5 results on '"YURTSEVEN, Nurgül"'
Search Results
2. Use of Endotracheal Tubes with Subglottic Drainage Reduces Ventilator-associated Pneumonia in Chronic Obstructive Pulmonary Disease Patients After Coronary Surgery.
- Author
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Düzyol, İpek Yakın, Yurtseven, Nurgül, Düzyol, Çağrı, and Köse, Abbas
- Subjects
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CHRONIC obstructive pulmonary disease , *VENTILATOR-associated pneumonia , *BODY surface area , *ENDOTRACHEAL suctioning , *ENDOTRACHEAL tubes , *CORONARY artery bypass , *RED blood cell transfusion - Abstract
Objectives: We investigated the effects of endotracheal tubes with subglottic drainage (SGAETT) on the incidence of ventilator-associated pneumonia (VAP) in patients with chronic obstructive pulmonary disease (COPD) undergoing coronary artery bypass grafting (CABG). Methods: The patients were assigned to one of two groups. Group 1 patients used a SGAETT (n=94); Group 2 controls received standard endotracheal tubes (n=100). The demographic data, number of coronary bypasses performed, and cross clamp (CC) and cardiopulmonary bypass (CPB) durations were recorded. Endotracheal aspiration samples were obtained from patients with suspected VAP in the intensive care unit (ICU). Intubation time, length of ICU and hospital stays, erythrocyte transfusion volume, enteral nutrition needs, transportation needs, and reintubation and sedation needs were recorded. Results: The VAP rate was 6.8% in Group 1 and 19% in Group 2 (p<0.05). Group 1 patients had lower body weight, smoking, and transportation needs; Group 1 patients also had shorter ICU and hospital stays but demonstrated a greater average body surface area, higher mean pulmonary arterial pressure, more-frequent peptic ulcers, higher mean pulmonary arterial pressure, and Group 1 patients were more likely to have ejection fractions (EFs) less than 40% (p<0.05). A logistic regression analyses found SGAETT independently reduced VAP independently (OR: 0.037) (p<0.05). Conclusion: SGAETT reduces the incidence of VAP in patients with COPD undergoing cardiac surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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3. Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience
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Özdemir, Fatih, primary, Korun, Oktay, additional, Dedemoğlu, Mehmet, additional, Çiçek, Murat, additional, Biçer, Mehmet, additional, Yurdakök, Okan, additional, Fırat Altın, Hüsnü, additional, Hekim Yılmaz, Emine, additional, Yurtseven, Nurgül, additional, Ali Aydemir, Numan, additional, and Şaşmazel, Ahmet, additional
- Published
- 2022
- Full Text
- View/download PDF
4. Outcomes of Norwood procedure with hypoplastic left heart syndrome: Our 12-year single-center experience
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Fatih Özdemir, Oktay Korun, Mehmet Dedemoğlu, Murat Çiçek, Mehmet Biçer, Okan Yurdakök, Hüsnü Fırat Altın, Emine Hekim Yılmaz, Nurgül Yurtseven, Numan Ali Aydemir, Ahmet Şaşmazel, Biçer, Mehmet, Özdemir, Fatih, Korun, Oktay, Dedemoğlu, Mehmet, Çiçek, Murat, Yurdakok, Okan, Altın, Hüsnü Fırat, Yılmaz, Emine Hekim, Yurtseven, Nurgül, Aydemir, Numan Ali, Sasmazel, Ahmet, and Koç University Hospital
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Pulmonary and Respiratory Medicine ,Hypoplastic left heart syndrome ,Inter-stage mortality ,Norwood procedure ,Surgery ,Cardiology and Cardiovascular Medicine - Abstract
Background: in this study, we aimed to analyze the predictors and risk factors of mortality in patients who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome. Methods: between January 2009 and December 2020, a total of 139 patients (95 males, 44 females) who underwent Norwood I procedure with the diagnosis of hypoplastic left heart syndrome in our center were retrospectively analyzed. Results: the median birth weight was 3,200 (range, 3,000 to 3,350) g and the median age at the time of operation was seven (range, 5 to 10) days. Pulmonary flow was achieved with a Sano shunt in the majority (72%) of patients. Survival rate was 41% after the first stage. Reoperation for bleeding (p=0.017), reoperation for residual lesion (p=0.011), and postoperative peak lactate level (p=0.029), were associated with in-hospital mortality. Nineteen (33%) of 57 patients died before the second stage. Thirty-three (58%) patients underwent second stage, and survival after the second stage was 94%. Thirteen patients underwent third stage, and survival after the third stage was 85%. Estimated probability of survival at six months, and one, two, three, and four years were 33%, 33%, 25%, 25%, and 22% respectively. Conclusion: hospital and inter-stage mortality rates are still high and this seems to be the most challenging period in term of survival efforts of the patients with hypoplastic left heart syndrome. Early recognition and reintervention of anatomical residual defects, close follow-up in the inter-stage period, and the accumulation of multidisciplinary experience may help to improve the results to acceptable limits. / Amaç: bu çalışmada, hipoplastik sol kalp sendromu tanısıyla Norwood I işlemi uygulanan hastalarda mortalitenin öngörücüleri