Research Article
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Travmatik olmayan kardiyopulmoner arrestlerde kalsiyumun prognostik bir faktör olarak değerlendirilmesi

Year 2020, Volume: 4 Issue: 6, 475 - 478, 01.06.2020
https://doi.org/10.28982/josam.735652

Abstract

Amaç: Kardiyopulmoner arrestler (KPA), acil servislerin en hızlı müdahale edilmesi gereken durumlardan birini oluşturmaktadır. Koroner kalp hastalıklarına bağlı arrestler, 18 yaş üstü ani ölümlerin yaklaşık %90’nından sorumlu tutulmaktadır. Çalışmamızda acil servisimize nontravmatik KPA olarak getirilen ve kardiyopulmoner resüsitasyon (KPR) yapılan hastalar üzerinde, kalsiyumun prognoza olan etkisi araştırdık.
Yöntemler: 1 Ocak 2017-31 Aralık 2019 yılları arasında acil servise başvuran 138 travmatik olmayan KPA hastasının verileri hastanenin otomasyon sisteminden kohort çalışması olarak incelendi. Olguların demografik özellikleri (yaş, cinsiyet, mortalite ve tıbbi geçmişlerinde hastalık varlığı) incelendi. Acil servise başvuru anında serum kalsiyum (Ca+2), potasyum (K) ve sodyum (Na) düzeyleri ölçüldü. Daha sonra, exitus olan grup ile yoğun bakım ünitesine yatırılan hasta grupları arasında düzeltilmiş serum Ca+2 elektrolit düzeyleri değerlendirildi.
Bulgular: Bu hastaların 58'i (%43,93) acil serviste exitus kabul edildi ve 74'ü (%56,07) yoğun bakım ünitelerine yatırıldı. Hastaların %50,76'sında komorbid hastalıklar bulunmadı. Koroner arter hastalığı %23,46, solunum sistemi hastalığı %6,06, diğer hastalıklar %19,7 olarak bulundu. KPR sonrası yoğun bakım ünitesinde exitus olarak bildirilen hasta grubunda serum düzeltilmiş Ca+2 düzeyleri sağ kalan hasta grubuna göre istatistiksel olarak anlamlı derecede yüksek bulundu (P=0,041).
Sonuç: Düzeltilmiş Ca+2 konsantrasyonunun, travmatik olmayan arrest vakalarda prognozun belirlenmesinde faydalı bir parametre olabileceği düşünüldü.

