Y�ld�r�m �arpmas� kaynakl� akut akci�er hasar�: Olgu sunumu

Uzel �ener, Melahat; Demir, Ali; �ener, Alp

Cilt : 30 Say� : 12 Y�l : 2024

30/12Gelecek Say� Ar�iv Kapaklar Pop�ler Makaleler

ICMJE COI Form

H�zl� Arama

Y�ld�r�m �arpmas� kaynakl� akut akci�er hasar�: Olgu sunumu [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2019; 25(2): 198-201 | DOI: 10.5505/tjtes.2018.41861

Y�ld�r�m �arpmas� kaynakl� akut akci�er hasar�: Olgu sunumu

Melahat Uzel �ener¹, Ali Demir², Alp �ener³
¹Sa�l�k Bilimleri �niversitesi, Ankara Atat�rk G��s Hastal�klar� ve G��s Cerrahisi E�itim ve Ara�t�rma Hastanesi, G��s Hastal�klar� Klini�i, Ankara
²Medicana Sa�l�k Grubu, �stanbul, T�rkiye
³Ankara Atat�rk E�itim ve Ara�t�rma Hastanesi, Acil T�p Klini�i, Ankara

Y�ld�r�m �arpmas�, y�ksek oranda morbidite ve mortaliteye sahip bir �evresel elektrik acilidir. Y�ld�r�m �arpmas�na ba�l� yaralanmalar y�ksek voltaj yaralanmalar� olarak isimlendirilir. Y�ld�r�m �arpmas�yla ili�kili solunumsal yaralanmalar aras�nda pulmoner �dem, pulmoner kont�zyon, akut solunum s�k�nt�s� sendromu ve pulmoner hemoraji say�labilir. Y�ksek voltajla ili�kili bir�ok farkl� mekanizmada oldu�u gibi direkt hasar�n yan�nda bu hastalar sekonder travmalara da maruz kalmaktad�r. Dolay�s�yla hastalar�n multitravma hastas� olarak de�erlendirilmesi her zaman ak�lc� yakla��m olacakt�r. Bu yaz�da, 19 ya��nda bir hasta, a��k arazide ger�ekle�en y�ld�r�m �arpmas�na direkt maruziyet sonucu amnezi, oryantasyon bozuklu�u, nefes darl�� ve kar�n a�r�s� �ikayetleri, akci�er kont�zyonu ve miyopati bulgular� ile acil servise ba�vurdu. Vital bulgular�nda; kan bas�nc� 80/50 mmHg, kalp h�z� 110/dakika, oksijen sat�rasyonu %85 olarak �l��ld�. Hastan�n akci�er tomografisinde iki tarafl� akci�er kont�zyonu ve plevral eff�zyon saptand�. Ayr�ca hastan�n yap�lan ekokardiyografisinde global kardiyak hipokinezi ve %20�25 ejeksiyon fraksiyonu saptand�. Hastan�n santral sinir sistemi ve abdominal g�r�nt�lemeleri do�ald�. Hasta, yo�un bak�m �nitesine yat�r�ld� ve destek oksijen, intraven�z hidrasyon, antibiyotik, sistemik steroid ve invaziv kardiyak monit�rizasyon ile tedavi ve takip edildi. Hastaneye yat�r�lmas�n�n onuncu g�n�nde klinik ve radyolojik iyile�me sa�lanan hasta taburcu edildi. Taburculuk sonras� 20. g�nde �ekilen tomografide toraksta patolojik bulgu kalmad�� g�r�ld�.

Anahtar Kelimeler: Akci�er yaralanmas�, �evresel aciller; miyopati; y�ld�r�m �arpmas�; y�ksek voltaj yaralanmas�.

Lightning-strike-induced acute lung injury: a case report

Melahat Uzel �ener¹, Ali Demir², Alp �ener³
¹Department of Chest Disease, University of Health Sciences Ankara Atat�rk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara-Turkey
²Department of Anesthesiology and Reanimation, Medicana Health Group, �stanbul-Turkey
³Department of Emergency Medicine, Ankara Atat�rk Training and Research Hospital, Ankara-Turkey

Lightning strike is an environmental electrical injury with high rates of morbidity and mortality. Lightning strike injuries are also considered to be high-voltage injuries. Respiratory injuries associated with lightning strikes include pulmonary edema, pulmonary contusion, acute respiratory distress syndrome, and pulmonary hemorrhage. In addition to direct damage, the affected patients are also exposed to secondary trauma; similarly, many other mechanisms associated with lightning injury have the same risk. It will therefore always be a rational approach to evaluate patients as multiple trauma patients. In this case report, a 19-year-old patient was admitted to the emergency department with amnesia, disorientation, shortness of breath, abdominal pain complaints and lung contusion, and myopathy signs as a result of a lightning strike in open terrain. The patient had a blood pressure of 80/50 mmHg, a heart rate of 110/min, and oxygen saturation of 85%. Bilateral lung contusion and pleural effusion were detected on the computerized tomography of the thorax. In addition, global cardiac hypokinesia and the 20%�25% ejection fraction were detected on echocardiography. The central nervous system and abdominal scans were normal. The patient was admitted to the intensive care unit and treated with supportive oxygen, intravenous hydration, antibiotics, systemic steroids, and invasive cardiac monitoring. On the 10th day of admission to the hospital, the patient was discharged with clinical and radiological improvement. On the 20th day after discharge, tomography scans showed no thoracic pathologic findings.

Keywords: Environmental emergency, high-voltage injury; lightning strike; lung injury; myopathy.

Sorumlu Yazar: Melahat Uzel �ener, T�rkiye
Makale Dili: �ngilizce

ATIF KOPYALA

Tam Metin PDF At�f dosyas� indir RIS EndNote BibTex Medlars Procite Reference Manager Yazara e-posta g�nder Benzer makaleler PubMed Google Scholar