Search

Objectives: The most prevalent form of anemia is iron deficiency anemia (IDA). In the intensive care unit (ICU) setting, frequent blood sampling for diagnostic purposes is one of the most important causes of anemia among patients. In our study, we aimed to retrospectively scan and compare patients diagnosed with IDA in our institution’s ICU, with and without iron therapy. Methods: In this study, patients with IDA who were hospitalized in our ICU for more than 21 days were included. The patients were divided into two groups: group 1 (patients with iron therapy) and group 2 (patients without iron therapy). Information regarding demographics (age and sex), comorbidities, total volume of blood samples drawn, hemoglobin, hematocrit, ferritin values, requirement for blood transfusion, length of ICU stay, Acute Physiology and Chronic Health Evaluation II score, Glasgow coma scale, and mortality rates were recorded. Results: In this study, 48 patients were analyzed, including 25 (18 women, 7 men) with iron therapy and 23 (13 women, 10 men) without iron therapy. A statistically significant difference was found in the mean blood volume per patient transfused over the 21-day period between the two groups. Conclusion: We noted that oral iron therapy was effective in reducing blood transfusions in patients with prolonged ICU stays. We believe that studies with larger patient groups are warranted regarding this topic. [ABSTRACT FROM AUTHOR]

Objective: Neutrophil, lymphocyte, monocyte, thrombocyte counts and as novel inflammatory factors, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and red cell distribution width (RDW) play an important role in the occurrence and development of diseases. In this study, it was aimed to investigate the relationship between preoperative NLR, PLR, LMR and RDW values of patients hospitalized in the intensive care unit (ICU) after oncological surgery, and the length of intensive care and mortality rates. In addition, it was aimed to compare the demographic, clinical characteristics and laboratory parameters of the patients between both groups. Methods: Patients hospitalized in the ICU after oncological surgery were included in the study. The patients were divided into two groups as patients undergoing gastrointestinal malignancy (colorectal, stomach and hepatocellular) surgery (group 1) and patients who had undergoing urologic malignancy (kidney, bladder and prostate) surgery (group 2). Information regarding demographics (age and gender), comorbidities, neutrophil-lymphocyte-platelet counts, NLR-PLR-LMR-RDW values, length of ICU stay, acute physiology and chronic health evaluation II (APACHE-II) score, Glasgow coma scale and mortality rates were recorded. Results: Two hundred sixty-eight patients were analyzed including 144 patients (99 women, 45 men) undergoing gastrointestinal malignancy surgery (group 1), 124 patients (28 women, 96 men) undergoing urologic malignancy surgery (group 2). We found differences in lymphocyte count, LMR, and PLR values between the two groups. We found that NLR, PLR, LMR, and RDW values, as well as the counts of neutrophils, lymphocytes, and platelets, can predict mortality at specific cut-off points. Furthermore, we also identified an association between NLR, PLR, RDW values, and the APACHE-II score with the length of ICU stay. There was a difference in lymphocyte count, LMR and PLR values between the two groups. Conclusion: By utilizing cost-effective and practically applicable laboratory parameters, we can anticipate the mortality rates of patients following after cancer surgery. Patients predicted to have a high mortality rate can be followed more closely and comprehensively. [ABSTRACT FROM AUTHOR]

The serratus posterior superior intercostal plane (SPSIP) block is a novel technique recently described for thoracic analgesia. This study presents two cases using this technique for postoperative pain after mastectomy with axillary lymph node dissection. The SPSIP block was administered to the patients in the preoperative period as part of multimodal analgesia, and postoperative pain was monitored using the numeric rating scale (NRS). In both patients, the NRS pain scores were below 3/10. SPSIP provided adequate postoperative analgesia in these cases without the need for any opioid agents. Thus, an SPSIP block can be a valuable treatment option for postoperative pain after breast surgery. [ABSTRACT FROM AUTHOR]

Objective: During the pandemic period, hospital admissions for reasons other than COVID-19 infection decreased compared to the pre-pandemic period. In our study, it was aimed to examine the surgical (emergency and elective) and anesthesia (general and regional) type, clinical and demographic characteristics, COVID-19 (Polymerase Chain Reaction (PCR) status, length of stay and mortality rates of postoperative patients hospitalized in the non-COVID-19 intensive care unit during the pandemic, retrospectively. Methods: The files of the patients hospitalized in the postoperative intensive care unit between March, 2021 and March, 2022 were reviewed retrospectively. The patients were divided into two groups as emergency (Group A) and elective surgery (Group E). Age, gender, reason and duration of hospitalization, accompanying comorbidities, COVID-19 PCR results, Acute Physiology and Chronic Health Evaluation II (APACHE) score, Glasgow coma scale and mortality rates of the patients were recorded. Results: Gender, APACHE II score and Glasgow coma scale were similar in both groups. However, there was a difference between the two groups in terms of age, length of stay, accompanying comorbidities, COVID-19 PCR results and mortality rates. Conclusion: The positive effect of the PCR test taken from elective surgeries in the preoperative period was observed. We think that the risk of COVID-19 infection is higher in patients undergoing emergency surgery and because of the high risk of transmission, isolation intensive care units are needed for these patients. [ABSTRACT FROM AUTHOR]