References

  • 1. Leong BSH. Bystander CPR and Survival. Singapore Medical Journal. 2011 August;52(8):573-5.
  • 2. Şener S, Yaylacı S. Cardiopulmonary resuscitation and emergency cardiovascular care guideline "Two guidelines and important changes to daily practice". Turk J Emerg Med. 2010;10(4):199-208.
  • 3. Kozacı N, Oğuzhan Ay M, İçme F, Aktürk A, Satar S. Are We Successful in Cardiopulmonary Resuscitation? Cukurova Medical Journal. 2013;38(4):601-9.
  • 4. Walker WM. Dying, sudden cardiac death and resuscitation technology. Int Emerg Nurs. 2008 April;16(2):119-26. doi: 10.1016 / j.ienj.2008.01.0075.
  • 5. Kandiş BH, Boz V, Sarıtaş AM. Çandar M, Baltacı D, Çıkman M. Kardiyopulmoner Resüsitasyon Konusunda Tıp Fakültesi Öğrencilerinin ve Araştırma Görevlilerinin Bilgi ve Beceri Düzeylerinin Geliştirilmesi. Konuralp Medical Journal. 2014;6(3):8-11.
  • 6. Berek K, Lechleitner P, Luef G, Felber S, Saltuari L, Schinnerl A, et al. Early Determination of Neurological Outcome After Prehospital Cardiopulmonary resuscitation. Stroke. 1995 April;26(4):543-9. doi.org/10.1161/01.STR.26.4.5437.
  • 7. Santana LF, Gomez AM, Kranias EG, Lederer WJ. Amount of calcium in the sarcoplasmic reticulum: influence on excitation-contraction coupling in heart muscle. Heart Vessels. 1997;Suppl 12:44-9.
  • 8. Doğan Ö. Total Calcium Levels in Patients with Hypocalcemia Compared to Ionized Calcium and Adjusted Calcium. Journal of Duzce University Health Sciences Institute. 2019 May;9(2):67-70. doi: 10.33631/duzcesbed.547378
  • 9. Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Medicine. 2007 Feb;33(2):237-45. doi: 10.1007/s00134-006-0326-z
  • 10. Hayashi M, Shimizu W, Albert CM. The Spectrum of Epidemiology Underlying Sudden Cardiac Death. Circulation Research. 2015 Jun;116(12):1887–906. doi: 10.1161/CIRCRESAHA.116.304521.
  • 11. Akahane M, Ogawa T, Koike S, Tanabe S, Horiguchi H, Mizoguchi T, et al. The effects of sex on out-of-hospital cardiac arrest outcomes. The American Journal of Medicine. 2011 April;124(4):325-33. doi.org/10.1016/j.amjmed.2010.10.020
  • 12. Çakmak S. Hastane Dışı Kardiyak Arrest Geçiren Hastalarda Serum Copeptin Düzeyleri İle Spontan Dolaşımın Geri Dönüşü Arasındaki İlişki. T.C. Health Sciences University Haseki Health Practice and Research Center;2019.
  • 13. Geçmen Ç, Kahyaoğlu M, Kalaycı A, Nase A, Akgün Ö, Candan Ö, et al. Cardiac Arrest Registry at a Tertiary Center. Koşuyolu Heart J. 2018;21(1):16-20. doi: 10.5578/khj.57289
  • 14. Özen C. Kardiyopulmoner Resüsitasyon Yapılan Hastalarda Kardiyak Ultrason İle Bakılan Ventrikül Hareketinin Prognozla Olan İlişkisinin Araştırılması. T.C. Marmara University School of Medicine; 2015.
  • 15. Alanezi K, Alanzi F, Faidi S,Sprague S , Cadeddu M, Baillie F, et al. Survival rates for adult trauma patients who require cardiopulmonary resuscitation. Canadian Journal of Emergency Medicine. 2004 Jul;6(4):263-5. doi: 10.1017/s1481803500009234.
  • 16. Hessels L, Hoekstra M, Mijzen LJ, Vogelzang M, Dieperink W, Lansink AO, et al. The relationship between serum potassium, potassium variability and in-hospital mortality in critically ill patients and a before-after analysis on the impact of computer-assisted potassium control. Critical Care. 2015 Jan;6(19):4. doi: 10.1186/s13054-014-0720-9.
  • 17. Van der Sande FM, Ter Meulen KJA, Kotanko P, Kooman JP. Dialysate calcium levels: do they matter?. Blood Purification. 2019;47:230–5. doi: 10.1159/000494584
  • 18. John E. Guyton and Hall Textbook of Medical Physiology 12th Edition. 2011.
  • 19. Rincon F, Mayer SA. Therapeutic hypothermia for brain injury after cardiac arrest. Semin Neurol. 2006 Sep;26(4):387-95. doi: 10.1055/s-2006-948319.
  • 20. Ovbiagele B, Starkman S, Teal P, Lyden P, Kaste M, Davis SM, et al. Serum Calcium as Prognosticator in Ischemic Stroke. Stroke. 2008 Aug;39(8):2231-6. doi: 10.1161/STROKEAHA.107.513499

The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests

Year 2020, Volume: 4 Issue: 6, 475 - 478, 01.06.2020
https://doi.org/10.28982/josam.735652

