{"id":767,"date":"2026-08-04T10:57:46","date_gmt":"2026-08-04T07:57:46","guid":{"rendered":"https:\/\/tatd.org.tr\/geriatri\/?p=767"},"modified":"2026-08-04T10:57:48","modified_gmt":"2026-08-04T07:57:48","slug":"yasli-hastada-mekanik-ventilasyon-klinik-karar-verme-ve-sonuclandirma","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/geriatri\/akademik-blog-yazisi\/yasli-hastada-mekanik-ventilasyon-klinik-karar-verme-ve-sonuclandirma\/","title":{"rendered":"Ya\u015fl\u0131 Hastada Mekanik Ventilasyon: Klinik Karar Verme Ve Sonu\u00e7land\u0131rma"},"content":{"rendered":"\n

Yazar:<\/strong> Do\u00e7.Dr. Tanzer Korkmaz Edit\u00f6r: <\/strong>Do\u00e7.Dr. Rana Di\u015fel<\/p>\n\n\n\n

D\u00fcnya genelinde ya\u015fam s\u00fcresinin uzamas\u0131yla birlikte yo\u011fun bak\u0131m \u00fcnitelerinde tedavi edilen ya\u015fl\u0131 hasta say\u0131s\u0131 h\u0131zla artmaktad\u0131r. \u00d6zellikle akut solunum yetmezli\u011fi, pn\u00f6moni, kronik obstr\u00fcktif akci\u011fer hastal\u0131\u011f\u0131 (KOAH) alevlenmesi, akut solunum s\u0131k\u0131nt\u0131s\u0131 sendromu (ARDS) ve sepsis gibi kritik hastal\u0131klar nedeniyle mekanik ventilasyon deste\u011fine ihtiya\u00e7 duyan ya\u015fl\u0131 bireyler, yo\u011fun bak\u0131m prati\u011finin giderek daha b\u00fcy\u00fck bir b\u00f6l\u00fcm\u00fcn\u00fc olu\u015fturmaktad\u0131r. Ancak ya\u015fl\u0131 hastalarda mekanik ventilasyon karar\u0131, yaln\u0131zca gaz de\u011fi\u015fiminin d\u00fczeltilmesi veya solunum i\u015f y\u00fck\u00fcn\u00fcn azalt\u0131lmas\u0131 a\u00e7\u0131s\u0131ndan de\u011fil; ayn\u0131 zamanda hastan\u0131n fizyolojik rezervleri, k\u0131r\u0131lganl\u0131k d\u00fczeyi, komorbiditeleri, ya\u015fam beklentisi ve tedavi hedefleri a\u00e7\u0131s\u0131ndan da de\u011ferlendirilmesi gereken karma\u015f\u0131k bir klinik s\u00fcre\u00e7tir.<\/p>\n\n\n\n

Ya\u015flanma ile birlikte solunum sisteminde meydana gelen yap\u0131sal ve fonksiyonel de\u011fi\u015fiklikler, mekanik ventilasyon uygulamalar\u0131n\u0131 gen\u00e7 eri\u015fkinlerden farkl\u0131 hale getirmektedir. K\u00fc\u00e7\u00fck hava yollar\u0131nda daralma, alveoler geni\u015fleme, elastik geri \u00e7ekilme kuvvetinde azalma, g\u00f6\u011f\u00fcs duvar\u0131 rijiditesinde art\u0131\u015f ve solunum kaslar\u0131nda g\u00fc\u00e7 kayb\u0131 gibi de\u011fi\u015fiklikler ya\u015fl\u0131 bireylerde ventilasyon-perf\u00fczyon uyumsuzlu\u011funu art\u0131rmakta ve solunum rezervlerini azaltmaktad\u0131r. Bunun sonucundavital kapasite <\/strong>azal\u0131rken rezid\u00fcel vol\u00fcm <\/strong>artmakta, dif\u00fczyon kapasitesi <\/strong>d\u00fc\u015fmekte ve hipoksemiye<\/strong> yatk\u0131nl\u0131k geli\u015fmektedir. Bu fizyolojik de\u011fi\u015fiklikler, mekanik ventilasyon gereksinimini art\u0131rd\u0131\u011f\u0131 gibi ventilat\u00f6r ili\u015fkili komplikasyonlara duyarl\u0131l\u0131\u011f\u0131 da y\u00fckseltmektedir.1<\/sup><\/p>\n\n\n\n

