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Objective: Current data in intensive care unit (ICU) suggest that at least 70-100% of patients’ energy have to met, while the effects of hypocaloric nutrition (HN) on patient outcomes are questioned. This study aimed to determine the relationship between renal replacement requirement and other organ failure and patient outcomes in normocaloric and hypocaloric fed patients. Materials and Methods: The data of patients followed up in the intensive care unit between 2003- 2012 were retrospectively evaluated. Normocaloric nutrition (NN) group is determined as patients with 70%-110% of the daily energy requirement was reached, HN group is determined as patients with less than 70% of their daily energy requirement. Patient data were recorded for 14 days. Results: Data of 1,955 patients were evaluated and 92 patients were included to NN group, 199 patients were included to HN group. There was a significant decrease in Sequential Organ Failure Assessment score in the HN group compared to the hospitalization day (p<0.005). Renal replacement therapy was needed in 19 (20.7%) patients in the NN group, whereas renal replacement was performed in 35 (17.6%) patients in the HN group (p=0.643). In the HN group, the number of RIFLE stage-3 days was 460 (25%), and in the NN group it was 157 (15.1%) days (p<0.001). The length of stay in ICU was 16.88±10.88 days in NN group and 11.42±9.11 days in the HN group (p<0.001). There was no significant difference in ICU mortality and 28th day mortality in both groups (p>0.05). Conclusion: There was no difference between NN and HN in critically ill patients in ICU. Although the duration of ICU stay was less in the hypocaloric group, no significant difference was found between low-calorie intake and 28th day and hospital mortality. There is still a need for a prospective, randomized controlled trial on this subject. [ABSTRACT FROM AUTHOR]

Amaç: Solid organ nakli alıcılarında immünosüpresyonun ağır COVID-19 enfeksiyonu için bir risk faktörü olduğu düşünülmekte ve bu hastalarda greft disfonksiyonu, çoklu organ yetmezliği ve mortalite riski normal popülasyona göre artmaktadır. British Transplantation Society (BTS) bu hastalarda immünsüpresif tedavilerde doz azaltımı ve destekleyici tedaviler önermektedir. Bu çalışma ile; daha önce homojen verisi olmayan COVID-19’lu yoğun bakım hasta grubunda renal transplant alıcılarının klinik sonuçları sunulmuştur. Gereç ve Yöntem: Etik kurul onamı sonrası 3. düzey üniversite hastanesi COVID-19 yoğun bakımında Mart 2020-Ocak 2022 arası takip edilmiş 550 hasta retrospektif olarak tarandı ve böbrek nakil alıcısı olan hastalar çalışma grubu olarak belirlendi. Bulgular: Çalışmaya alınan 550 hastanın 15’i renal nakil alıcısı bunlardan 5’i kadındı.Ortalama yaş 52 yıl idi. Yoğun bakım öncesi hastane yatış süresi medyan 4 (IQR: 2-5) gün idi. Renal nakil zamanı COVID-19 tanısından medyan 30 ay (IQR: 11-58) önce idi. Hastaların 13’ü (%86,7) COVID-19 ilişkili ARDS (CARDS) tanısı mevcuttu. Hastaların bazal kreatinin medyan değeri 1,18 (IQR: 1,02-1,46) mg/dL idi. Eksitus olan hastalarda KDIGO evresi daha ileriydi. Hastaların %93,3’ünde pulse steroid tedavisine rağmen progresyon devam etti. Hastaların 12'sinde (%80) periferik kan dolaşımı enfeksiyonu tanısı konuldu. Hastaların demografik özellikleri ve yoğun bakım kabul klinik değerleri Tablo 1’de, uygulanan tedavilerin dağılımı Tablo 2’de, birincil ve ikincil sonlanımlar Tablo 3’te, mortaliteye göre kreatinin trendi Şekil 1’de ve KDIGO trendleri Şekil 2’de verildi. Hastalar medyan 2. günde (0-10) entube edildiler. Entübe edilen hastalarda mortalite %100 idi. Beş (%33,3) hasta yoğun bakımdan taburcu edildi. Yoğun bakım mortalitesi %66,7 idi. Sonuç: COVID-19 tanısı konulan renal transplant alıcılarında CARDS nedeni ile yoğun bakım ihtiyacı geliştiğinde sağkalım oldukça düşüktür. Çalışmamızda hastaların transplantasyon zamanı ile tanı zamanı arasında uzun süre mevcuttu ve çoğunun birden fazla komorbiditesi vardı. CARDS ile takip edilen ve mortal seyreden olguların tamamı IMV ile takip edilen ve KDIGO evresi ileri olan AKI hastalarıydı. Sekonder enfeksiyonların sık görüldüğü bu hasta grubunda immünosüpresif ilaçların yönetimi oldukça önemlidir. Çalışmanın karşılaştırmalı analizleri yapılmaya devam edilmektedir. Ön analiz sonuçları sunulmuştur. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Drowning is a common and important cause of accidental deaths. Complications and mortality rates are high in patients requiring intensive care unit (ICU) support. The aim of our study was to determine the clinical course and treatment efficacy of a limited number of patients with acute respiratory failure and multiorgan failure due to drowning. Materials and Methods: Patients who were hospitalized >24 hours in the ICU between January 2010 and August 2018 and who met the inclusion criteria were retrospectively analyzed. Results: Of 103 patients admitted to the emergency department over an 8-year period, 13 required intensive care support. Five patients (38.4%) died and eight patients (61.5%) were discharged. Steroids were used in six patients (46.2%), but no statistically significant difference was found in terms of mortality (p=0.592). The presence of diffuse cerebral edema in five patients (38.5%) was associated with a statistically higher mortality rate compared to six patients (46.2%) with normal findings (p=0.003). Mechanical ventilation was performed with synchronized intermittent mandatory ventilation mode in nine patients (69.2%) and with airway pressure-release ventilation (APRV) mode in four patients (31.8%). According to our clinical observations, apparent radiological improvement was detected in patients who received mechanical ventilation with APRV mode. Conclusion: Neither steroids nor prophylactic antibiotherapy are found effective on mortality rates. In addition to these ineffective interventions, mechanical ventilation strategies, the degree of metabolic acidosis at admission and the neurological status of the patient may be considered as variable clinical parameters that may affect patient outcome. [ABSTRACT FROM AUTHOR]

