Follow Us:Respiratio 2017; 7 (1-2): 9-18
ISPITIVANJE GASNIH ANALIZA ARTERIJSKE KRVI U AKUTNOJ
RESPIRATORNOJ INSUFICIJENCIJI KOD PACIJENATA SA
HRONIČNOM OPSTRUKTIVNOM BOLESTI PLUĆA
ANALYSIS OF ARTERIAL BLOOD GASES IN ACUTE RESPIRATORY FAILURE IN PATIENTS
WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Tanja Šobot¹, Zorislava Bajić¹, Želimir Erić¹, Peđa Kovačević¹, Marinko Vučić²
¹Katedra za fiziologiju, Medicinski fakultet, Univerzitet u Banja Luci, Bosna Hercegovina
²Klinika za plućne bolesti Univerzitetski klinički centar, Banja Luka, Bosna i Hercegovina
Original Research
Naučni članak
SAŽETAK
Uvod: Hronična opstruktivna bolest pluća (HOBP) je jedan od glavnih uzroka morbiditeta I mortaliteta širom svijeta. U toku egzacerbacija HOBP može se javiti akutna respiratorna insuficijencija (ARI) tip 2, koja se karakteriše hiperkapnijom, vrijednošću parcijalnog pritiska ugljendioksida (PaCO2) većom od 6,67 kPa (50 mm Hg), hipoksemijom (snižen PaO2) kao i vrijednošću pH manjom od 7,3.
Cilj rada je utvrditi uticaj mehaničke ventilacije na oksigenacioni i acido-bazni status kod
pacijenata sa akutnom hiperkapnijskom respiratornom insuficijencijom na podlozi postojeće HOBP.
Metodologija: Retrospektivnom studijom je obuhvaćeno 30 ispitanika koji su liječeni na Klinici intenzivne medicine za nehirurške grane Univerzitetskog kliničkog centra Republike Srpske, tokom 2016. godine. Ispitanici sa razvijenom ARI tip 2 na podlozi HOBP terapijski su bili izloženi izloženi invanzivnoj i/ili neinvanzivnoj mehaničkoj ventilaciji. Kod ispitanika smo analizirali gasne parameter arterijske krvi (pH, parcijalni pritisak kiseonika, parcijalni pritisak ugljen-dioksida, bikarbonate, zasićenost krvi kiseonikom, bazni eksces, kao i odnos parcijalnog pritiska kiseonika sa frakcijom inspiratornog kiseonika). Parametri su mjereni u tri vremena: prije, u toku i poslije mehaničke ventilacije.
Rezultati: Testiranjem razlika za vrijednosti parametara gasnih analiza izmjerenih poslije mehaničke ventilacije između preživjelih i umrlih ispitanika dobijene su statistički značajne razlike (p< 0.05) za pH, PaO2/FiO2, HCO3 i BE (pH t=-2,96; PaO2/FiO2 t=2,78; HCO3 t=2,29; BE t=3,21).
Zaključak: Na osnovu rezultata našeg istraživanja možemo zaključiti da je mehanička ventilacija integralni dio intenzivne terapije pacijenata sa akutnim pogoršanjima HOBP, sa značajnim doprinosom povoljnom ishodu nastalog akutnog oboljenja.
Ključne riječi: arterijske gasne analize, mehanička ventilacija, hronična opstruktivna bolest pluća, akutna respiratorna hiperkapnijska insuficijencija
Ključne riječi: arterijske gasne analize, mehanička ventilacija, hronična opstruktivna bolest pluća, akutna respiratorna hiperkapnijska insuficijencija
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Submitted: April 10th, 2017
Accepted: May 10th, 2017
Zorislava Bajić
Katedra za fiziologiju,
Medicinski fakultet Univerziteta u Banjaluci,
Save Mrkalja 14, Banjaluka
Tel: 051 234 151; This email address is being protected from spambots. You need JavaScript enabled to view it.