Ya\u015flanman\u0131n hava yolu anatomisi ve akci\u011fer biyomekani\u011fi \u00fczerindeki etkileri yaln\u0131zca klinik g\u00f6zlemlerle de\u011fil, deneysel ve say\u0131sal modellemelerle de ortaya konmu\u015ftur. \u0130nsan bron\u015fiolleri \u00fczerinde yap\u0131lan sim\u00fclasyon \u00e7al\u0131\u015fmalar\u0131nda, 50-80 ya\u015f aras\u0131nda distal bron\u015fiol \u00e7aplar\u0131nda yakla\u015f\u0131k %10 azalma meydana geldi\u011fi, alveoler keselerin geni\u015fledi\u011fi ve akci\u011fer dokusunun daha sert hale geldi\u011fi g\u00f6sterilmi\u015ftir. Bunun sonucunda hava ak\u0131m\u0131 dinamikleri de\u011fi\u015fmekte, gaz de\u011fi\u015fim etkinli\u011fi azalmakta ve ventilasyon s\u0131ras\u0131nda olu\u015fan mekanik stresin da\u011f\u0131l\u0131m\u0131 farkl\u0131la\u015fmaktad\u0131r. Solunum mekani\u011finde 30 ya\u015f sonras\u0131nda y\u0131lda yakla\u015f\u0131k %1 oran\u0131nda ilerleyici bir kay\u0131p oldu\u011fu bildirilmektedir.2<\/sup><\/p>\n\n\n\n

Mekanik ventilasyon ya\u015fam kurtar\u0131c\u0131 bir tedavi y\u00f6ntemi olmakla birlikte, \u00f6zellikle ya\u015fl\u0131 hastalarda ventilat\u00f6r ili\u015fkili akci\u011fer hasar\u0131 (VILI), ventilat\u00f6r ili\u015fkili pn\u00f6moni, diyafram disfonksiyonu ve uzam\u0131\u015f ventilat\u00f6r ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 gibi komplikasyon risklerini de beraberinde getirmektedir. Nitekim mekanik ventilasyon uygulanan kritik hastalarda mortalite yakla\u015f\u0131k %35 iken, bu oran ileri ya\u015f gruplar\u0131nda %50’nin \u00fczerine \u00e7\u0131kabilmektedir. \u00c7in’de \u00e7ok merkezli yo\u011fun bak\u0131m \u00fcnitelerinde ger\u00e7ekle\u015ftirilen geni\u015f bir retrospektif \u00e7al\u0131\u015fmada, 80 ya\u015f ve \u00fczerindeki mekanik ventilasyon uygulanan hastalarda hastane mortalitesinin yakla\u015f\u0131k %50’ye ula\u015ft\u0131\u011f\u0131; ya\u015f\u0131n, APACHE II skoru ve oksijenizasyon parametrelerinden ba\u011f\u0131ms\u0131z olarak mortalite i\u00e7in \u00f6nemli bir risk fakt\u00f6r\u00fc oldu\u011fu g\u00f6sterilmi\u015ftir.3<\/sup><\/p>\n\n\n\n

