KPR S\u0131ras\u0131nda Duraksama \u00d6ncesi Ekokardiyografik G\u00f6r\u00fcnt\u00fcleme ve Akustik Pencerenin Belirlenmesi \u0130KYD S\u0131ras\u0131nda KPR Duraksama S\u00fcresini Azalt\u0131r: Prospektif Bir Kohort \u00c7al\u0131\u015fmas\u0131<\/strong><\/p>\n EKO kullan\u0131m\u0131 \u0130KYD s\u0131ras\u0131nda kardiyak arrestin etiyolojisini ayd\u0131nlatma, kompresyon yerini do\u011frulama, ps\u00f6do-NEA\u2019y\u0131 NEA\u2019dan ay\u0131rmada kullan\u0131\u015fl\u0131 olsa da kardiyak kompresyonlar\u0131 kesintiye u\u011fratt\u0131\u011f\u0131ndan faydas\u0131 ve zarar\u0131 hala tart\u0131\u015fmal\u0131<\/u> olan bir uygulamad\u0131r. \u0130KYD s\u0131ras\u0131nda uygulanabilir hale getirmek i\u00e7in standart EKO incelemelerinin KPR duraksamalar\u0131nda uzamaya yol a\u00e7mamas\u0131 i\u00e7in k\u0131salt\u0131lmalar\u0131 ile birtak\u0131m protokoller geli\u015ftirilmi\u015ftir. US-CAB protokol\u00fcnde kardiyak, inferior vena kava (\u0130VK), trakea ve plevral kayma i\u00e7in akci\u011fer incelemesini i\u00e7eren k\u0131sa bir protokol olu\u015fturulmu\u015f ancak res\u00fcsitasyon s\u0131ras\u0131nda etkinli\u011fi ara\u015ft\u0131r\u0131lmam\u0131\u015ft\u0131r.\u00a0 CASA protokol\u00fcnde ise standart EKO 3 k\u0131sma b\u00f6l\u00fcnm\u00fc\u015f, her duraksamada bir patolojiye y\u00f6nelik inceleme yap\u0131larak duraksama s\u00fcreleri \u00fczerindeki etkisi ara\u015ft\u0131r\u0131lm\u0131\u015f ve bu teknikle duraksama s\u00fcrelerinde azalma oldu\u011fu bildirilmi\u015ftir.<\/p>\n \u0130nceleyece\u011fimiz bu \u00e7al\u0131\u015fmada ise; \u0130KYD k\u0131lavuzlar\u0131nda nab\u0131z kontrol\u00fc i\u00e7in \u00f6nerilen 10 sn. duraksama s\u0131ras\u0131nda yap\u0131lan EKO yerine, KPR devam eden ederken hemen duraksama \u00f6ncesinde kalbi k\u0131smi g\u00f6r\u00fcnt\u00fcleyebildi\u011fimiz suboptimal inceleme ile \u00f6n ke\u015fif yapman\u0131n KPR duraksamas\u0131 s\u0131ras\u0131nda daha kaliteli g\u00f6r\u00fcnt\u00fcler al\u0131nmas\u0131na katk\u0131s\u0131 olup olmayaca\u011f\u0131 ara\u015ft\u0131r\u0131lm\u0131\u015f. \u00c7al\u0131\u015fman\u0131n amac\u0131; hastane d\u0131\u015f\u0131 kardiyak arrest vakalar\u0131nda duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fclemenin KPR duraksamalar\u0131 \u00fczerine etkisini tan\u0131mlamak olarak belirtilmi\u015f.<\/p>\n Y\u00d6NTEM:<\/strong><\/p>\n \u00c7al\u0131\u015fma Kas\u0131m 2018 ile Kas\u0131m 2019 tarihleri aras\u0131nda, 13 ay s\u00fcre ile, y\u0131lda 75000 hasta ba\u015fvurusu olan 1. d\u00fczey travma merkezi ve e\u011fitim klini\u011fi olan UMASS Memorial Medical Center Acil T\u0131p Klini\u011fi\u2019nde prospektif olarak y\u00fcr\u00fct\u00fclm\u00fc\u015f. \u00c7al\u0131\u015fman\u0131n ilk 6 ay\u0131 bazal periyod, ikinci 7 ayl\u0131k d\u00f6nem m\u00fcdahaleli (<\/strong>interventional)<\/strong> periyod olarak tan\u0131mlanm\u0131\u015f.