Abstract

Aim: Cardiopulmonary arrests (CPA) should be rapidly responded to in emergency departments (ED). Arrests associated with coronary cardiac diseases are held responsible for about 90% of sudden mortality over the age of 18 years. In our study, the effect of calcium on prognosis was investigated in patients who were admitted to our emergency department with non-traumatic CPA and underwent cardiopulmonary resuscitation (CPR).
Methods: The data of 132 non-traumatic CPA patients who were admitted to the emergency room between 1 January 2017 and 31 December 2019 were examined from the hospital registry for this cohort study. The demographic features (age, gender, mortality, and the presence of diseases in their medical history) were noted. Blood was collected from patients at the time of admission to the ED. Adjusted serum Ca+2, potassium (K+) and sodium (Na+) electrolyte levels were evaluated among patients who were either admitted to the intensive care unit or died.
Results: Fifty-eight (43.93%) patients died in the emergency department, and 74 (56.07%) were admitted to intensive care units. There were no comorbid diseases in 50.76%. Coronary artery disease, respiratory diseases and others were found in 23.46%, 6.06% and 19.7% of the patients, respectively. In the patient group declared “exitus” in the intensive care unit after CPR, serum adjusted calcium levels were significantly higher compared to the surviving patient group (P=0.041)
Conclusion: It was noted that adjusted Ca+2 concentration can be a beneficial parameter in determining the prognosis in non-traumatic arrest cases. 

References

  • 1. Leong BSH. Bystander CPR and Survival. Singapore Medical Journal. 2011 August;52(8):573-5.
  • 2. Şener S, Yaylacı S. Cardiopulmonary resuscitation and emergency cardiovascular care guideline "Two guidelines and important changes to daily practice". Turk J Emerg Med. 2010;10(4):199-208.
  • 3. Kozacı N, Oğuzhan Ay M, İçme F, Aktürk A, Satar S. Are We Successful in Cardiopulmonary Resuscitation? Cukurova Medical Journal. 2013;38(4):601-9.
  • 4. Walker WM. Dying, sudden cardiac death and resuscitation technology. Int Emerg Nurs. 2008 April;16(2):119-26. doi: 10.1016 / j.ienj.2008.01.0075.
  • 5. Kandiş BH, Boz V, Sarıtaş AM. Çandar M, Baltacı D, Çıkman M. Kardiyopulmoner Resüsitasyon Konusunda Tıp Fakültesi Öğrencilerinin ve Araştırma Görevlilerinin Bilgi ve Beceri Düzeylerinin Geliştirilmesi. Konuralp Medical Journal. 2014;6(3):8-11.
  • 6. Berek K, Lechleitner P, Luef G, Felber S, Saltuari L, Schinnerl A, et al. Early Determination of Neurological Outcome After Prehospital Cardiopulmonary resuscitation. Stroke. 1995 April;26(4):543-9. doi.org/10.1161/01.STR.26.4.5437.
  • 7. Santana LF, Gomez AM, Kranias EG, Lederer WJ. Amount of calcium in the sarcoplasmic reticulum: influence on excitation-contraction coupling in heart muscle. Heart Vessels. 1997;Suppl 12:44-9.
  • 8. Doğan Ö. Total Calcium Levels in Patients with Hypocalcemia Compared to Ionized Calcium and Adjusted Calcium. Journal of Duzce University Health Sciences Institute. 2019 May;9(2):67-70. doi: 10.33631/duzcesbed.547378
  • 9. Sandroni C, Nolan J, Cavallaro F, Antonelli M. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Medicine. 2007 Feb;33(2):237-45. doi: 10.1007/s00134-006-0326-z
  • 10. Hayashi M, Shimizu W, Albert CM. The Spectrum of Epidemiology Underlying Sudden Cardiac Death. Circulation Research. 2015 Jun;116(12):1887–906. doi: 10.1161/CIRCRESAHA.116.304521.
  • 11. Akahane M, Ogawa T, Koike S, Tanabe S, Horiguchi H, Mizoguchi T, et al. The effects of sex on out-of-hospital cardiac arrest outcomes. The American Journal of Medicine. 2011 April;124(4):325-33. doi.org/10.1016/j.amjmed.2010.10.020
  • 12. Çakmak S. Hastane Dışı Kardiyak Arrest Geçiren Hastalarda Serum Copeptin Düzeyleri İle Spontan Dolaşımın Geri Dönüşü Arasındaki İlişki. T.C. Health Sciences University Haseki Health Practice and Research Center;2019.
  • 13. Geçmen Ç, Kahyaoğlu M, Kalaycı A, Nase A, Akgün Ö, Candan Ö, et al. Cardiac Arrest Registry at a Tertiary Center. Koşuyolu Heart J. 2018;21(1):16-20. doi: 10.5578/khj.57289
  • 14. Özen C. Kardiyopulmoner Resüsitasyon Yapılan Hastalarda Kardiyak Ultrason İle Bakılan Ventrikül Hareketinin Prognozla Olan İlişkisinin Araştırılması. T.C. Marmara University School of Medicine; 2015.
  • 15. Alanezi K, Alanzi F, Faidi S,Sprague S , Cadeddu M, Baillie F, et al. Survival rates for adult trauma patients who require cardiopulmonary resuscitation. Canadian Journal of Emergency Medicine. 2004 Jul;6(4):263-5. doi: 10.1017/s1481803500009234.
  • 16. Hessels L, Hoekstra M, Mijzen LJ, Vogelzang M, Dieperink W, Lansink AO, et al. The relationship between serum potassium, potassium variability and in-hospital mortality in critically ill patients and a before-after analysis on the impact of computer-assisted potassium control. Critical Care. 2015 Jan;6(19):4. doi: 10.1186/s13054-014-0720-9.
  • 17. Van der Sande FM, Ter Meulen KJA, Kotanko P, Kooman JP. Dialysate calcium levels: do they matter?. Blood Purification. 2019;47:230–5. doi: 10.1159/000494584
  • 18. John E. Guyton and Hall Textbook of Medical Physiology 12th Edition. 2011.
  • 19. Rincon F, Mayer SA. Therapeutic hypothermia for brain injury after cardiac arrest. Semin Neurol. 2006 Sep;26(4):387-95. doi: 10.1055/s-2006-948319.
  • 20. Ovbiagele B, Starkman S, Teal P, Lyden P, Kaste M, Davis SM, et al. Serum Calcium as Prognosticator in Ischemic Stroke. Stroke. 2008 Aug;39(8):2231-6. doi: 10.1161/STROKEAHA.107.513499
There are 20 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Research article
Authors

