{"id":2367,"date":"2017-02-06T00:00:00","date_gmt":"2017-02-05T21:00:00","guid":{"rendered":"https:\/\/tatd.org.tr\/tatdus\/2020\/03\/09\/ayirt-edilmemis-hipotansiyon-ve-kardiyak-arrestte-sonografi-shoc\/"},"modified":"2022-04-06T14:37:28","modified_gmt":"2022-04-06T11:37:28","slug":"ayirt-edilmemis-hipotansiyon-ve-kardiyak-arrestte-sonografi-shoc","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/tatdus\/2017\/02\/06\/ayirt-edilmemis-hipotansiyon-ve-kardiyak-arrestte-sonografi-shoc\/","title":{"rendered":"Ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrestte Sonografi (SHoC)"},"content":{"rendered":"\r\n\r\n\r\n<h2 class=\"wp-block-heading\">Uluslararas\u0131 Acil T\u0131p Federasyonu (IFEM) Konsens\u00fcs Bildirimi: Ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrestte Sonografi (SHoC)\u00a0<\/h2>\r\n\r\n\r\n\r\n<h2 class=\"wp-block-heading\">Ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrest s\u0131ras\u0131nda bak\u0131m noktas\u0131 ultrasonunun kullan\u0131m\u0131 konusunda uluslararas\u0131 bir konsensus<\/h2>\r\n\r\n\r\n\r\n<p>Acil T\u0131p ve kritik bak\u0131mda PoCUS \u00fczerinde uzman uluslararas\u0131 tan\u0131nm\u0131\u015f liderler taraf\u0131ndan olu\u015fturulan bir panel ile Bak\u0131m Noktas\u0131nda Ultrasonografi (PoCUS) kullan\u0131m\u0131, IFEM Ultrasonografi \u00e7al\u0131\u015fma grubu taraf\u0131ndan ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrest esnas\u0131nda ba\u015flang\u0131\u00e7 y\u00f6netimsel ara\u00e7 olarak bildirilerek, muhtemel etiyoloji saptamaya ve res\u00fcsitasyonu y\u00f6nlendirmeye y\u00f6nelik uluslararas\u0131 alanda yayg\u0131n bir \u015fekilde uygulanabilir olacak \u015fekilde tasarlanm\u0131\u015f. Ayn\u0131 zamanda protokol\u00fcn amac\u0131 devam eden res\u00fcsitayondaki kesilmeyi de minimale indirmeyi ama\u00e7lam\u0131\u015f. Protokol; hastal\u0131k insidanslar\u0131na, \u00f6nceden yay\u0131mlanm\u0131\u015f protokollere (<a href=\"http:\/\/tatdus.org\/rehber\/4-kritik-hasta-degerlendirilmesinde-kullanilan-sonografik-protokoller\">bkz<\/a>.) ve t\u0131bbi literat\u00fcre dayal\u0131 uzman g\u00f6r\u00fc\u015f birli\u011fiyle hiyerar\u015fik bir model olarak geli\u015ftirilmi\u015f ve 4F olarak tan\u0131mlanan pratik bir kontrol listesi yap\u0131lm\u0131\u015f.<\/p>\r\n\r\n\r\n\r\n<p><strong>4F: Fluid (s\u0131v\u0131), Form (yap\u0131), Function (fonksiyon), Filling (doluluk).<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Protokol, \u00f6nerilerini ay\u0131rt edilememi\u015f hipotansiyon ve kardiyak arrest esnas\u0131nda her iki durum i\u00e7in de;<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>\u00c7ekirdek (Core),<\/li>\r\n<li>Tamamlay\u0131c\u0131 (Suplementary) ve<\/li>\r\n<li>Ek (Additional) \u00f6neriler olacak \u015fekilde \u00fc\u00e7 d\u00fczeyde belirlemi\u015f.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>\u00c7ekirdek \u00f6neriler rutin olarak t\u00fcm hastalara, tamamlay\u0131c\u0131 \u00f6neriler hastan\u0131n devam eden kritik bak\u0131m s\u00fcrecini etkilemeyecek ise t\u00fcm hastalara ve ek \u00f6neriler ise spesifik klinik durumlar\u0131 i\u015faret eden hasta gruplar\u0131nda \u00f6nerilmi\u015f.