Ya\u015fl\u0131 Hastalarda Mekanik Ventilasyon Y\u00f6netimi: <\/strong>Ya\u015fl\u0131 hastada mekanik ventilasyon, yaln\u0131zca ventilat\u00f6r ayarlar\u0131n\u0131n belirlenmesinden ibaret de\u011fildir. Do\u011fru hasta se\u00e7imi, ventilasyon stratejisinin bireyselle\u015ftirilmesi, komplikasyonlar\u0131n \u00f6nlenmesi, ventilat\u00f6rden ay\u0131rma (weaning) s\u00fcrecinin y\u00f6netimi ve tedavinin sonland\u0131r\u0131lmas\u0131na ili\u015fkin etik kararlar, klinik ba\u015far\u0131n\u0131n temel bile\u015fenlerini olu\u015fturmaktad\u0131r. Ya\u015flanmaya ba\u011fl\u0131 olarak geli\u015fen bu anatomik ve fizyolojik de\u011fi\u015fiklikler, akut solunum yetmezli\u011fi geli\u015fti\u011finde ya\u015fl\u0131 hastalar\u0131n mekanik ventilasyona yan\u0131t\u0131n\u0131 belirgin \u015fekilde etkilemektedir. Azalm\u0131\u015f fizyolojik rezervler, e\u015flik eden \u00e7oklu komorbiditeler, k\u0131r\u0131lganl\u0131k sendromu ve yo\u011fun bak\u0131m ili\u015fkili komplikasyonlara yatk\u0131nl\u0131k nedeniyle ya\u015fl\u0131 bireylerde mekanik ventilasyon y\u00f6netimi gen\u00e7 eri\u015fkinlerden farkl\u0131 bir yakla\u015f\u0131m gerektirir. Ya\u015fl\u0131 n\u00fcfusun art\u0131\u015f\u0131yla birlikte, yo\u011fun bak\u0131m \u00fcnitelerinde mekanik ventilasyon deste\u011fine ihtiya\u00e7 duyan geriatrik hastalar\u0131n y\u00f6netimi, kendine \u00f6zg\u00fc fizyolojik ve etik zorluklar\u0131 beraberinde getirmektedir. Ama\u00e7 yaln\u0131zca ya\u015fam\u0131 s\u00fcrd\u00fcrmek de\u011fil; ayn\u0131 zamanda fonksiyonel ba\u011f\u0131ms\u0131zl\u0131\u011f\u0131 korumak, gereksiz invaziv giri\u015fimlerden ka\u00e7\u0131nmak ve hastan\u0131n de\u011ferleri do\u011frultusunda tedavi hedeflerini belirlemektir. Bu nedenle ya\u015fl\u0131 hastalarda mekanik ventilasyon s\u00fcreci; ent\u00fcbasyon karar\u0131ndan ventilat\u00f6r ayarlar\u0131n\u0131n se\u00e7imine, ventilat\u00f6rden ay\u0131rma stratejilerinden ya\u015fam sonu planlamas\u0131na kadar b\u00fct\u00fcnc\u00fcl bir de\u011ferlendirme gerektirmektedir.<\/p>\n\n\n\n

Ya\u015fl\u0131 Hastada Ent\u00fcbasyon Karar\u0131:<\/strong> Geriatrik hastalarda invaziv mekanik ventilasyona ba\u015flama karar\u0131; persistan apne, y\u00fcksek d\u00fczeyde havayolu t\u0131kan\u0131kl\u0131\u011f\u0131, koruyucu reflekslerin kayb\u0131, ciddi hipoksemi veya di\u011fer tedavilere yan\u0131ts\u0131z hiperkarbi gibi kesin endikasyonlara dayanmal\u0131d\u0131r.4<\/sup> Ancak karar verme s\u00fcrecinde kronolojik ya\u015f tek ba\u015f\u0131na bir engel te\u015fkil etmemeli; bunun yerine hastan\u0131n fizyolojik rezervi, e\u015flik eden hastal\u0131klar\u0131 ve k\u0131r\u0131lganl\u0131k d\u00fczeyi temel al\u0131nmal\u0131d\u0131r. Akut solunum yetmezli\u011fi geli\u015fen ya\u015fl\u0131larda, \u00f6zellikle KOAH ve pulmoner \u00f6dem durumlar\u0131nda, ent\u00fcbasyon ihtiyac\u0131n\u0131 ve mortaliteyi azaltt\u0131\u011f\u0131 kan\u0131tlanm\u0131\u015f olan Non-\u0130nvaziv Pozitif Bas\u0131n\u00e7l\u0131 Ventilasyon (NIPBV) ilk se\u00e7enek olarak de\u011ferlendirilmelidir. Ent\u00fcbasyon karar\u0131 al\u0131nd\u0131\u011f\u0131nda ise ya\u015fl\u0131lardaki anatomik de\u011fi\u015fiklikler (di\u015f kayb\u0131, servikal rijidite) ve ila\u00e7lara (opioid ve sedatifler) kar\u015f\u0131 artm\u0131\u015f duyarl\u0131l\u0131k nedeniyle dozlar\u0131n %30-50 oran\u0131nda azalt\u0131lmas\u0131 ve “d\u00fc\u015f\u00fck ba\u015fla, yava\u015f git” <\/strong>ilkesinin uygulanmas\u0131 hayati \u00f6nem ta\u015f\u0131r.<\/p>\n\n\n\n