Objective: In smokers, COVID-19 may have a more severe course due to impaired mucociliary activity, increased permeability, and inflammation of the airway epithelium. However, data on the impact of smoking in patients with COVID-19 pneumonia are conflicting. The study aimed to evaluate the effects of smoking on laboratory parameters, intensive care unit (ICU) length of stay, length of hospital stay, and mortality in COVID-19 patients hospitalized in the intensive careunit. Methods: Medical records of 576 patients who were followed up in the ICU for COVID-19 between January and September 2021 were analyzed retrospectively. Demographic data, comorbidities, laboratory parameters (hemoglobin, white blood cell (WBC), lymphocyte, neutrophil, thrombocyte, AST, ALT, CRP, D-dimer, ferritin, BNP, albumin), ICU and hospital stay of the patients were recorded. The patients were divided into 2 groups according to whether they smoked or not. Results: The data of 576 patients were evaluated in the study. The mean age of the patients was 69±14.8 years, and 53.8% were male. The smoking rate was 30%, and the smoking rate in men was 76.9%. The intensive care unit admission age of smokers was lower than non-smokers (p=0.01). The presence of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and malignancy was significantly higher in smokers. Among the laboratory parameters, white blood cell count (WBC) and neutrophil were higher in smokers (p=0.01). There was no relationship between ICU length of stay, length of hospital stay, and mortality in smokers (p=0.769, p=0.699, p=0.852, respectively). Conclusion: We did not find any significant association between smoking and COVID-19 mortality. We recommend clinicians to monitor WBC and neutrophil count closely as markers of possible progression to critical illness in patients hospitalized in the ICU due to smoking COVID-19. [ABSTRACT FROM AUTHOR]

Objective: About 5.8 million people die each year as a result of injuries. Since trauma is an important problem that increases mortality and morbidity, these patients are usually followed up in intensive care units. In this study, we aimed to investigate the demographic characteristics, the effectiveness of trauma scoring systems, mortality rates, and factors affecting mortality in patients with trauma who were followed up and treated in our Intensive Care Unit (ICU). Methods: The files of the patients who were followed up and treated in the Anesthesiology and Reanimation ICUs of our hospital between January 2017 and August 2019 were retrospectively reviewed. In addition to demographic data such as age, sex, trauma region, comorbidities, duration of hospitalization, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Acute Physiological and Chronic Health Assessment II (APACHE II), surgical history, hospital and ICU length of stay, the duration of invasive mechanical ventilation, ICU mortality, admission lactate, Procalcitonin (pct), ratio of neutrophil/lymphocyte values were recorded from the files of the patients. Results : A total of 115 had complete data available for the analysis. The median age of the patients was 57.0 (44.0) years and 58.3% of the patients were male. ICU length of stay 6.0 (10.0) days, invasive mechanical ventilation (IMV) duration 5.0 (12.0) days, mortality rate 23.5% was found. The mean GCS, RTS scores were lower and APACHE II scores, duration of IMV, admission lactate levels, pct, ICU length of stay were higher in the non-survivors group than survivors (p<0.05). Conclusion: It is important to know the characteristics of trauma patients who are among the main causes of death. We believe that knowing factors that negatively affect prognosis in patients with trauma may contribute positively to trauma management. High APACHE II, GCS, lactate levels, and low RTS increase mortality during admission to ICU for trauma patients. [ABSTRACT FROM AUTHOR]

Objective: Diabetes Mellitus (DM) is a common disease with high mortality and morbidity worldwide. We aimed to assess the oxidative stress levels in patients with and without DM who underwent knee replacement surgery using a pneumatic tourniquet and investigate whether signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) levels are correlated with other ischemia- reperfusion (IR) markers such as malondialdehyde (MDA), and total antioxidant status (TAS). Method: Patients were assigned into either the diabetic (Group D; n=15) or non-diabetic groups (Group C; n=15). MDA, TAS, and SCUBE-1 were assessed at three time points before spinal anesthesia (T1), 5 minutes before (T2) and 2 hours after deflation of the tourniquet (T3). Results: Demographic variables of the groups were similar. There were no statistically significant differences in SCUBE-1, MDA and TAS levels of both groups at all time points. SCUBE-1 levels were higher at T2 and returned to almost normal levels at T3. Conclusion: SCUBE-1, MDA and TAS levels increased following tourniquet application and decreased during the reperfusion period. The magnitude of increase, however, didn’t differ between patients with or without DM. Our results suggest that SCUBE-1 may be used as a marker of tourniquet-related ischemia-reperfusion model. [ABSTRACT FROM AUTHOR]

