{"id":2362,"date":"2016-06-27T00:00:00","date_gmt":"2016-06-26T21:00:00","guid":{"rendered":"https:\/\/tatd.org.tr\/tatdus\/2020\/03\/09\/kritik-hasta-degerlendirilmesinde-kullanilan-sonografik-protokoller\/"},"modified":"2022-04-06T14:33:21","modified_gmt":"2022-04-06T11:33:21","slug":"kritik-hasta-degerlendirilmesinde-kullanilan-sonografik-protokoller","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/tatdus\/2016\/06\/27\/kritik-hasta-degerlendirilmesinde-kullanilan-sonografik-protokoller\/","title":{"rendered":"Kritik Hasta De\u011ferlendirilmesinde Kullan\u0131lan Sonografik Protokoller"},"content":{"rendered":"\r\n\r\n\r\n

Son 30 y\u0131ll\u0131k d\u00f6nem i\u00e7erisindeki deneyimler radyolog d\u0131\u015f\u0131 klinisyenler taraf\u0131ndan uygulanan yatak ba\u015f\u0131 nedene y\u00f6nelik ultrasonografik de\u011ferlendirmenin (POCUS) tan\u0131ya gidi\u015fte kullan\u0131\u015fl\u0131 ve fizik muayenenin tamamlay\u0131c\u0131s\u0131 kabul edildi\u011fini ortaya koymaktad\u0131r. Klinisyen taraf\u0131ndan karar verme s\u00fcrecinde spesifik sorular\u0131n yan\u0131t\u0131n\u0131 var\/yok \u015feklinde ortaya koyan POCUS, hastay\u0131 detayl\u0131 radyolojik tetkiklerden koruyarak zaman kayb\u0131n\u0131 azalt\u0131r, tan\u0131ya h\u0131zl\u0131 ve do\u011fru algoritmalar ile ula\u015fmay\u0131 sa\u011flar. \u00d6zellikle kritik hastan\u0131n de\u011ferlendirilmesi gibi zaman\u0131n k\u0131s\u0131tl\u0131 oldu\u011fu hasta grubunda acil ve \u00f6nemli sorulara verdi\u011fi do\u011fruluk oran\u0131 y\u00fcksek cevaplar ile g\u00f6zde uygulamalardan birisi haline gelmi\u015ftir. Fizik muayeneye paralel olarak uyguland\u0131\u011f\u0131nda hastan\u0131n res\u00fcsitasyon ve stabilizasyonunda yol g\u00f6sterici oldu\u011fu kadar tekrarlayan de\u011ferlendirmelere olanak sa\u011flamas\u0131 ile de duyarl\u0131l\u0131\u011f\u0131 artt\u0131r\u0131r. Ayn\u0131 zamanda POCUS radyoloji d\u0131\u015f\u0131 hekim taraf\u0131ndan uyguland\u0131\u011f\u0131nda anatomik \u00e7al\u0131\u015fmadan \u00e7\u0131karak daha fizyolojik bir \u00e7al\u0131\u015fma haline gelmi\u015ftir. \u00d6rne\u011fin hipovolemik \u015fok res\u00fcsitasyonunda \u0130nferior Vena Kava (IVC) \u00f6l\u00e7\u00fcm\u00fc ile hastan\u0131n takip edilmesi gibi…<\/p>\r\n\r\n\r\n\r\n