Ventilat\u00f6r Ayarlar\u0131n\u0131n Bireyselle\u015ftirilmesi: <\/strong>Ya\u015flanan akci\u011ferlerde elastin fiberlerin kayb\u0131, elastik geri \u00e7ekimde azalmaya ve statik akci\u011fer kompliyans\u0131nda yakla\u015f\u0131k %41 oran\u0131nda bir art\u0131\u015fa neden olur. Bu durum, pozitif bas\u0131n\u00e7l\u0131 ventilasyon s\u0131ras\u0131nda alveollerin a\u015f\u0131r\u0131 gerilmesine ve ventilat\u00f6rle ili\u015fkili akci\u011fer hasar\u0131na (VILI) duyarl\u0131l\u0131\u011f\u0131 art\u0131r\u0131r. Bu nedenle, \u00f6zellikle sepsis veya ARDS tablosundaki ya\u015fl\u0131larda, tidal hacmin 6 mL\/kg gibi d\u00fc\u015f\u00fck seviyelerde tutuldu\u011fu “akci\u011fer koruyucu ventilasyon”<\/strong> stratejileri uygulanmal\u0131d\u0131r. Ayr\u0131ca, ya\u015fl\u0131 kalbin \u00f6ny\u00fcke (preload) olan hassas ba\u011f\u0131ml\u0131l\u0131\u011f\u0131 nedeniyle, ventilasyon s\u0131ras\u0131nda konservatif s\u0131v\u0131 y\u00f6netimi uygulanmas\u0131 ventilat\u00f6r kaynakl\u0131 mortalitenin \u00f6nlenmesinde kritik bir rol oynar.3,5,6<\/sup><\/p>\n\n\n\n

