there was no difference between hyperbaric oxygen and 100% oxygen treatment.There is a general opinion that the supportive treatment is very important for survival.
Açıklama
Anahtar Kelimeler
Acil Tıp, Karbonmonoksit, zehirlenme, hiperbarik oksijen, mekanik ventilasyon, Carbon monoxide, poisoning, hyperbaric oxygen, mechanical ventilation
Kaynak
Akademik Acil Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
9
Sayı
4
Künye
Cander, B., Dündar, Z. D., Yaylalı, Ç., Bayır, A., Girişgin, S., (2010). Karbon Monoksit Zehirlenmesi ve Mekanik Ventilasyon: Olgu Sunumu Literatür Derlemesi. Akademik Acil Tıp Dergisi, 9(4), 179-181. Doi:10.4170/jaem.2009.85866