<\/p>\n Dahil edilen hastalar; hastane d\u0131\u015f\u0131, travmatik olmayan kardiyak arrestlerden KPR ba\u015flanarak acil servise getirilen hastalar olarak belirlenmi\u015f. D\u0131\u015flanan hastalar ise; video kay\u0131tlar\u0131 olmayan veya akredite olmayan klinisyenler taraf\u0131ndan EKO yap\u0131lan hastalar olarak belirlenmi\u015f. G\u00f6r\u00fcnt\u00fclemede; EKO subksifoid veya parasternal pencerelerden biri kullan\u0131larak yap\u0131lm\u0131\u015f.<\/p>\n M\u00fcdahaleli (Intervention) Periyod <\/strong><\/p>\n \u00c7al\u0131\u015fmadan 6 ay \u00f6nce acil t\u0131p uzman ve asistanlar\u0131 \u201cDuraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme ile g\u00f6r\u00fcnt\u00fc alma zaman\u0131n\u0131 k\u0131saltma y\u00f6ntemi\u201d \u00fczerine 30 dk s\u00fcren standart bir e\u011fitime al\u0131nm\u0131\u015flar. \u00c7al\u0131\u015fmaya kat\u0131lan klinisyenlere hipotez ve \u00e7al\u0131\u015fma amac\u0131 ile ilgili bilgi verilmi\u015f.<\/p>\n EKO ile duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme tekni\u011fi \u015fu \u015fekilde tarif edilmi\u015f; prob KPR s\u0131ras\u0131nda\u00a0\u00a0 kardiyak pencereyi ke\u015ffedebilecek veya kalbin g\u00f6r\u00fclebilece\u011fi bir yere yerle\u015ftirilir. Bu teknikle suboptimal g\u00f6r\u00fcnt\u00fcler al\u0131nsa da fikir vericidir ve KPR duraksat\u0131ld\u0131\u011f\u0131 anda probun do\u011fru yere daha h\u0131zl\u0131 bir \u015fekilde yerle\u015ftirilmesi sa\u011flanarak daha kaliteli g\u00f6r\u00fcnt\u00fcler al\u0131nmas\u0131 sa\u011flan\u0131r. G\u00f6r\u00fcnt\u00fc al\u0131n\u0131r al\u0131nmaz KPR\u2019ye devam edilir ve duraksaman\u0131n 10 sn alt\u0131nda tutulmas\u0131 hedeflenir. KPR ekibinin y\u00f6netimi, EKO yapan klinisyen d\u0131\u015f\u0131nda ba\u015fka bir klinisyen taraf\u0131ndan yap\u0131l\u0131r.<\/p>\n \u00d6l\u00e7\u00fcmler <\/strong><\/p>\n S\u00fcre verileri, res\u00fcsitasyon odas\u0131ndaki hareketle aktive olan ve 7\/24 kay\u0131t alan bir video kay\u0131t cihaz\u0131ndan elde edilmi\u015f. Kat\u0131l\u0131mc\u0131lar\u0131n \u00e7al\u0131\u015fma hipotezine k\u00f6r olmad\u0131\u011f\u0131 belirtilmi\u015f. EKO incelemeleri 2 adet 2-4 MHz kardiyak probu olan USG cihazlar\u0131 ile yap\u0131lm\u0131\u015f. Toplam kardiyak arrest s\u00fcreleri ve her bir duraksama s\u00fcresi, \u00f6nceden haz\u0131rlanm\u0131\u015f bir forma \u00e7al\u0131\u015fmaya k\u00f6r olmayan bir ki\u015fi taraf\u0131ndan kaydedilmi\u015f. KPR\u2019ye ba\u015flama ve durma s\u00fcreleri hastan\u0131n ambulans sedyesinden hastane sedyesine transfer edildi\u011fi saniye ve KPR’nin son siklusunun sona erdi\u011fi saniye olarak \u00f6nceden tan\u0131mlanm\u0131\u015f.