Weaning ve Ekst\u00fcbasyon S\u00fcreci: <\/strong>Ya\u015fl\u0131 hastalarda ventilat\u00f6rden ayr\u0131lma (weaning) s\u00fcreci, sarkopeni (kas k\u00fctlesi kayb\u0131) ve diyafram atrofisi nedeniyle s\u0131kl\u0131kla uzayabilmektedir. Ba\u015far\u0131l\u0131 bir weaning i\u00e7in, 2026 SCCM k\u0131lavuzlar\u0131 taraf\u0131ndan \u00f6nerilen ve spontan solunum denemelerini (SBT) i\u00e7eren “ABCDEF bundle” protokolleri titizlikle uygulanmal\u0131d\u0131r. [A: Assess, prevent, and manage pain-A\u011fr\u0131y\u0131 de\u011ferlendir, \u00f6nle ve y\u00f6net; B: Both SAT and SBT: Hem Spontan Uyand\u0131rma Denemeleri (SAT) hem de Spontan Solunum Denemeleri (SBT); C: Choice of analgesia and sedation- Analjezi ve sedasyon se\u00e7imi; D: Delirium- assess, prevent, and manage- de\u011ferlendir, \u00f6nle ve y\u00f6net; E: Early mobility and exercise- Erken mobilizasyon ve egzersiz; F: Family engagement and empowerment- Aile kat\u0131l\u0131m\u0131 ve g\u00fc\u00e7lendirilmesi]. Bu yakla\u015f\u0131m\u0131n, mekanik ventilasyon s\u00fcresini, deliryum s\u0131kl\u0131\u011f\u0131n\u0131 ve yo\u011fun bak\u0131mda kal\u0131\u015f s\u00fcresini azalt\u0131rken; fonksiyonel iyile\u015fmeyi ve hasta sonu\u00e7lar\u0131n\u0131 iyile\u015ftirdi\u011fi g\u00f6sterilmi\u015ftir.7,8 <\/sup>Akut sarkopeni ile m\u00fccadele etmek i\u00e7in hastaya g\u00fcnl\u00fck 1.2 – 1.5 g\/kg protein deste\u011fi sa\u011flanmal\u0131 ve fizik tedaviye m\u00fcmk\u00fcn olan en erken a\u015famada (ilk 72 saat i\u00e7inde) ba\u015flanmal\u0131d\u0131r Ayr\u0131ca, ya\u015fl\u0131larda ventilat\u00f6rle ili\u015fkili pn\u00f6moni (V\u0130P) mortalite i\u00e7in ba\u011f\u0131ms\u0131z bir risk fakt\u00f6r\u00fc oldu\u011fundan, a\u011f\u0131z bak\u0131m\u0131 (Klorheksidin) ve yatak ba\u015f\u0131n\u0131n 30\u00b0-45\u00b0 y\u00fckseltilmesi gibi \u00f6nleyici paketlerin uygulanmas\u0131 weaning ba\u015far\u0131s\u0131n\u0131 art\u0131r\u0131r.9<\/sup><\/p>\n\n\n\n

Prognoz ve Ya\u015fam Sonu Kararlar\u0131: <\/strong>Mekanik ventilasyon y\u00f6netimi, t\u0131bbi ba\u015far\u0131n\u0131n \u00f6tesine ge\u00e7erek biyoetik ilkeler (\u00f6zerklik, yararl\u0131l\u0131k, zarar vermeme ve adalet) \u00e7er\u00e7evesinde de\u011ferlendirilmelidir. Hastan\u0131n kendi ad\u0131na karar veremedi\u011fi durumlarda, hekimlerin t\u0131bbi verileri sundu\u011fu, hasta vekillerinin ise hastan\u0131n de\u011ferlerini temsil etti\u011fi “Ortak Karar Verme” (Shared Decision-Making)<\/strong> modeli<\/strong> uygulanmal\u0131d\u0131r.4<\/sup><\/p>\n\n\n\n

Klinik belirsizli\u011fin y\u00fcksek oldu\u011fu vakalarda, ventilasyonun s\u00fcresiz ba\u015flat\u0131lmas\u0131 yerine, 48-96 saatlik objektif fizyolojik hedeflerin belirlendi\u011fi “Zaman S\u0131n\u0131rl\u0131 Denemeler” (Time-Limited Trials) <\/strong>yap\u0131lmas\u0131 \u00f6nerilir.10<\/sup> E\u011fer tedavi hastaya net bir fayda sa\u011flam\u0131yor ve sadece \u00f6lme s\u00fcrecini uzat\u0131yorsa, ya\u015fam\u0131 s\u00fcrd\u00fcren tedavinin geri \u00e7ekilmesi veya DNAR (res\u00fcsitasyon yapmama) kararlar\u0131n\u0131n uygulanmas\u0131 etik ve yasal olarak kabul edilebilir bir yakla\u015f\u0131md\u0131r. Bu a\u015famada odak noktas\u0131, hastan\u0131n onurunu koruyan kaliteli bir palyatif bak\u0131m sunmak olmal\u0131d\u0131r.<\/p>\n\n\n\n

Kaynaklar<\/p>\n\n\n\n

1. T\u00fcrk \u0130\u00e7 Hastal\u0131klar\u0131 Uzmanl\u0131k Derne\u011fi. Solunum sisteminde ya\u015flanma ve fizyolojik de\u011fi\u015fiklikler. Accessed July 19, 2026. https:\/\/www.tihud.org.tr\/uploads\/content\/kongre\/5\/5.31.pdf<\/p>\n\n\n\n