Levent Şahin 0000-0003-0193-4393

Hüseyin Fatih Gül 0000-0002-9828-1298

Turgut Dolanbay 0000-0002-4092-1192

Mesut Öterkuş This is me 0000-0003-1025-7662

Publication Date June 1, 2020
Published in Issue Year 2020 Volume: 4 Issue: 6

Cite

APA Şahin, L., Gül, H. F., Dolanbay, T., Öterkuş, M. (2020). The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests. Journal of Surgery and Medicine, 4(6), 475-478. https://doi.org/10.28982/josam.735652
AMA Şahin L, Gül HF, Dolanbay T, Öterkuş M. The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests. J Surg Med. June 2020;4(6):475-478. doi:10.28982/josam.735652
Chicago Şahin, Levent, Hüseyin Fatih Gül, Turgut Dolanbay, and Mesut Öterkuş. “The Evaluation of Calcium As a Prognostic Factor in Non-Traumatic Cardiopulmonary Arrests”. Journal of Surgery and Medicine 4, no. 6 (June 2020): 475-78. https://doi.org/10.28982/josam.735652.
EndNote Şahin L, Gül HF, Dolanbay T, Öterkuş M (June 1, 2020) The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests. Journal of Surgery and Medicine 4 6 475–478.
IEEE L. Şahin, H. F. Gül, T. Dolanbay, and M. Öterkuş, “The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests”, J Surg Med, vol. 4, no. 6, pp. 475–478, 2020, doi: 10.28982/josam.735652.
ISNAD Şahin, Levent et al. “The Evaluation of Calcium As a Prognostic Factor in Non-Traumatic Cardiopulmonary Arrests”. Journal of Surgery and Medicine 4/6 (June 2020), 475-478. https://doi.org/10.28982/josam.735652.
JAMA Şahin L, Gül HF, Dolanbay T, Öterkuş M. The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests. J Surg Med. 2020;4:475–478.
MLA Şahin, Levent et al. “The Evaluation of Calcium As a Prognostic Factor in Non-Traumatic Cardiopulmonary Arrests”. Journal of Surgery and Medicine, vol. 4, no. 6, 2020, pp. 475-8, doi:10.28982/josam.735652.
Vancouver Şahin L, Gül HF, Dolanbay T, Öterkuş M. The evaluation of calcium as a prognostic factor in non-traumatic cardiopulmonary arrests. J Surg Med. 2020;4(6):475-8.