<\/p>\r\n\r\n\r\n\r\n<p>Hipotansiyonda 4F bulgular\u0131na g\u00f6re de\u011ferlendirmede; kardiyak g\u00f6r\u00fcnt\u00fclemede s\u0131v\u0131-perikardiyal ef\u00fczyon var m\u0131?, yap\u0131-kalp b\u00fcy\u00fckl\u00fc\u011f\u00fc k\u00fc\u00e7\u00fck\/normal\/b\u00fcy\u00fck ve sol ventrik\u00fcl sa\u011f ventrik\u00fclden b\u00fcy\u00fck m\u00fc?, fonksiyon-kontraktilite var m\u0131 ve kapaklar a\u00e7\u0131l\u0131yor mu?, inferior vena kava ve akci\u011fer g\u00f6r\u00fcnt\u00fclemesinde doluluk-IVC dilate\/kollapse, B \u00e7izgileri var m\u0131 ve plevral s\u0131v\u0131 var m\u0131? sorular\u0131n\u0131n yan\u0131tlar\u0131na bak\u0131lmas\u0131 \u00f6nerilmi\u015f.<\/p>\r\n\r\n\r\n\r\n<p>Kardiyak arrestte ise \u00e7ekirdek \u00f6neriler sadece kardiyak g\u00f6r\u00fcnt\u00fcleme ile s\u0131n\u0131rlanm\u0131\u015f ve sadece kompresyona ara verilen ritim kontrol\u00fc esnas\u0131nda bak\u0131lmas\u0131 \u00f6nerilmi\u015f. De\u011ferlendirme bir tak\u0131m \u00e7al\u0131\u015fmas\u0131 olarak tan\u0131mlam\u0131\u015f, en k\u0131sa s\u00fcrede ultrason cihaz\u0131n\u0131n hastan\u0131n yan\u0131na al\u0131nmas\u0131, kompresyona verilen aralarda g\u00f6r\u00fcnt\u00fclerin al\u0131nmas\u0131, kompresyon esnas\u0131nda g\u00f6r\u00fcnt\u00fclerin incelenmesi \u015feklinde uygulanarak kompresyona ara vermeksizin de\u011ferlendirme yapmay\u0131 \u00f6nermi\u015f. Akci\u011fer ve IVC de\u011ferlendirmesi tamamlay\u0131c\u0131 \u00f6neriler i\u00e7erisine al\u0131nm\u0131\u015f.<\/p>\r\n\r\n\r\n\r\n<p>Protokol\u00fcn slogan\u0131\u00a0<strong><em>tek beden herkese uyar<\/em><\/strong>\u00a0\u201cone size fits all\u201d<\/p>\r\n\r\n\r\n\r\n<figure class=\"wp-block-image size-large is-resized\"><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-1256\" src=\"https:\/\/tatd.org.tr\/tatdus\/wp-content\/uploads\/sites\/5\/2021\/10\/capture-20200309-214120-crop-1.png\" alt=\"\" width=\"708\" height=\"600\" \/><\/figure>\r\n\r\n\r\n\r\n<figure class=\"wp-block-image size-large is-resized\"><img decoding=\"async\" class=\"wp-image-1257\" src=\"https:\/\/tatd.org.tr\/tatdus\/wp-content\/uploads\/sites\/5\/2021\/10\/capture-20200309-214201gh-1.png\" alt=\"\" width=\"708\" height=\"552\" \/><\/figure>\r\n\r\n\r\n\r\n<h3 class=\"wp-block-heading\"><strong>Kaynak<\/strong><\/h3>\r\n\r\n\r\n\r\n<p>Atkinson P et al. International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): An international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest. CJEM 2016:1-12.\u00a0(<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27998322\">Pubmed<\/a>)<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Uluslararas\u0131 Acil T\u0131p Federasyonu (IFEM) Konsens\u00fcs Bildirimi: Ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrestte Sonografi (SHoC)\u00a0 Ay\u0131rt edilmemi\u015f hipotansiyon ve kardiyak arrest s\u0131ras\u0131nda&hellip;<\/p>\n","protected":false},"author":1599,"featured_media":2370,"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":[46,63,89,96],"class_list":["post-2367","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rehberler-surekli-yayinlar","category-surekli-yayinlar","tag-feel","tag-kardiyak-usg","tag-rehberler","tag-shoc"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/2367","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=2367"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/2367\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media\/2370"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media?parent=2367"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/categories?post=2367"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/tags?post=2367"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}