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Introduction: Despite significant advances in the management of patients with COVID-19, there is a need for markers to guide treatment and predict disease severity. In this study, we aimed to evaluate the relationship of the ferritin/albumin (FAR) ratio with disease mortality. Methodology: Acute Physiology and Chronic Health Assessment II scores and laboratory results of patients diagnosed with severe COVID-19 pneumonia were retrospectively analyzed. The patients were divided into two groups: survivors and non-survivors. Data for ferritin, albumin, and ferritin/albumin ratio among COVID-19 patients were analyzed and compared. Results: The mean age was higher in non-survivors (p = 0.778, p < 0.001, respectively). The ferritin/albumin ratio was significantly higher in the non-survival group (p < 0.05). Taking the cut-off value of the ferritin/albumin ratio of 128.71 in the ROC analysis, it predicted the critical clinical status of COVID-19 with 88.4% sensitivity and 88.4% specificity. Conclusions: ferritin/albumin ratio is a practical, inexpensive, and easily accessible test that can be used routinely. In our study, the ferritin/albumin ratio has been identified as a potential parameter in determining the mortality of critically ill COVID-19 patients treated in intensive care.

Aim We aimed to evaluate the indications for tracheostomy and early complications in patients who underwent percutaneous tracheostomy with the Griggs method in our clinic. Material and Method This study is retrospective and observational. Demographic data, hospitalization diagnoses, days of opening tracheostomy, days of intensive care hospitalization, indications for tracheosotomy and early complications of tracheostomy were recorded and evaluated in a total of 78 patients between the ages of 23-93 who underwent percutaneous tracheostomy with the Griggs method between January 2021 and September 2022. Results A total of 78 patients were included in the study. Of the patients, 42 (54%) were female and 36 (46%) were male. In the patients included in the study, the earliest tracheostomy day was the 7th day of intubation and the latest tracheostomy day was the 32nd day of intubation. The mean day in terms of tracheostomy day was 23rd day of intubation. In terms of early complications, bleeding was observed in 5 (6.5%) patients, tracheoesophageal fistula in 1 (1.3%) patient, and pneumothorax in 1 (1.3%) patient. No complications were encountered in 71 (90.9%) patients.

Ultrasonography is an imaging tool that is increasingly used in the diagnosis and follow-up of many lung and heart diseases. Full lung ultrasonography is the examination of both hemithorax and protocols and image definitions have been created to make the examination more systematic and accurate. Cardiac ultrasonography is used to evaluate a moving organ. It requires users to be able to detect and interpret dynamic and variable values. Another feature of ultrasonography is its ability to guide interventional procedures. Ultrasonography will develop in the future and will be used more as a modern diagnostic tool in lung and heart evaluation by specialists.

Background & Objectives: The aim of this study is investigate the relationship of C-reactive protein, albumin, C-reactive protein/albumin ratio with prognosis and 28-day mortality in critically ill patients over 85 years of age with acute ıschaemic stroke. Methods: This study is a retrospective and observational study. A total of 189 patients aged 85 years and older who were followed up in the intensive care unit between 2017 and 2020 were included in the study. Demographic data of the patients included in the study, length of stay in the intensive care unit, comorbidities, laboratory data of hospitalization in the intensive care unit, C-reactive protein, albumin, C-reactive protein/albumin ratio, neutrophil/lymphocyte ratios, thrombocyte/lymphocyte ratios, APACHE II, SAPS II values of intensive care admissions were recorded. Results: In the statistical analysis performed for C-reactive protein, albumin, C-reactive protein/albumin ratio between survival and non-survival groups, a statistically significant difference was found between the groups (For C-reactive protein, p = 0.03; for albumin, p = 0.02; for C-reactive protein/albumin ratio, p= 0.03). The logistic regression model was applied to investigate the independent risk factors affecting the patients’ mortality at 28 days. Albumin, CRP , C-reactive protein/albumin ratio was found to be associated with 28-day mortality according to the logistic regression analysis. (For albumin; p= 0.04, for C-reactive protein; p= 0.04, for C-reactive protein/albumin ratio; p= 0.04). According to the ROC curve analysis result, Cut-off value was found to be 2.47 for C-reactive protein/albumin ratio. Conclusion: The CRP/albumin ratio is a valuable parameter that can be used to predict 28-day mortality in critically ill very elderly patients with acute ischemic stroke.

