Acil Serviste Kardiyopulmoner Resüsitasyonda Perfüzyon İndeksinin Değeri

Abstract

DOGAN B, Value of Perfusion Index in Cardiopulmonary Resuscitation in Emergency Department, Hacettepe University Faculty of Medicine, Emergency Medicine Thesis. Ankara, 2020. Perfusion index (PI) is an effective parameter used in critical patient monitoring to show cardiac output and tissue perfusion. In our study, it was planned to investigate the relationship between End Tidal Carbon Dioxide (EtCO2) and PI values in cardiopulmonary resuscitation and its effectiveness in predicting survival. Out of hospital cardiopulmonary arrest adult patients who were brought to Hacettepe University Emergency Department and cardiopulmonary arrest adult patients while being treated within the hospital between November 2018 and April 2019, were included in this prospective and observational study. 100 patients were included in the study. Data were obtained using Utstein parameters. In addition, a one-month survival and cerebral performance scale score was analyzed, along with EtCO2 and PI values at baseline, fifth, tenth, fifteenth, twentieth, twentyfifth, thirtieth, thirtyfifth, fortieth and end of cardiopulmonary resuscitation (CPR), EtCO2 and PI values. It was observed that gender, presence of comorbidity, etiology, arrival rhythm, witness status, pre-hospital CPR or defibrillation did not affect the PI value of the patients (p=0,803), (p=0,764), (p=0,69), (p=0,244), (p=0,769). The cut-off value could not be determined in predicting mortality and neurological outcome. When the patients who were returned to spontaneous circulation (ROSC) were examined, PI values were found to be insufficient to predict one month survival (p=0,15). There is no relation between hemoglobin, mean arterial pressures after ROSC and PI value (p=1). PI was not effective in predicting prognosis and survival in cardiopulmonary resuscitation (p = 0.270). There is not enough study on the prognostic value of PI in cardiopulmonary arrest patients, there is a need for extensive studies on this subject.