Anesteziyoloji ve Reanimasyon Yoğun Bakım Ünitesinde Beta Bloker Kullanımının Mortalite ve Morbidite Üzerine Etkileri

Abstract

In this study; it was aimed to investigate the effects of the usage of beta-blockers on mortality and morbidity in the Anesthesiology and Reanimation Intensive Care Unit. Following ethical commitee approval; files of 850 patients over 45 years that had been hsopitalized in the Anesthesia Intensive Care Unit between dates of 01.01.2006 and 01.01.2011 45 were analysed. It was investigated whether there were any correlations between the usage of beta blockers before and during the hospitalization and the hemodynamic parameters and mortality of the patients hospitalized in the intensive care unit. And also the hospitalized patients were divided into 2 groups; elderly (≥ 65 years) and young (< 65 years) patients and two groups were analysed according to the beta blocker effects. The data of the groups was compared by using Kolmogorov - Smirnov, one-way Anova test, t- test, Kruskal -Wallis analysis, Mann-Whitney U, paired samples t-test, Wilcoxon test and chi- square test and p <0.05 values were accepted as statistically significant. In our study, statistically significant difference was found between the patients used beta blockers and the patients not used beta blockers about cardiovascular drug usage, anemia, hypotension, mechanical ventilation at admission and during the hospitalization, death in ICU and hospital, vasopressor drug usage, GCS at admission, the highest and lowest value of heart rate at admission, the systolic and mean arterial blood pressure values at admission, and Charlson and APACHE II scores (p < 0,05). It was found that cardiovascular drugs usage and anemia had higher rates among beta blocker users in all groups. It was determined that beta blockers non-used had a higher rate of hypotension, mechanical ventilation at admission and during the hospitalization, while it was established that the patients over 65 and not used beta blockers had higher mortality rates in the intensive care unit and hospital, vasopressor usage rates and Charlson and APACHE II scores. v However, in our study, although statistically significant differences were found in binary analysis; in multivariate analysis, the usage of beta-blockers in elderly patients was not found as an independent variable for neither intensive care nor hospital mortality. Due to the inability to reach the target value of heart rate, it was established that the beta-blockage was not efficient enough, and so it was thought that its protective effect was probably not observed. In the light of the results obtained in our study, we think that the beta blockers that are commonly used in intensive care unit, should be used in effective levels in case of observing their effects on patients and we also think that it needs to be discussed by the help of more advanced studies conducted about this subject.