Ultrasonografi ile ölçülen arteriyal kan akımının radiyal arterkateterizasyonuna etkisi
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Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmada, genel ve lokal anestezi sonrası invaziv arteriyal monitörizasyon
planlanan hastalarda, USG ile radiyal arter akım ölçümleri yapılarak arteriyal
kataterizasyonun ilk geçiş başarısına, kataterizasyon süresine ve cilt perforasyon
sayısına olan etkisi araştırıldı.
Yöntem: Çalışma; anestezisti tarafında invaziv arteriyal monitörizasyonu uygun
görülmüş ve kataterizasyonu USG eşliğinde yapılmış hastalar dahil edildi. Çalışmaya
dahil edilen hastalar, lokal anestezi sonrası arter kanülasyon grubu (Grup L),
indüksiyon sonrası arter kanülasyonu grubu (Grup G) olarak ayrıldı. Hastaların
demografik özellikleri, vital bulguları ve kateteriasyon öncesi radyal arter akım ve
çapları kaydedilip bu hastalarda radial artere ilk geçiş başarısı, kullanılan katater
sayısı, cilt perforasyon sayısı, başarılı kanülasyona ulaşma süresi (saniye)
değerlendirildi.
Bulgular: Grup L’nin kanülasyon sırasındaki sistolik kan basınçları, diyasyolik kan
basınçları, ortalama arter basınçları ve SPO2 değerleri Grup G’den yüksek bulundu
(p<0,001). İki grup arasında arter çapları arasında anlamlı fark görülmedi (p:0,872;
p:0,239). Grup L’de akım parametleri daha yüksek olarak bulundu (p<0,001;
p:0,003). İki grup arasında kateterizasyon başarısı açısından fark görülmedi (p:0,152;
p:0,152; p:0,152; p:0,212). Ancak diyabetes mellitus (OR: 2,043, P: 0,027, CI %95:
1,26-46,9), hipertansiyon (OR:1,603, P:0,042, CI %95: 1,05- 23,29) ve end
diyastolik akım düşüklüğü (OR: 0,221, P:0,023, CI %95: 0,662-0,970)
kateterizasyon başarızlığında risk faktörü olarak belirlendi.
Sonuç: Radial arter akımlarına bakıldığında; lokal anestezi ile kanülasyon sırasında
ölçülen Pik Sistolik ve End-Diyastolik arter akımlarının genel anestezi sonrası
ölçülen akımlardan yüksek görüldü. Genel anestezi ile meydana gelen MAP düşüşü
arter kan akışı yanıtının ana belirteçlerinden olabilir. Çalışmada lokal anestezi ile
genel anestezi gruplarının kataterizasyon başarılarına bakıldığında anlamlı fark
bulunmadı. Diyabetes mellitus, hipertansiyon, end diyastolik arter akımı ilk geçiş
başarısızlığına etki eden risk faktörleri olarak bulundu. Pik sistolik radiyal arter
akımı için cut off değer 33.6 cm/s; end diyastolik radiyal arter akımı için cut-off 7.6
cm/sn olarak bulundu.
In this study, the effect of arterial catheterization on first pass success, catheterization time and skin perforation number was investigated by making radial arterial flow measurements with USG in patients scheduled for invasive arterial monitoring after general and local anesthesia. Method: Study; Patients who were deemed suitable for invasive arterial monitoring by the anesthesiologist and whose catheterization was performed under USG guidance were included. Patients included in the study were divided into post-local anesthesia arterial cannulation group (Group L) and post-induction arterial cannulation group (Group G). The demographic characteristics, vital signs, and radial artery flow and diameters before catheterization were recorded, and the success of the first passage to the radial artery, the number of catheters used, the number of skin perforations, and the time to reach successful cannulation (seconds) were evaluated. Results: Systolic blood pressures, diastolic blood pressures, mean arterial pressures and SPO2 values during cannulation of Group L were found to be higher than Group G (p<0.001). There was no significant difference in arterial diameters between the two groups (p:0.872; p:0.239). Flow parameters were found to be higher in Group L (p<0.001; p:0.003). There was no difference in catheterization success between the two groups (p:0.152; p:0.152; p:0.152; p:0.212). However, diabetes mellitus (OR: 2.043, P: 0.027, CI 95%: 1.26-46.9), hypertension (OR: 1.603, P: 0.042, CI 95%: 1.05-23.29) and end-diastolic low flow (OR: 0.221, P: 0.023, CI 95%: 0.662-0.970) was determined as a risk factor for catheterization failure. Conclusion: Considering the radial arterial flows; Peak Systolic and End-Diastolic arterial flows measured during cannulation with local anesthesia were higher than those measured after general anesthesia. MAP decrease with general anesthesia may be one of the main markers of arterial blood flow response. In the study, when the catheterization successes of the local anesthesia and general anesthesia groups were examined, no significant difference was found.Diabetes mellitus, hypertension, and end-diastolic arterial flow were found to be risk factors for first-pass failure.The cut-off value for peak systolic radial artery flow was 33.6 cm/s; The cut-off for end diastolic radial artery flow was 7.6 cm/sec. We think that arterial catheterization failure is higher in flows below these values.
In this study, the effect of arterial catheterization on first pass success, catheterization time and skin perforation number was investigated by making radial arterial flow measurements with USG in patients scheduled for invasive arterial monitoring after general and local anesthesia. Method: Study; Patients who were deemed suitable for invasive arterial monitoring by the anesthesiologist and whose catheterization was performed under USG guidance were included. Patients included in the study were divided into post-local anesthesia arterial cannulation group (Group L) and post-induction arterial cannulation group (Group G). The demographic characteristics, vital signs, and radial artery flow and diameters before catheterization were recorded, and the success of the first passage to the radial artery, the number of catheters used, the number of skin perforations, and the time to reach successful cannulation (seconds) were evaluated. Results: Systolic blood pressures, diastolic blood pressures, mean arterial pressures and SPO2 values during cannulation of Group L were found to be higher than Group G (p<0.001). There was no significant difference in arterial diameters between the two groups (p:0.872; p:0.239). Flow parameters were found to be higher in Group L (p<0.001; p:0.003). There was no difference in catheterization success between the two groups (p:0.152; p:0.152; p:0.152; p:0.212). However, diabetes mellitus (OR: 2.043, P: 0.027, CI 95%: 1.26-46.9), hypertension (OR: 1.603, P: 0.042, CI 95%: 1.05-23.29) and end-diastolic low flow (OR: 0.221, P: 0.023, CI 95%: 0.662-0.970) was determined as a risk factor for catheterization failure. Conclusion: Considering the radial arterial flows; Peak Systolic and End-Diastolic arterial flows measured during cannulation with local anesthesia were higher than those measured after general anesthesia. MAP decrease with general anesthesia may be one of the main markers of arterial blood flow response. In the study, when the catheterization successes of the local anesthesia and general anesthesia groups were examined, no significant difference was found.Diabetes mellitus, hypertension, and end-diastolic arterial flow were found to be risk factors for first-pass failure.The cut-off value for peak systolic radial artery flow was 33.6 cm/s; The cut-off for end diastolic radial artery flow was 7.6 cm/sec. We think that arterial catheterization failure is higher in flows below these values.
Açıklama
Anahtar Kelimeler
İnvaziv arteriyal kateterizasyon, Akım, USG, Invasive arterial catheterization, Flow, USG
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Erdem. F. K. (2023). Ultrasonografi ile ölçülen arteriyal kan akımının radiyal arterkateterizasyonuna etkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Anesteziyoloji ve Reanimasyon Anabilim Dalı, Konya.