<\/p>\n EKO g\u00f6r\u00fcnt\u00fc alma zaman\u0131 USG probunun hasta cildine de\u011fdi\u011fi andan kald\u0131r\u0131ld\u0131\u011f\u0131 ana kadar; KPR duraksama s\u00fcresi ise kompresyonlar\u0131n kesilip yeniden ba\u015flad\u0131\u011f\u0131 ana kadar ge\u00e7en s\u00fcre olarak kaydedilmi\u015f. EKO g\u00f6r\u00fcnt\u00fc kalitesi ve kardiyak aktivite olup olmad\u0131\u011f\u0131 kaydedilerek dijital bir ortamda depolanm\u0131\u015f. Bu g\u00f6r\u00fcnt\u00fcler; \u00e7al\u0131\u015fmaya k\u00f6r 2 tecr\u00fcbeli klinisyen taraf\u0131ndan kardiyak aktivite olup olmamas\u0131, organize kardiyak aktivite olup olmamas\u0131 ve g\u00f6r\u00fcnt\u00fc kalitesi a\u00e7\u0131s\u0131ndan de\u011ferlendirilmi\u015f. Organize kardiyak aktivite; miyokard\u0131n ventrik\u00fcler kavitenin boyutunu de\u011fi\u015ftirecek kadar kas\u0131lmas\u0131, ventrik\u00fcl duvar\u0131n\u0131n senkronize hareketi olarak tan\u0131mlanm\u0131\u015f.<\/p>\n G\u00f6r\u00fcnt\u00fc Kalitesi De\u011ferlendirme \u00d6l\u00e7e\u011fi<\/strong><\/p>\n G\u00f6r\u00fcnt\u00fc kalitesi de\u011ferlendirme \u00f6l\u00e7e\u011fi \u00e7al\u0131\u015fman\u0131n iki yazar\u0131 taraf\u0131ndan geli\u015ftirilmi\u015f ve 5 puan \u00fczerinden puanlanm\u0131\u015f:<\/p>\n Sonlan\u0131m Noktalar\u0131 <\/strong><\/p>\n Primer sonlan\u0131m noktas\u0131; Duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme entegre edildikten sonra KPR duraksama s\u00fcresindeki de\u011fi\u015fiklik olarak belirlenmi\u015f.<\/p>\n Sekonder sonlan\u0131m noktalar\u0131 ise;<\/p>\n SONU\u00c7LAR<\/strong><\/p>\n \u00c7al\u0131\u015fmaya kardiyak arrest geli\u015fip devam eden KPR ile getirilen toplam 204 hastadan; hastane i\u00e7i kardiyak arrest, travmatik arrest ve kay\u0131tlar\u0131 eksik olan hastalar d\u0131\u015fland\u0131ktan sonra kalan 145 hasta dahil edilmi\u015f. Bazal periyotta de\u011ferlendirilen \u201cPre-intervention\u201d olarak tan\u0131mlanan gruba 70 hasta, duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme tekni\u011fin uyguland\u0131\u011f\u0131 periyotta de\u011ferlendirilen \u201cPost-intervention\u201d olarak tan\u0131mlanan gruba ise 75 hasta dahil edilmi\u015f.<\/p>\n \u015eekil 1. \u00c7al\u0131\u015fma ak\u0131\u015f \u015femas\u0131.<\/p>\n Pre-intervention gruptaki toplam 159 duraksamaya kar\u015f\u0131 post-intervention grupta 206 duraksama incelenmi\u015f. Her iki periyotta olgular\u0131n \u00e7o\u011funda subksifoid pencereden inceleme yap\u0131lm\u0131\u015f (bazal %68, interventional %58).\u00a0 T\u00fcm duraksamalar i\u00e7in ortalama KPR duraksama uzunlu\u011fu, duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme \u0130KYD’ye dahil edildikten sonra 28,3 sn\u2019den (%95 CI 25,1-31,5) 12,8 sn\u2019ye (%95 CI 11,9-13,7) d\u00fc\u015fm\u00fc\u015f.