Literat\u00fcr tarand\u0131\u011f\u0131nda \u015fok, solunum s\u0131k\u0131nt\u0131s\u0131, kardiyak arrest, multitravma gibi maj\u00f6r res\u00fcsitasyon gerektiren kritik hastalarda POCUS kullan\u0131m\u0131 ile ilgili Acil T\u0131p ve kritik bak\u0131m alanlar\u0131nda yay\u0131mlanm\u0131\u015f algoritmalar ile kar\u015f\u0131la\u015f\u0131lmaktad\u0131r. Acil serviste POCUS kullan\u0131m\u0131na ilk \u00f6rnek travma hastalar\u0131nda kullan\u0131lan Travma Hastas\u0131 i\u00e7in Odaklanm\u0131\u015f Bat\u0131n G\u00f6r\u00fcnt\u00fclemesi yani FAST y\u00f6ntemidir. Sonraki y\u0131llarda travma d\u0131\u015f\u0131 kritik hastalar\u0131n y\u00f6netiminde kullan\u0131lmak \u00fczere birden fazla alan\u0131n algoritmik \u015fekilde de\u011ferlendirilmesi ile protokoller geli\u015ftirilmeye ba\u015flanm\u0131\u015ft\u0131r. Algoritmalar farkl\u0131 kombinasyonlar i\u00e7erisinde travma d\u0131\u015f\u0131 hastalarda hayat\u0131 tehdit eden olaylar\u0131 ortaya koymak ama\u00e7l\u0131 kardiyak (perikardiyal alan, sol ventrik\u00fcl, sa\u011f ventrik\u00fcl, duvar hareket kusuru de\u011ferlendirmesi), IVC (vol\u00fcm durumu), aorta (r\u00fcpt\u00fcr ya da diseksiyon), abdominal (serbest s\u0131v\u0131) ve akci\u011fer (plevral s\u0131v\u0131, interstisyel s\u0131v\u0131, pn\u00f6motoraks) gibi alanlar\u0131n de\u011ferlendirilmelerini i\u00e7ermektedir.
Literat\u00fcr tarand\u0131\u011f\u0131nda kritik hastan\u0131n de\u011ferlendirilmesi y\u00f6nelik ultrasonografi i\u00e7eren \u00e7ok say\u0131da algoritim kar\u015f\u0131m\u0131za \u00e7\u0131kar.\u00a0A\u015fa\u011f\u0131da uygulamada kullan\u0131lan algoritmler y\u0131l\u0131na g\u00f6re s\u0131ralanm\u0131\u015f ve hitap etti\u011fi hasta grubu, hastal\u0131k durumu ve algoritman\u0131n i\u00e7erdi\u011fi sonografik alanlar k\u0131saca \u00f6zetlenmi\u015ftir.

FAST\u00a0Focused Assessment on Sonography for Trauma 1995, The journal of trauma, Rozycki ve ark. (Cerrahi) Travma hastas\u0131nda, perikardial ve peritoneal bo\u015flukta kan aramak
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/7473914\/<\/a><\/p>\r\n\r\n\r\n\r\n

UHP\u00a0A novel ultrasound approach to the empiric evaluation of the undifferentiated hypotensive patient 2001, American Journal of Emergency Medicine,\u00a0Rose ve ark, (Acil T\u0131p)\u00a0\u015eok hastas\u0131nda, bat\u0131n, kardiyak ve aorta de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/11447518\/<\/a><\/p>\r\n\r\n\r\n\r\n

Trinity\u00a0A Hypotensive Ultrasound Protocol 2002, Journal of Diagnostic Medical Sonography, Bahner (Acil T\u0131p)\u00a0\u015eok hastas\u0131nda, kardiyak, aort, bat\u0131n ve plevra de\u011ferlendirmesi
http:\/\/jdm.sagepub.com\/content\/18\/4\/193.abstract<\/a><\/p>\r\n\r\n\r\n\r\n

E-FAST\u00a0Extended Focused Assessment with Sonography for Trauma 2004, The journal of trauma, Kirkpatrick ve ark (Yo\u011fun bak\u0131m) Travma hastas\u0131nda FAST + Akci\u011fer (pn\u00f6motoraks taramas\u0131)
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15345974\/<\/a><\/p>\r\n\r\n\r\n\r\n

FATE\u00a0Focus assessed transthoracic echo protocol 2004, European journal of anesthesiology, Jensen ve ark (Anestezi ve Yo\u011fun bak\u0131m) \u015eok hastas\u0131nda, eko ile de\u011ferlendirme\u00a0\u00a0
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15595582\/<\/a><\/p>\r\n\r\n\r\n\r\n

BLEEP\u00a0Bedside limited echocardiography by the emergency physician 2004, Pediatrics\u00a0, Pershard ve ark (\u00c7ocuk acil ve yo\u011fun bak\u0131m) \u015eok hastas\u0131nda Sol ventrik\u00fcl fonksiyonu, IVC de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15545620\/<\/a><\/p>\r\n\r\n\r\n\r\n

FEER\u00a0Focused echocardiographic evaluation in resuscitation management
2007, Critical care medicine, Breitkreutz ve ark (Acil T\u0131p)\u00a0Kardiyak arrestte, eko ile de\u011ferlendirme
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17446774\/<\/a><\/p>\r\n\r\n\r\n\r\n


BEAT\u00a0Bedside Echocardiographic Assessment in Trauma 2008, The Journal of Trauma: Injury, Infection, and Critical Care, Gunst ve ark (Cerrahi) Travma hastas\u0131nda, Kardiyak index, ef\u00fczyon, fonksiyon ve IVC de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18784562\/<\/a><\/p>\r\n\r\n\r\n\r\n