It is estimated that there are a total of 1014 microorganisms colonized in many organs and tissues in the human body. It is also estimated that there are trillions of bacteria in the human body, almost 10 times that of host cells. This new life association, which we define as microbiomes, has been shown to be essential for protection against enteric and systemic pathogens through many direct and indirect (immunologically mediated) mechanisms in preclinical studies. Dysbiosis or imbalance in the homeostasis of the intestinal microbiota has been associated with many different diseases such as diabetes, obesity, inflammatory bowel disease and rheumatoid arthritis. In general, intestinal microbiota in patients with sepsis following intensive care unit (ICU) follow-up is characterized by lower diversity and commensal species (such as Faecalibacterium, Blautia, Ruminococcus) and an increase in strains such as Escherichia, Shigella, Salmonella, Enterococcus, C. difficile or Staphylococcus. Current treatment methods are based on two principles, either to reduce the excess proliferation of potentially pathogenic microorganisms (decolonization strategies) or to re-supply the pool of beneficial organisms. As in all areas, research on microbiota-targeted treatment strategies in ICU continues. [ABSTRACT FROM AUTHOR]

Meningococcemia is a highly mortal disease that can cause septic shock and multiple organ failure, which can be accompanied by sudden onset, rapid course, purpura fulminans and diffuse intravenous coagulation tables. Mortality increases when meningococcal causes to meningitis. The fact that it is the cause of neurological sequelae and extremity losses even in the recovering cases makes the support provided by the intensive care unit quite important in the management of cases. A case with meningococcal meningitis with high mortality, who was successfully treated through the use of supportive methods, such as monitorization, mechanical ventilation practices with new modalities, plasmapheresis and sympathetic ganglion blockage, has been presented in company with the literature. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)