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3. Prognostic factors for 30-days mortality in eighty years aged and older critically ill patients: a single center retrospective cohort study.

Author

KASAPOĞLU, Umut Sabri, KAÇMAZ, Osman, GÖK, Abdullah, YILDIZ EGLEN, Merih, ŞAYAN, Hasan, and ÇOLAK, Fatih

Subjects
LIFE expectancy, CRITICALLY ill, OLDER patients, PROGNOSIS, COHORT analysis, INTENSIVE care patients, LENGTH of stay in hospitals
Abstract

Background/aim: Nowadays, with the rise in average life expectancy, the rate of hospitalization of the older population in intensive care unit (ICU) is gradually increasing. Unfortunately, there are no ideal combination of prognostic factors predicting the mortality in older patients admitted to the ICU. In the present study, we aim to determine the prognostic factors and their impacts on short-time mortality in older critically ill patients. Materials and methods: This retrospective cohort study was performed between January 2019 and February 2020. We included 133 patients aged ≥80 years and hospitalized ≥24 h in the ICU. Results: A total of 133 critically ill patients enrolled in the present study. And, the median age of the patients was 85 (80–106) years. 30-days and overall ICU mortality rates were found 30.1% and 34.6%, respectively. The patients were grouped as survivors (n = 94) and nonsurvivors (n = 39). Hospital length of stay before the ICU admission was found significantly longer in nonsurvivors (p = 0.001). Sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation-II (APACHE-II) score were significantly higher in nonsurvivors (p < 0.001, p < 0.001). Also, blood lactate level and glucose level were respectively significantly higher in nonsurvivors (p < 0.001, p = 0.006). We found that modified nutrition risk in critically ill (mNUTRIC) score and prehospital clinical frailty scale (CFS) were independent prognostic factors for the older critically ill patients (HR = 9.19, 95% CI=1.47–57.32, p = 0.018, HR = 20.16, 95% CI = 2.63–54.07, p =0.004). Conclusion: mNUTRIC score and prehospital CFS score were the most important prognostic factors in the admission of older patients to intensive care units. [ABSTRACT FROM AUTHOR]

Published
2021
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5. Erişkinlerde laringeal maske (Lma Unique) yerleştirilmesinde üç farklı tekniğin karşılaştırılması

Author

Yildiz Eglen, Merih, Kuvaki Balkan, Bahar, and Anesteziyoloji ve Reanimasyon Ana Bilim Dalı

Subjects
Anestezi ve Reanimasyon, Laryngeal masks, Respiration, Positive pressure respiration, Anesthesia and analgesia, Anesthesia, Anesthesiology and Reanimation, Respiratory function tests, Placement
Abstract