2. Kim J, Heise RL, Reynolds AM, Pidaparti RM. Aging effects on airflow dynamics and lung function in human bronchioles. PLoS One. 2017;12(8):e0183654. doi:10.1371\/journal.pone.0183654<\/p>\n\n\n\n

3. Ma JG, Zhu B, Jiang L, Jiang Q, Xi XM. Clinical characteristics and outcomes of mechanically ventilated elderly patients in intensive care units: a Chinese multicentre retrospective study. J Thorac Dis. 2021;13(4):2148-2159. doi:10.21037\/jtd-20-2748<\/p>\n\n\n\n

4. Karamercan MA, Bellou A, Blain H. Primary assessment and stabilization of life-threatening conditions in older patients. In: Nickel CH, Bellou A, Conroy S, eds. Geriatric Emergency Medicine. Springer International Publishing; 2018:23-48. doi:10.1007\/978-3-319-19318-2_3. ISBN:978-3-319-19317-5. Turkish translation: Geriatrik Acil T\u0131p. Denizba\u015f\u0131 A, translation editors coordinator; Karc\u0131o\u011flu \u00d6, Oktay C, K\u00f6ksal \u00d6, Korkmaz T, Karacabey S, Sanr\u0131 E, \u00c7etin M, translation eds.<\/p>\n\n\n\n

5. Ely EW, Evans GW, Haponik EF. Mechanical ventilation in a cohort of elderly patients admitted to an intensive care unit. Ann Intern Med. 1999;131(2):96-104. doi:10.7326\/0003-4819-131-2-199907200-00004<\/p>\n\n\n\n

6. Nicolas-Robin A, Leblanc J, Bouadma L, et al. Elderly patients undergoing mechanical ventilation in and out of intensive care units. J Am Geriatr Soc. 2007;55(12):2065-2070. doi:10.1111\/j.1532-5415.2007.01452.x<\/p>\n\n\n\n

7. Marra A, Ely EW, Pandharipande PP, Patel MB. The ABCDEF bundle in critical care. Crit Care Clin. 2017;33(2):225-243. doi:10.1016\/j.ccc.2016.12.005<\/p>\n\n\n\n

8. Devlin JW, Skrobik Y, G\u00e9linas C, et al. Clinical practice guidelines for the prevention and management of pain, agitation\/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825-e873. doi:10.1097\/CCM.0000000000003299<\/p>\n\n\n\n

9. Sert H, Aygin D, B\u00f6l\u00fckta\u015f RP. Yo\u011fun bak\u0131mdaki ya\u015fl\u0131 hastalarda ventilat\u00f6rle ili\u015fkili pn\u00f6moni ve \u00f6nlenmesi. Yo\u011fun Bak\u0131m Hem\u015fireli\u011fi Dergisi. 2015;19(2):60-67.<\/p>\n\n\n\n

10. Kruser JM, Nadig NR, Viglianti EM, Clapp JT, Secunda KE, Halpern SD. Time-limited trials for patients with critical illness: a review of the literature. Chest. 2024;165(4):881-891. doi:10.1016\/j.chest.2023.12.014<\/p>\n","protected":false},"excerpt":{"rendered":"

Yazar: Do\u00e7.Dr. Tanzer Korkmaz Edit\u00f6r: Do\u00e7.Dr. Rana Di\u015fel D\u00fcnya genelinde ya\u015fam s\u00fcresinin uzamas\u0131yla birlikte yo\u011fun bak\u0131m \u00fcnitelerinde tedavi edilen ya\u015fl\u0131 hasta say\u0131s\u0131…<\/p>\n","protected":false},"author":1185,"featured_media":769,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","_tatd_show_on_main_site":"1","footnotes":""},"categories":[10014],"tags":[10020,10018,10070],"class_list":["post-767","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi","tag-acil-tip","tag-geriatri","tag-mekanik-ventilasyon"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/767","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/users\/1185"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/comments?post=767"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/767\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media\/769"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media?parent=767"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/categories?post=767"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/tags?post=767"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}