Objective: Today, the number of patients waiting for organ transplantation is increasing. The detection of brain death in a cadaveric donor is valuable and should be performed quickly. In 2014, Turkish Ministry of Health introduced new regulation on the detection of brain death. With this regulation, it was decided that the medical death that was previously diagnosed by four physicians is now unanimously diagnosed by two physicians in accordance with the evidencebased medicine rules. In this study, we aimed to determine whether the current regulation change has an effect on the duration of brain death diagnosis and the number of donors. Materials and Methods: After obtaining the approval of the local ethics committee, the data of patients diagnosed with brain death in our hospital between 2009-2018 were examined. Patients with missing files were excluded from the study. The demographic data of the patients, time of hospitalization, brain death diagnosis time, donor status, tests performed for the diagnosis, physicians named in the brain death detection report and the time of cardiac death were noted. All cases were divided into two groups as "before 2014" (group 1) and "after 2014" (group 2). Results: In this study, 118 patients were included. Nineteen (16.1%) of the patients were children (<18 years) and 99 (83.9%) were adults. There were 67 patients (55.9%) in group 1 and 51 patients (44.1%) patients in group 2. The time of diagnosis was longer in group 1 (4.82±3.6 days) than group 2 (2.3±1.72 days) (p<0.05). Both groups were similar in terms of time of cardiac arrest after diagnosis (p>0.05). Intracranial hemorrhage was the most common cause of hospitalization in both groups. Conclusion: In this study, new regulation in 2014 made a positive contribution to the time of diagnosis of brain death and shortened this period in our hospital. [ABSTRACT FROM AUTHOR]

Objective: The most important function of the endotracheal tube cuff is that it does not cause leakage during positive pressure ventilation and prevents aspiration of pharyngeal content. endotracheal tube cuff. Different methods are used for inflating cuffs. The aim of this study is to check whether these methods provide safe measurement values and to review the awareness about this issue. Method: After approval of the local ethics committee was obtained, 249 patients in the ASA I-IV risk group were included. Routine induction and maintenance of anesthesia was applied for patients undergoing routine anesthesia monitoring. Demographic data, tube number, cuff pilot inflation method and the individuals who inflated the cuffs were recorded. After 15 minutes, the cuff pressure was measured with the manometer and recorded. High pressures were lowered to the normal range without causing leakage. Complications in the recovery room and at the 24th hour as for sore throat, hoarseness and dysphagia were recorded. Results: A total of 249 patients were included in this study. None of the patients had cuff pressures below the acceptable safe limit of 20 cmH2O. Patients were divided into four groups according to cuff pressures: Group N (20-30 cmH2O), group I (30-50 cmH2O), Group II (50-70 cmH2O) and Group III (>70 cmH2O). Eighteen (7.2%) patients were in Group N, 105 (42.1%) were in Group I, 50 (20%) were in Group II, 76 patients (30.5%) were in Group III with the highest cuff pressure. Palpation method was used in 78% of the patients (p<0.001). Postoperative sore throat occurred in 8 patients (3.2%) in the recovery room and 78 (31.3%) patients at 24.hr after operation. All of 8 patients who had sore throat in the recovery room were in Group III with the highest cuff pressure (p<0.001). Sore throat at 24 hours was especially correlated with elevated cuff pressure and 61 (80.2%) of 76 patients had positive cuff pressure (p<0.001). Conclusion: With this study, we have seen that the pressure of the endotracheal tube cuff cannot be adjusted by the routine methods which we use (palpation and minimum leak volume methods) and mostly cause high pressures. We also found that these high pressures are associated with postoperative sore throat. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Anesthesia / Anestezi Dergisi (JARSS) is the property of Logos Medical Publishing 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.)