Amaç: Bu çalışmada laringeal maske yerleştirilmesinde standart teknik ile üçlü havayolu manevrası ve rotasyonel teknik; ilk denemede laringeal maske yerleştirme başarısı, yerleştirme süresi, laringeal maske yerleşimine hasta yanıtı, laringeal maskenin hipofarinkste yerleşme şekli açısından karşılaştırılmıştır. Ayrıca bu üç tekniğin uygulanması sırasında kalp atım hızı ile kan basıncı üzerine etkileri ve tüm süreç ile ilgili morbiditeleri de araştırılmıştır.Gereç ve yöntem: Çalışmaya ASA I-II sınıfı, 18-65 yaş arası 180 hasta alındı. Her hasta için standart anestezi protokolü uygulandı. Rastgele sayılar tablosuna göre önceden belirlenen yöntem kullanılarak; kafı tamamen söndürülmüş olan laringeal maske, standart teknikle (Grup S), rotasyonel teknikle (Grup R) ve üçlü havayolu manevrası kullanılarak (Grup T) yerleştirildi.Bulgular: İlk denemede laringeal maske yerleştirme başarısı açısından gruplar arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Standart teknikle %93, rotasyonel teknikle %90 ve üçlü havayolu manevrası kullanılan teknikle %95 başarı saptandı (p>0,05). Hastaların hiçbirisinde laringeal maske yerleşimine reaksiyon gözlenmedi. Laringeal maske yerleştirme süresi, Grup T'de Grup S'den (p= 0,0001) ve Grup R'den (p= 0,001) anlamlı ölçüde kısa bulundu. Ancak Grup S ile Grup R arasında yerleştirme süreleri açısından anlamlı farklılığa rastlanmadı (p>0,05). Fiberoptik bronkoskop ile derecelendirilen glottis görünümü gruplar arasında benzer bulundu (p>0,05). Ortalama arter basıncı ortalama değerleri ve kalp atım hızı ortalama değerleri açısından gruplar arasında anlamlı farklılık saptanmadı (p>0,05). Laringofaringeal komplikasyonlar açısından gruplar arasında anlamlı farklılık saptanmadı (p>0,05).Sonuç: Alternatif tekniklerin öğrenilmesiyle bir teknikle başarısızlık durumunda, diğer teknik kullanıldığında; laringeal maske yerleştirilmesi ile havayolu travmasına maruziyet, gereksiz endotrakeal entübasyon, laringospazm, hipoksi veya abartılı hemodinamik yanıt gibi riskler azalabilir. Üçlü havayolu manevrası ile laringeal maskenin diğer tekniklere göre daha kısa sürede yerleştirilebiliyor olması bu tekniğe üstünlük sağlamaktadır.Anahtar Kelimeler: Laringeal maske, yerleştirme teknikleri Aim of the study: The purpose of the study was to compare successful insertion of the LMA-Unique at the first attempt, insertion time, reaction to insertion, fiberoptic assessment of the airway view using three different insertion techniques. Secondary outcomes as airway morbidity and haemodynamic response to insertion were also compared.Methods: After obtaining approvel from the Institutional Ethics Committe and written informed consent, one hundred and eighty ASA I and II adult patients, aged 18-65 years, were included into the study. A standart anaesthesia protocol was followed for all patients and they were randomly allocated into one of the three groups: Group Standart (S), Group Rotational (R) and Group Triple (T). In all groups the cuff was fully deflated during insertion.Results: Demographic data demonstrated no significant difference between groups. Successful insertion at the first attempt was not statistically significant among the groups (p>0,05). Overall succes rate was %93 for Group S, %90 for Group R and %95 for Group T (p>0,05). No reaction to insertion occured in any patient. Time for successful insertion was significantly shorter in Group T compared with Group S (p= 0,0001) and Group R (p= 0,001). Fiberoptic assesment and airway morbidity were similar in all groups (p>0,05). There was no significant difference between groups according to haemodynamic responses and laringopharyngeal complications (p>0,05). Desaturation and laryngospasm did not occured in any of the patients.Conclusion: To learn alternative techniques is important because when one technique fails, the other can be used. Using these alternative techniques may reduce undesirable events like airway trauma due to repeated attempts, unnecessary endotracheal intubation, laryngospasm, hypoxia or exaggerated haemodynamic responses. Because of shorter insertion time in group triple, this technique may be superior to the other two techniques.Key words: Laryngeal mask airway, insertion techniques 63

Published
2010

6. Comparison of the effects of 2 different doses of remifentanil infusion for sedation during in-vitro fertilization procedure.

Author

Sarikaya HB, Iyilikci L, Gulekli B, Posaci C, Erbil Dogan O, Ok E, Eglen M, Ellidokuz H, and Gunerli A

Subjects
Adolescent, Adult, Deep Sedation, Double-Blind Method, Female, Humans, Prospective Studies, Remifentanil, Young Adult, Fertilization in Vitro, Hypnotics and Sedatives administration & dosage, Piperidines administration & dosage
Abstract

Objective: To compare the sedation level, hemodynamic effects, patient and physician satisfactions following sedation achieved by 2 different doses of remifentanil (R) infusion with additional bolus infusions of propofol for in vitro fertilization (IVF) procedure., Methods: A double-blind prospective randomized study was implemented on 86 ASA I-II grade female patients, 18-40 years of age that underwent IVF procedure. This study was performed in the Department of Anesthesiology and Obstetrics and Gynecology, School of Medicine, Dokuz Eylul University, Izmir, Turkey between November 2006 to August 2008. Group R1 received 0.1 mcg/kg/min while Group R2 received 0.15 mcg/kg/min infusion dose remifentanil. Side effects, total doses of remifentanil and propofol administered, heart rate (HR), systolic arterial pressure and diastolic arterial pressure values have been recorded. Fertilization, cleavage, and pregnancy rates together with prognosis of pregnancies were compared., Results: Groups did not show statistically significant differences for hemodynamic parameters of HR and MAP (p = 0.281). Comparison of the satisfaction levels of 2 groups showed that anesthesiologist satisfaction was superior in R1 (p = 0.009) whereas surgeon satisfaction was superior in R2 (p = 0.01). Both groups reported good patient satisfaction levels (p = 0.31). There were no differences between the groups in terms of fertilization, cleavage, pregnancy rates and prognosis of pregnancies (p>0.05)., Conclusion: Both doses of remifentanil provided stable hemodynamics along with fast and uncomplicated recovery.

Published
2011

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