<\/p>\n EKO ile g\u00f6r\u00fcnt\u00fc alma s\u00fcreleri, duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme \u0130KYD’ye dahil edildikten sonra 20,4 sn\u2019den (%95 CI 18,0-22,7) 11 sn\u2019ye (%95 CI 10,1-11,8) d\u00fc\u015fm\u00fc\u015f.<\/p>\n Tekni\u011fin kullan\u0131ld\u0131\u011f\u0131 periyotta ger\u00e7ekle\u015ftirilen EKO\u2019lar\u0131n %74\u2019\u00fcnde (106\/143) duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme yap\u0131lm\u0131\u015f. Bu d\u00f6nemde duraksama \u00f6ncesi EKO kullan\u0131ld\u0131\u011f\u0131nda g\u00f6r\u00fcnt\u00fc alma s\u00fcresi daha h\u0131zl\u0131 olmu\u015f (5,5 sn daha h\u0131zl\u0131, 11,8 sn (10,7-12,8) ve 17,3 sn (15,2-19,4)). G\u00f6r\u00fcnt\u00fc kalitesi a\u00e7\u0131s\u0131ndan 2 periyod kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda fark izlenmemi\u015f (3 sn (%95 GA 2,8-3,2) ile 2,7 sn (%95 GA 2,5-2,9)).<\/p>\n G\u00f6r\u00fcnt\u00fcleme i\u00e7in subksifoid yakla\u015f\u0131m (%64,7), parasternal uzun aks penceresi (%35,3) ve \u00e7oklu yakla\u015f\u0131mlar (%7,6) tercih edilmi\u015f. Her iki d\u00f6nemde yakla\u015f\u0131m a\u00e7\u0131s\u0131ndan fark izlenmemi\u015f. Subksifoid ve parasternal uzun aks kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda g\u00f6r\u00fcnt\u00fc alma s\u00fcrelerinde istatistiksel anlaml\u0131 fark izlenmemi\u015f (20 sn (%95 CI 17,3-22,7) ile 18,7 sn (%95 CI 15,2-22,3), p=0,5808), ancak \u00e7oklu yakla\u015f\u0131mla de\u011ferlendirilen olgularda KPR duraksamalar\u0131 \u00f6nemli \u00f6l\u00e7\u00fcde daha uzun bulunmu\u015f (45 sn, %95 CI 31,9-63,7). KPR duraksamas\u0131n\u0131n uzamas\u0131na en b\u00fcy\u00fck katk\u0131y\u0131 duraksama s\u0131ras\u0131nda \u00e7oklu yakla\u015f\u0131mla yap\u0131lan EKO sa\u011flarken bunu intraven\u00f6z eri\u015fim ve herhangi bir EKO d\u0131\u015f\u0131 olay izlemi\u015f.<\/p>\n TARTI\u015eMA <\/strong><\/p>\n \u00c7al\u0131\u015fman\u0131n sonu\u00e7lar\u0131na bak\u0131ld\u0131\u011f\u0131nda duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fclemenin KPR duraksama s\u00fcrelerini belirgin bir \u015fekilde k\u0131saltt\u0131\u011f\u0131 g\u00f6r\u00fclmektedir. EKO i\u00e7in ge\u00e7en s\u00fcre; duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme yap\u0131larak EKO yap\u0131lan KPR\u2019lerde, duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme yapmadan direkt duraksama an\u0131nda EKO yap\u0131lan KPR\u2019lerden daha k\u0131sayd\u0131. \u00c7al\u0131\u015fman\u0131n bazal periyodunda KPR duraksama s\u00fcreleri \u00f6nerilen 10 sn s\u00fcresinden belirgin \u015fekilde uzundu. \u0130KYD k\u0131lavuzlar\u0131 duraksamay\u0131 10 sn \u00f6nerse de d\u00fcnya \u00e7ap\u0131nda bu s\u00fcrelere uyulabildi\u011fini destekleyen veri \u00e7ok de\u011fildir.