ve risk faktörleri incelendi. Ça¬lış¬ma pla¬nı: Ocak 2009 ve Aralık 2020 tarihleri arasında merkezimizde hipoplastik sol kalp sendromu tanısıyla Norwood I işlemi uygulanan toplam 139 hasta (95 erkek, 44 kadın) retrospektif olarak incelendi. Bulgular: medyan doğum ağırlığı 3200 (dağılım, 3000-3350) g ve ameliyat sırasında medyan yaş yedi (dağılım, 5-10) gün idi. Hastaların büyük kısmında (%72) pulmoner akım, Sano şant ile sağlandı. İlk aşama sonrası sağkalım %41 idi. Kanama nedeniyle tekrar ameliyat (p=0.017), rezidü anatomik lezyon nedeniyle tekrar ameliyat (p=0.011) ve ameliyat sonrası birinci gün pik laktat seviyesi (p=0.029) hastane mortalitesi ile ilişkili idi. Taburcu edilen 57 hastanın 19’u (%33) ikinci aşamaya ulaşamadan kaybedildi. Otuz üç (%58) hastaya ikinci aşama ameliyatı uygulandı ve ikinci aşama sonrası sağkalım %94 idi. On üç hastaya üçüncü aşama ameliyatı uygulandı ve üçüncü aşama sonrası sağkalım %85 idi. Altı ay ve birinci, ikinci, üçüncü ve dördüncü yılda tahmini sağkalım olasılığı sırasıyla %33, %33, %25, %25 ve %22 idi. So¬nuç: hastane ve aşamalar arası mortalite oranları halen yüksek olup, hipoplastik sol kalp sendromu tanılı hastaların sağkalma çabalarındaki en zorlayıcı zaman dilimi olarak görünmektedir. Anatomik rezidü defektlerin erken tanılanması ve erken yeniden girişim yapılması, aşamalar arası dönemde yakın takip ve multidisipliner birikim ve tecrübe sonuçların kabul edilebilir seviyelere ulaşmasına yardım edebilir., NA
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- 2022
5. A novel fontan Y-graft for interrupted inferior vena cava and azygos continuation
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S Samaneh Lashkarinia, Murat Cicek, Banu Kose, Mohammad Rezaeimoghaddam, Emine Hekim Yılmaz, Numan Ali Aydemir, Reza Rasooli, Sercin Ozkok, Nurgul Yurtseven, Hasan Erdem, Kerem Pekkan, Ahmet Sasmazel, Lashkarinia, S. Samaneh, Pekkan, Kerem (ORCID 0000-0001-7637-4445 & YÖK ID 161845), Rezaeimoghaddam, Mohammad, Rasooli, Reza, Çicek, Murat, Köse, Banu, Yılmaz, Emine Hekim, Aydemir, Numan Ali, Özkök, Serçin, Yurtseven, Nurgül, Erdem, Hasan, Sasmazel, Ahmet, Graduate School of Sciences and Engineering, College of Engineering, and Department of Mechanical Engineering
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Pulmonary and Respiratory Medicine ,Heart Defects, Congenital ,Intratrial ,Y-Graft ,1004 Medical Biotechnology ,Respiratory System ,Hemodynamics ,Single Ventricle ,1103 Clinical Sciences ,Vena Cava, Inferior ,Computational Fluid Dynamics ,Pulmonary Artery ,Extracardiac ,Fontan Procedure ,Total Cavopulmonary Connection ,Cardiac and cardiovascular systems ,Respiratory system ,Surgery ,Patient-Specific Analysis ,Pre-Surgical Planning ,Humans ,Total cavopulmonary connection ,Computational fluid dynamics ,Y-graft ,Fontan procedure ,Pre-surgical planning ,Single ventricle ,Patient-specific analysis ,Cardiology and Cardiovascular Medicine - Abstract
Objectives: to evaluate the hemodynamicdynamic advantage of a new Fontan surgical template that is intended for complex single-ventricle patients with interrupted inferior vena cava-azygos and hemi-azygos continuation. The new technique has emerged from a comprehensive pre-surgical simulation campaign conducted to facilitate a balanced hepatic flow and somatic Fontan pathway growth after Kawashima procedure. Methods: for 9 patients, aged 2 to 18 years, majority having poor preoperative oxygen saturation, a pre-surgical computational fluid dynamics customization is conducted. Both the traditional Fontan pathways and the proposed novel Y-graft templates are considered. Numerical model was validated against in vivo phase-contrast magnetic resonance imaging data and in vitro experiments. Results: the proposed template is selected and executed for 6 out of the 9 patients based on its predicted superior hemodynamic performance. Pre-surgical simulations performed for this cohort indicated that flow from the hepatic veins (HEP) do not reach to the desired lung. The novel Y-graft template, customized via a right- or left-sided displacement of the total cavopulmonary connection anastomosis location resulted a drastic increase in HEP flow to the desired lung. Orientation of HEP to azygos direct shunt is found to be important as it can alter the flow pattern from 38% in the caudally located direct shunt to 3% in the cranial configuration with significantly reversed flow. The postoperative measurements prove that oxygen saturation increased significantly (P-value = 0.00009) to normal levels in 1 year follow-up. Conclusions: the new Y-graft template, if customized for the individual patient, is a viable alternative to the traditional surgical pathways. This template addresses the competing hemodynamic design factors of low physiological venous pressure, high postoperative oxygen saturation, low energy loss and balanced hepatic growth factor distribution possibly assuring adequate lung development., European Union (EU); Horizon 2020; European Research Council (ERC); Proof of Concept Grant; BloodTurbine; ERC Starting Grant; Scientific and Technological Research Council of Turkey (TÜBİTAK); 1003 Priority-Research Program Grant
- Published
- 2022
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