CAUSE\u00a0Cardiac arrest ultrasound exam 2008, Resuscitation, Hernandez ve ark. (Acil T\u0131p) Kardiyak arrestte kardiyak ve plevra de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17822831<\/a><\/p>\r\n\r\n\r\n\r\n

BLUE\u00a0Bedside Lung Ultrasound in Emergency\u00a02008, Chest, Lichtenstein ve ark. (Yo\u011fun bak\u0131m) Nefes darl\u0131\u011f\u0131nda akci\u011fer de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18403664\/<\/a><\/p>\r\n\r\n\r\n\r\n

ACES\u00a0Abdominal and Cardiac Evaluation with Sonography in Shock 2009, Emergency Medicine Journal, Atkinson ve ark. (Acil T\u0131p) \u015eok hastas\u0131nda, 6 pencere Kardiyak fonksiyon\/ef\u00fczyon, IVC, Aorta, peritoneal ve plevral serrbest s\u0131v\u0131 de\u011ferlendirmesi\u00a0
http:\/\/emj.bmj.com\/content\/26\/2\/87.long<\/a><\/p>\r\n\r\n\r\n\r\n

ETUDES\u00a0Emergency thoracic ultrasound in the differentiation of the etiology of shortness of breath 2009, Academic Emergency Medicine, Liteplo ve ark. (Acil T\u0131p)
Nefes darl\u0131\u011f\u0131nda akci\u011fer de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19183402<\/a><\/p>\r\n\r\n\r\n\r\n

RUSH-HIMAP\u00a0Rapid Ultrasound for Shock and Hypotension 2009, emedhome, eingart ve ark. (Acil t\u0131p) \u015eok ve hipotansiyonda, Kardiyak, IVC, bat\u0131n, aort, akci\u011fer de\u011ferlendirmesi
http:\/\/emcrit.org\/rush-exam\/original-rush-article\/<\/a><\/p>\r\n\r\n\r\n\r\n

RUSH-Pump\/Tank\/Pipes\u00a0Rapid Ultrasound in SHock 2010, Emergency medicine clinics of North America, Perera ve ark. (Acil T\u0131p)\u00a0\u00a0\u015eok hastas\u0131nda, Pompa, tank, borular
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19945597\/<\/a><\/p>\r\n\r\n\r\n\r\n

FEEL\u00a0Focused echocardiographic evaluation in life support 2010, Resusication, Breitkreutz ve ark. (Acil T\u0131p)\u00a0Kardiyak arrestte, kardiyak hareket, ventrik\u00fcler fonksiyon (LV\/RV) de\u011ferlendirmesi\u00a0
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20801576\/<\/a><\/p>\r\n\r\n\r\n\r\n

Elmer\/Noble Protocol\u00a0An Evidence-Based Approach for Integrating Bedside Ultrasound Into Routine Practice in the Assessment of Undifferentiated Shock 2010, ICU Director, Elmer ve ark. (Acil T\u0131p) \u015eok hastas\u0131nda, perikard, kardiyak fonksiyon, IVC, peritoneal, akci\u011fer de\u011ferlendirmesi
http:\/\/icu.sagepub.com\/content\/1\/3\/163.full.pdf<\/a><\/p>\r\n\r\n\r\n\r\n

CAVEAT\u00a0Sonographic examination in the evaluation of chest, abdomen, vena cava, and extremities in acute triage 2010, World journal of orthopedics, Stawicki ve ark (Cerrahi) Travmada hastane \u00f6ncesinde\/triajda, akci\u011fer, abdomen, IVC ve ekstremite de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22474622<\/a><\/p>\r\n\r\n\r\n\r\n

EGLS \u00a0Echo guided life support 2011, critical ultrasound journal, Lanctot ve ark. (Acil T\u0131p ve Yo\u011fun bak\u0131m)\u00a0\u015eok hastas\u0131nda, Akci\u011fer, perikard, IVC, kardiyak fonksiyon de\u011ferlendirmesi
https:\/\/prismic-io.s3.amazonaws.com\/hemodynamik%2F6e17a0ba-8b94-4e11-ab14-144f0ea3e2de_egls-+echo-guided+life+support.pdf<\/a><\/p>\r\n\r\n\r\n\r\n

FREE\u00a0A transthoracic focused rapid echocardiographic evaluation 2011, The journal of trauma, Ferrada ve ark. (Cerrahi ve travma)\u00a0Travma hastas\u0131nda, eko ve IVC ile de\u011ferlendirme
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21217482\/<\/a><\/p>\r\n\r\n\r\n\r\n