<\/p>\n Clattenburg ve arkada\u015flar\u0131n\u0131n geli\u015ftirdikleri CASA protokol\u00fcnde KPR duraksama s\u00fcrelerini k\u0131saltabildi\u011fini g\u00f6stermi\u015ftir, bu protokolde standart EKO 3 k\u0131sma b\u00f6l\u00fcn\u00fcp, her duraksamada bir patolojiye y\u00f6nelik inceleme yap\u0131lmaktad\u0131r. Bu teknik de KPR\u2019de daha \u00e7ok say\u0131da duraksamaya sebep olabilir ve toplam duraksama s\u00fcresini ge\u00e7ip ge\u00e7medi\u011fi k\u0131sm\u0131 belirsizdir. \u00a0Di\u011fer \u00e7al\u0131\u015fmalar KPR duraksama ve ba\u015flatma s\u00fcrelerine \u00f6ncelik verilmedi\u011fi durumda EKO\u2019nun duraksama s\u00fcresini uzatt\u0131\u011f\u0131n\u0131 g\u00f6stermi\u015ftir ancak yaln\u0131zca EKO\u2019ya odaklanmak da g\u00f6r\u00fcnt\u00fc elde edilmesiyle e\u015f zamanl\u0131 yap\u0131lan aktivitelerin g\u00f6z ard\u0131 edilmesine sebep olmu\u015ftur.<\/p>\n Bu \u00e7al\u0131\u015fmada KPR duraksama s\u00fcresindeki en uzun gecikme \u00e7oklu yakla\u015f\u0131mla EKO yap\u0131lan olgularda izlendi. Duraksama s\u00fcresinin uzamas\u0131n\u0131 ara\u015ft\u0131ran di\u011fer \u00e7al\u0131\u015fmalarda \u00e7oklu EKO tecr\u00fcbesi olmad\u0131\u011f\u0131 g\u00f6r\u00fcld\u00fc.<\/p>\n Bu \u00e7al\u0131\u015fman\u0131n sonu\u00e7lar\u0131 tek bir EKO\u2019nun gecikmeye sebep olaca\u011f\u0131n\u0131 desteklememektedir. Bu ve di\u011fer \u00e7al\u0131\u015fmalar KPR duraksama s\u00fcrelerini k\u0131saltmak i\u00e7in bir \u00e7aba harcanmad\u0131\u011f\u0131 takdirde<\/u> genelde 10 sn\u2019den uzun oldu\u011funu g\u00f6stermi\u015ftir. Duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme ile KPR duraksama s\u00fcreleri 10 sn alt\u0131na \u00e7ekebilir ancak USG\u2019nin \u0130KYD\u2019ye en uygun \u015fekilde entegre edilmesine y\u00f6nelik ara\u015ft\u0131rmalara devam edilmelidir.<\/p>\n KISITLILIKLAR<\/strong><\/p>\n TATDUS yazar\u0131n\u0131n \u00e7al\u0131\u015fma i\u00e7in yorumlar\u0131;<\/strong><\/p>\n KPR esnas\u0131nda yap\u0131lan yatak ba\u015f\u0131 USG hastadaki arreste g\u00f6t\u00fcren sebebi hem saptamak hem de KPR kalitesini de\u011ferlendirmek i\u00e7in kullan\u0131labilmekte ve literat\u00fcr tarand\u0131\u011f\u0131nda bu konu \u00fczerine bir\u00e7ok \u00e7al\u0131\u015fma oldu\u011fu g\u00f6r\u00fclmektedir. Ancak yap\u0131lan \u00e7al\u0131\u015fmalar hali haz\u0131rda net bir kan\u0131t d\u00fczeyi verememekte ve bu sebeple kesin \u00f6neri olarak KPR uygulamas\u0131nda USG kullan\u0131m\u0131 ge\u00e7mese de bir\u00e7ok k\u0131lavuz destekler nitelikte yararl\u0131 yorumlarda bulunmaktad\u0131r.