Yıl: 2015 Cilt: 14 Sayı: 1 Sayfa Aralığı: 30 - 34 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Noninvasive Ventilation for Severe Acute Asthmatic Attacks

Öz:
Astım, bronşial düz kas kontraksiyonu, hava yolu inflamasyonu ve sekresyonlarda artış sonucu oluşan reverzibıl hava yolu obstrüksiyonu ile karakterize kronik bir hastalıktır. Astım hastalarının çoğunda ataklar medikal tedavi ile kolayca kontrol altına alınabilir. Ancak çok küçük bir hasta grubunda astım atakları ölümcül olabilmektedir. Bu hasta grubunda şiddetli astım atakları standart tedaviye dirençlidir ve bu hastaların bir kısmında mekanik ventilasyon tedavisine ihtiyaç olmaktadır. Astımlı hastalar invaziv mekanik ventilasyonun olağan komplikasyonlarına ilave olarak başka komplikasyonlar için de risk altındadırlar. Bu hastalarda yeterli ventilasyonu sağlamak yüksek inspiratuar basınçlarda dahi zor olabilmekte ve sıklıkla hasta-ventilator asenkronisi gelişmektedir. Noninvaziv ventilasyon (NIV) son 20 yıldır akut solunum yetmezliği tedavisinde giderek artan bir şekilde kullanılmaktadır. Günümüzde NIV'in KOAH alevlenmesi ve akut akciğer ödeminin standart ilk seçenek tedavisi olduğu kabul edilmektedir. Bilgi ve tecrübelerdeki artış NIV'in daha önce kontrendike olduğu düşünülen astımda da kullanılabileceği konusunu gündeme getirmiştir. Bu derlemede şiddetli akut astım ataklarında NIV'nin kullanımı ile ilgili güncel bilgileri gözden geçirilmesi amaçlanmıştır. Günümüzde şiddetli astım ataklarında NIV kullanımını tavsiye etmek için yeterli veriler olmamakla birlikte bazı ilginç ve ümit verici sonuçlar vardır. Sonuç olarak çelişkileri ortadan kaldırabilmek için respiratuar asidozu ve hiperkapnisi olan hastaların dâhil edildiği iyi dizayn edilmiş yeni çalışmalara ihtiyaç vardır.
Anahtar Kelime:

Konular: Acil Tıp

Şiddetli Astım Akut Alevlenmelerinde Noninvaziv Ventilasyon

Öz:
Asthma is a chronic disease characterized by reversible airway obstruction caused by bronchial smooth muscle contraction, airway inflammation, and increased secretion. In most patients, control of disease activity is easily achieved with medical therapy. However, in a small minority, asthmatic attacks may be fatal. Some patients with severe asthmatic attacks are refractory to standard treatment, and a few of these patients have a history of severe asthmatic attacks that necessitated mechanical ventilation. In addition to the usual complications of mechanical ventilation, invasive mechanical ventilation in asthmatic patients is associated with other risks. These patients are often difficult to ventilate, have low compliance with high inspiratory pressures, and have frequent patient-ventilator asynchrony. Noninvasive ventilation (NIV) has been increasingly used to treat acute respiratory failure in the past two decades. It is now considered as standard first-line therapy in chronic obstructive pulmonary disease exacerbations and acute pulmonary edema. The increase in knowledge and experience has revived the use of NIV in asthma, which has previously been thought to be contraindicated. The purpose of this article is to review the up-to-date information on the use of NIV during severe acute asthmatic attacks. Nowadays, although sufficient data are not present to recommend the use of NIV in severe asthmatic attacks, there are some interesting and promising results about NIV. In conclusion, new well-designed studies including cases with respiratory acidosis and hypercapnia are necessary to eliminate the controversy.
Anahtar Kelime:

Konular: Acil Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA TEKE T, YAVŞAN M, UZUN K (2015). Noninvasive Ventilation for Severe Acute Asthmatic Attacks. , 30 - 34.
Chicago TEKE TURGUT,YAVŞAN Mehmet,UZUN Kürşat Noninvasive Ventilation for Severe Acute Asthmatic Attacks. (2015): 30 - 34.
MLA TEKE TURGUT,YAVŞAN Mehmet,UZUN Kürşat Noninvasive Ventilation for Severe Acute Asthmatic Attacks. , 2015, ss.30 - 34.
AMA TEKE T,YAVŞAN M,UZUN K Noninvasive Ventilation for Severe Acute Asthmatic Attacks. . 2015; 30 - 34.
Vancouver TEKE T,YAVŞAN M,UZUN K Noninvasive Ventilation for Severe Acute Asthmatic Attacks. . 2015; 30 - 34.
IEEE TEKE T,YAVŞAN M,UZUN K "Noninvasive Ventilation for Severe Acute Asthmatic Attacks." , ss.30 - 34, 2015.
ISNAD TEKE, TURGUT vd. "Noninvasive Ventilation for Severe Acute Asthmatic Attacks". (2015), 30-34.
APA TEKE T, YAVŞAN M, UZUN K (2015). Noninvasive Ventilation for Severe Acute Asthmatic Attacks. Eurasian Journal of Emergency Medicine, 14(1), 30 - 34.
Chicago TEKE TURGUT,YAVŞAN Mehmet,UZUN Kürşat Noninvasive Ventilation for Severe Acute Asthmatic Attacks. Eurasian Journal of Emergency Medicine 14, no.1 (2015): 30 - 34.
MLA TEKE TURGUT,YAVŞAN Mehmet,UZUN Kürşat Noninvasive Ventilation for Severe Acute Asthmatic Attacks. Eurasian Journal of Emergency Medicine, vol.14, no.1, 2015, ss.30 - 34.
AMA TEKE T,YAVŞAN M,UZUN K Noninvasive Ventilation for Severe Acute Asthmatic Attacks. Eurasian Journal of Emergency Medicine. 2015; 14(1): 30 - 34.
Vancouver TEKE T,YAVŞAN M,UZUN K Noninvasive Ventilation for Severe Acute Asthmatic Attacks. Eurasian Journal of Emergency Medicine. 2015; 14(1): 30 - 34.
IEEE TEKE T,YAVŞAN M,UZUN K "Noninvasive Ventilation for Severe Acute Asthmatic Attacks." Eurasian Journal of Emergency Medicine, 14, ss.30 - 34, 2015.
ISNAD TEKE, TURGUT vd. "Noninvasive Ventilation for Severe Acute Asthmatic Attacks". Eurasian Journal of Emergency Medicine 14/1 (2015), 30-34.