FALLS\u00a0The fluid administration limited by lung sonography protocol 2012, Journal of critical care, Lichtenstein ve ark. (Yo\u011fun bak\u0131m)\u00a0\u00a0\u015eok hastas\u0131nda, perikard, kardiyak fonksiyon, BLUE, IVC de\u011ferlendirmesi
http:\/\/www.sciencedirect.com\/science\/article\/pii\/S0883944112001025<\/a><\/p>\r\n\r\n\r\n\r\n

POCUS- Fast and reliable\u00a0Point-of-care ultrasound in the hypotensive patient 2012, Ultrasound, Liteplo ve ark. (Acil T\u0131p) Hipotansiyon hastas\u0131nda, minemonik FAST RELIABLE
http:\/\/ult.sagepub.com\/content\/20\/1\/64<\/a><\/p>\r\n\r\n\r\n\r\n

PAUSE\u00a0Prehospital Assessment with UltraSound for Emergencies 2013, Journal of Emergency Medicine, Chin ve ark (Acil T\u0131p) Travmatik ve atravmatik kritik hastalarda, plevra ve kardiyak de\u011ferlendirme
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22595631<\/a><\/p>\r\n\r\n\r\n\r\n

PEA\u00a0A Simplified and Structured Teaching Tool for the Evaluation and Management of Pulseless Electrical Activity 2014, Medical Principles and Practice, Littmann ve ark. (Dahiliye ve Acil T\u0131p)\u00a0Kardiyak arrestte EKG+USG birlikte de\u011ferlendirilmesi
http:\/\/www.karger.com\/Article\/FullText\/354195<\/a><\/p>\r\n\r\n\r\n\r\n

LUCUS\u00a0A lung and cardiac ultrasound protocol 2015, Academic Emergency Medicine, Russell ve ark (Acil T\u0131p) Nefes darl\u0131\u011f\u0131nda akut kalp yetmezli\u011fi tan\u0131s\u0131na y\u00f6nelik, akci\u011fer ve kardiyak de\u011ferlendirme
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25641227<\/a><\/p>\r\n\r\n\r\n\r\n

5Es\u00a0Emergency physician (EP)-performed focused cardiac ultrasound (EP FOCUS)
2015, Academic Emergency Medicine, Hall ve ark (Acil T\u0131p) \u015eok ve hipotansiyonda, kardiyak ve IVC de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25903585<\/a><\/p>\r\n\r\n\r\n\r\n

EASY\u00a0Point-of-care echocardiography for aortic dissection, pulmonary embolism and acute coronary syndrome in patients with killer chest pain 2015, Journal of echocardiography, Nishigami (Yo\u011fun bak\u0131m\/Kardiyoloji) G\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131nda, eko de\u011ferlendirmesi
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26497152<\/a><\/p>\r\n\r\n\r\n\r\n

SESAME\u00a0Sequential Echographic Scanning Assessing Mechanism Or Origin of Severe Shock of Indistinct Cause 2015, Anaesthesiol Intensive Theraphy, Lichtenstein ve ark. (Yo\u011fun bak\u0131m) \u015eok hastas\u0131nda, akci\u011fer, DVT, bat\u0131n, kardiyak de\u011ferlendirme
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26578398<\/a><\/p>\r\n\r\n\r\n\r\n

PEEPS\u00a0Prehospital Evaluation of Effusion, Pneumothorax, and Standstill 2015, Western Journal of Emergency Medicine, Bhat ve ark (Acil T\u0131p) Hastane \u00f6ncesi d\u00f6nem, akci\u011fer ve kardiyak
http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/26265961<\/a><\/p>\r\n","protected":false},"excerpt":{"rendered":"

Son 30 y\u0131ll\u0131k d\u00f6nem i\u00e7erisindeki deneyimler radyolog d\u0131\u015f\u0131 klinisyenler taraf\u0131ndan uygulanan yatak ba\u015f\u0131 nedene y\u00f6nelik ultrasonografik de\u011ferlendirmenin (POCUS) tan\u0131ya gidi\u015fte kullan\u0131\u015fl\u0131 ve…<\/p>\n","protected":false},"author":1599,"featured_media":2247,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[20,12],"tags":[73,89],"class_list":["post-2362","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rehberler-surekli-yayinlar","category-surekli-yayinlar","tag-kritik-hasta","tag-rehberler"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/2362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/users\/1599"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/comments?post=2362"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/2362\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media\/2247"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media?parent=2362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/categories?post=2362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/tags?post=2362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}