<\/p>\n Bu \u00e7al\u0131\u015fma \u00f6zelinde yorumlayacak olur isek; \u00e7al\u0131\u015fmada yer alan duraksama \u00f6ncesi g\u00f6r\u00fcnt\u00fcleme tekni\u011fi daha \u00f6ncesinde CASA protokol\u00fcnde de yer almaktad\u0131r. Duraksama s\u00fcresini k\u0131saltan fakt\u00f6rlerden biri olarak zaten tan\u0131mlanm\u0131\u015ft\u0131r. Bu \u00e7al\u0131\u015fmada CASA protokol\u00fcn\u00fcn duraksama s\u0131kl\u0131\u011f\u0131nda art\u0131\u015fa yol a\u00e7abilece\u011fi sonucuna y\u00f6nelik bir yorumlamada bulunulmu\u015f ve \u00e7al\u0131\u015fmada incelemeleri sadece KPR s\u00fcrecinde belirlenen duraksamalar s\u0131ras\u0131nda yaparak, nab\u0131z kontrol\u00fc d\u0131\u015f\u0131nda EKO i\u00e7in bir duraksama yap\u0131lmad\u0131\u011f\u0131 belirtilmi\u015ftir. B\u00f6ylelikle duraksama s\u0131kl\u0131\u011f\u0131nda art\u0131\u015f\u0131n \u00f6n\u00fcne ge\u00e7ildi\u011fi bildirilmi\u015ftir. Yine duraksamadan \u00f6nce klinisyenin USG i\u00e7in pencere haz\u0131rl\u0131\u011f\u0131 yaparak i\u015fleme ba\u015flamas\u0131n\u0131n hem duraksama s\u00fcrecinde EKO i\u00e7in harcanan s\u00fcreyi azaltt\u0131\u011f\u0131, hem de daha iyi g\u00f6r\u00fcnt\u00fc kalitesi ile pencere de\u011ferlendirmesi yap\u0131labilece\u011fini bildirmi\u015ftir. Bu sonu\u00e7lar de\u011ferlendirme i\u00e7in k\u0131sa zamana sahip bir KPR hastas\u0131 de\u011ferlendiren klinisyen i\u00e7in y\u00fcz g\u00fcld\u00fcr\u00fcc\u00fcd\u00fcr. Ancak limitasyon olarak da belirtildi\u011fi gibi bu \u00e7al\u0131\u015fmada tecr\u00fcbeli eller kullan\u0131lm\u0131\u015ft\u0131r. Farkl\u0131 uygulama becerilerine sahip USG uygulay\u0131c\u0131 aras\u0131nda bu durumun ara\u015ft\u0131r\u0131lmas\u0131 literat\u00fcre ek bilgi sa\u011flayacakt\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":" Kardiyopulmoner res\u00fcsitasyon (KPR) uygulanan kardiyak arrest hastalar\u0131nda sa\u011f kal\u0131m oranlar\u0131n\u0131 art\u0131rmak \u00fczere bir\u00e7ok \u00e7al\u0131\u015fma yap\u0131lm\u0131\u015f ve y\u0131llar i\u00e7erisinde sa\u011f kal\u0131m oran\u0131nda art\u0131\u015f…<\/p>\n","protected":false},"author":1049,"featured_media":4136,"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":[3,19,12,10014],"tags":[43,10026],"class_list":["post-4129","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-egitim","category-literatur-ozetleri-surekli-yayinlar","category-surekli-yayinlar","category-akademik-blog-yazisi","tag-eko","tag-kpr"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/4129","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\/1049"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/comments?post=4129"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/posts\/4129\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media\/4136"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/media?parent=4129"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/categories?post=4129"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/tatdus\/wp-json\/wp\/v2\/tags?post=4129"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
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