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: This study aims to determine the mortality rate and factors affecting the mortality of patients in the general intensive care unit (GICU) of a state hospital. Material and Methods: Data of patients who were hospitalized between January 2012 and March 2013 in GICU of the Konya Numune Hospital were retrospectively analyzed. Demographic characteristics and clinical data of patients were recorded. Patients were divided into two groups as survivors and dead. Factors that may affect the mortality of patients were examined. Results: A total of 930 patients were included. Median age of patients was 73 (63--80) years. Of 930 patients, 357 (38.4%) died and 573 (61.6%) survived; 457 (49.1%) patients were male. Median Glasgow coma scale (GCS) of the group was 13 (8--15) and median acute physiology and chronic health evaluation 2 score was 17 (13--21). Median duration of hospitalization was 4 (2--12) days. The number of patients who were treated with invasive mechanical ventilation was 380 (40.9%), while the number of patients who were treated with erythrocyte suspension, fresh frozen plasma, platelets, and albumin supplementation were 286 (30.8%), 354 (38.1%), 14 (1.5%), and 56 (6%), respectively. Logistic regression analysis revealed that advanced age, transfer of patients from level 2 ICU to level 3, mechanical ventilation, and renal replacement therapies were the factors that increased ICU mortality. High GCS and admission from emergency service to level 2 ICU were factors reducing ICU mortality. Conclusion: Longer duration of hospitalization and increased number and diversity of interventions were related to increased mortality. The mortality rate of patients in the state hospital ICUs can be reduced if the risk factors of patients were appropriately identified. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the mortality rate and factors affecting the mortality of trauma patients in general intensive care unit (ICU) of a state hospital. Material and Method: Data of trauma patients hospitalized between January 2012 and March 2013 in ICU of Konya Numune Hospital were retrospectively analyzed. Demographic characteristics and clinical data of patients were recorded. Patients were divided into two groups as survivors and dead. Mortality rate and factors affectin mortality were examined. Results: A total of 108 trauma patients were included in the study. The mortality rate of overall group was 19.4%. Median age of the patients was 44.5 years and 75.9% of them were males. Median Glasgow Coma Scale of death group was lower (5 (3-8) vs. 15 (13-15), p<0.0001), median APACHE II score was higher (20 (15-26) vs. 10 (8-13), p<0.0001) and median duration of ICU stay was longer (27 (5-62,5) vs. 2 (1-5), p<0.0001) than those in the survival group. The most common etiology of trauma was traffic accidents (47.2%) and 52.7% of patients had head trauma. The rate of patients with any fracture was significantly higher in the survival group (66.7% vs. 33.3%, p=0.007). The rate of erythrocyte suspension, fresh frozen plasma, trombocyte suspension and albumin were 38.9%, 27.8%, 0.9% and 8.3%, respectively in all group. The number of patients invasive mechanically ventilated was 27.8% and median length of stay of these patients were 5 (1.75-33.5) days. The rate of operated patients was 42.6%. The rate of tracheostomy, renal replacement therapy, bronchoscopy and percutaneous endoscopic gastrostomy enforcements were higher in the death group. The advanced age (p=0.016, OR: 1.054; 95% CI: 1.010-1100) and low GCS (p<0.0001, OR: 0.583; 95% CI: 0.456-0.745) were found to be independent risk factors the ICU mortality of trauma patients in logistic regression analysis. Conclusion: We believe that the determination of these risk factors affecting the mortality of trauma patients in our ICU may help to the management of trauma patients in other ICUs in our country. [ABSTRACT FROM AUTHOR]

Background: Although laparoscopic inguinal herniorrhaphy is associated with faster return to daily activity, inadequate postoperative pain control can cause prolonged hospital stays and patient discomfort. Erector spinae plane block (ESP) can be administered for postoperative pain management in abdominal and thoracic surgery. We investigated the effects of unilateral ESP block application in laparoscopic hernia surgery., Methods: A total of 60 patients who were scheduled for laparoscopic inguinal hernia surgery were included. ESP block was performed in group E (n = 30) after induction of anesthesia. There was no intervention in Group C (n = 30). Postoperative pain was assessed by the patient using the numeric rating scale (NRS) at postanesthetic care unit (PACU),1, 4, 6, 12, and 24 h after surgery. The quality of postoperative functional recovery was evaluated using the quality of recovery-40 questionnaire., Results: NRS scores were lower in Group E (n = 30) than in Group C (n = 30) at PACU, 1th, 4th, 6th hours in both rest and movement. Total tramadol consumption was reduced at postoperative 24 h by the ESP block [median(IQR), 60(40) versus 85(30)]. Quality of recovery score of the patients after operation was better in the ESP group than in the control group [mean(SD), 177.9(6.5) in group E and 173.2(7.09) in group C with mean differences: 4.633 and CI: 95% (1.11 to 8.15) respectively]., Discussion: Unilateral ESP blocks in laparoscopic inguinal hernia surgery reduce both postoperative pain levels and analgesic consumption. In addition, the ESP block could be used safely in pain management of this type of surgery and improve the quality of recovery.