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Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy. [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.)

OBJECTIVES: In this article, the results of severe coronavirus disease 2019 (COVID‑19) cases followed with extracorporeal membrane oxygenation (ECMO) support in a 3‑month period in the third wave when there were an increased number of cases of young patients in our intensive care unit (ICU) were presented. METHODS: The study was carried out with all COVID‑19 patients who were given ECMO support in our tertiary referral hospital ICU after obtaining the consent of the Ministry of Health Scientific Research Platform and after the approval of the local ethics committee. Patient data were obtained retrospectively from intensive care bedside follow‑up charts and computer records. The demographic and clinical characteristics of the patients were presented in average, median, and percentages. The data of the patients were evaluated and compared with the current literature. RESULTS: ECMO treatment was applied in seven patients who were followed up with severe COVID‑19 pneumonia in the last 3 months. Venovenous extracorporeal membrane oxygenation (VV‑ECMO) was applied to all patients. Five (71.5%) of seven patients were weaned from ECMO. Four (57.2%) of seven patients were discharged from the ICU and hospital in good health. While two of the patients had a cesarean section (C/S) before ECMO, one patient underwent C/S under ECMO. All three newborns were delivered via C/S and all were premature (C/S dates were 35 weeks, 32 weeks, and 27 weeks), and all were discharged from the hospital in good health. CONCLUSION: Our experience shows that ECMO in COVID‑19 patients is a lifesaving treatment option that can be successfully applied in severe acute respiratory distress syndrome cases who do not respond to conventional treatments. [ABSTRACT FROM AUTHOR]

Objective: Pneumothorax (PNX) and subcutaneous emphysema (SCE) have increased in importance as a frequently occurring complication. This study aimed to reveal the frequency, timing, and possible risk factors in patients with PNX and SCE who are followed up with coronavirus disease-2019 (COVID-19) diagnosis in our tertiary intensive care unit (ICU). Materials and Methods: All patients with confirmed COVID-19 who were followed up and treated in our unit between August 8, 2020, and February 20, 2021, in a 16-bed tertiary ICU and who developed PNX and SCE during their hospitalization were included. Results: PNX and SCE developed in 16 (9.6%) of 165 patients who were followed up in our ICU due to COVID-19. Of these 16 patients, 3 (18.8%) survived. The median age of patients was 66.5 years (interquartile range: 58.5-75.5). Diabetes mellitus was the most common comorbidity in patients with PNX and SCE. Additionally, 12 (75%) patients had a smoking history. Of 15 (93.8%) patients who developed PNX, 4 (25%) were bilateral, and SCE developed in 9 (56.3%) patients. Twelve (75%) patients with PNX and SCE were under invasive mechanical ventilation, 3 (18.8%) under spontaneous breathing, and 1 (6.2%) under non-invasive mechanical ventilation treatment. The number of oxygen support days until the time PNX and SCE developed was 9 (6.25-17) days in the whole group, the median time was 6 days in the survival group and 9 days in the non-survival group. Conclusion: In the COVID-19 pandemic, complications, such as PNX and SCE, are more frequently observed (9.5%) than in the general intensive care population and the later period of intensive care admission (median 9 days). Smoking is defined as a risk factor in most of these patients; however, increased PNX rates are thought to be related to both COVID-19 pneumonia and parenchymal damage due to cytokine storms. [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.)

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.)