Background: COVID-19 disease, which has taken over the world for more than a year, is unfortunately not yet understood and a definitive treatment has not been found. The aim of this study is to investigate the changes in clinical and laboratory tests of critical COVID-19 patients followed in the intensive care unit between March/2020 and December/2020 and to evaluate the factors that cause these changes with literature information.Material and Method: In the study, during the beginning of the pandemic and its progress; 50 COVID-19 patients treated in the intensive care unit between March-April-May/2020 were defined as group 1, and 50 COVID-19 patients treated in the intensive care unit between October-November-December/2020 were defined as group 2. Clinical, laboratory and intensive care processes of the patients in the groups were analyzed retrospectively and compared.Results: Demographic data were similar between groups. Group 2 patients had higher 28-day mortality, and this result was statistically significant (p=0.006). Transfer rates of group 1 patients to the service after intensive care were found to be statistically higher (p=0.029).Conclusion: 28-day mortality was found to be different between similar patient groups who were admitted to intensive care during different periods of the pandemic. The reasons for this may be: changes in pathogenicity as a result of viral mutations, different immune responses of hosts to viral infection, intensive care experience of healthcare professionals.

Aim: Computed tomography (CT) images of the chest were often used to support the diagnosis of COVID-19 and infectious diseases. This study aims to question the importance of specific chest CT results in predicting the prognosis of COVID-19 patients being followed up in the intensive care unit (ICU). Materials and Methods: For this study, 20 critically ill patients whose RT-PCR tests were positive for COVID-19 were included. Mortality, invasive and non-invasive mechanical ventilator requirement, APACHE II scores and ICU staying days were compared chest CT scans with have poor prognosis results before admission to ICU. Results: Critical patients who were followed up in the ICU due to COVID-19 disease with crazy laying pattern on chest CT images, it was concluded that there is a statistically significant requirement for invasive mechanical ventilation support during the ICU period (P = 0.04). We reported that all patients with pleural and pericardial effusion required invasive mechanical ventilation support. One of the chest CT results observed in critical COVID-19 patients ın ICU is that the consolidation / ground glass opacity pattern> 1 may have a higher (about five-fold) mortality rate. Most of our critical COVID-19 patients who stayed in intensive care for a long time had a crazy laying pattern on chest CT images. Conclusion: We believe that some results obtained from chest CT scans in COVID-19 disease may predict the prognosis of the patient during the intensive care period.

Nosocomial infections are infections that occur 48-72 hours after hospitalization, especially caused by bacteria, and pose a high risk for patients in the intensive care units (ICUs), including Covid-ICU. This study was aimed to reveal the distribution and antibiotic susceptibility profiles of bacteria isolated from various clinical samples of non-Covid-ICU and Covid-ICU patients. Bacterial strains isolated from ICUs patients in Kastamonu Training and Research Hospital between March 2020 and October 2020 were included in this study. The identification of the strains was carried out using the Vitek 2 compact automated system (BioMerieux, France) as well as standard microbiological methods. Antibiotic susceptibility tests were studied using the Vitek 2 automated system and the results were interpreted based on the European Committee for Antimicrobial Susceptibility Tests (EUCAST) guideline. There were 302 patients in the non-Covid-ICU and 440 patients in the Covid-ICU. A total of 470 strains, 370 from non-Covid-ICU and 100 from Covid-ICU, were isolated. Acinetobacter spp was the most frequently isolated species for both ICUs. Acinetobacter spp isolated from non-Covid-ICU had higher resistance rates to meropenem (p= 0.043), ceftazidime (p= 0.014), and levofloxacin (p=

Tracheostomy is life-saving procedure in critical care patients which require long-term mechanical ventilation (MV) and an alternative to endotracheal intubation.(1,2) The factors affecting the survival of tracheostomized patients are not clearly known. The aim of this study was to investigate the factors affecting intensive care unit (ICU) and long-term mortality in the tracheostomized patients due to respiratory failure. A retrospective observational cohort study was planned between January 2016-2019 in tertiary ICU. Each patient underwent percutaneous and surgical tracheostomy was included. Demographic characteristics, diagnoses, causes of tracheostomy, comorbidities, Charlson and APACHE 2 scores, culture antibiogram results, ICU day and mortality (1-3 and 12 months) were recorded. In the analysis of the data, appropriate statistical tests and analyzes were used. 115 of 3620 patients admitted to tertiary ICU and underwent percutaneous and surgical tracheostomy due to respiratory failure between January 2016-2019 were included. 75 (65%) of the patients were male and median age was 68±14 years. Hospital mortality was higher in the group with Acinetobacter baumannii growth (p=0.04). According to Kaplan-Meier survival analysis, long-term follow-up of Acinetobacter baumanii growth did not affect survival (p=0.938). Patients with cerebro-vascular accident (CVA) had lower survival in long-term follow-up (p [Med-Science 2020; 9(1.000): 1-5]

Introduction: COVID-19 disease spread rapidly worldwide, causing a pandemic. In this study, we aimed to explore the distribution of blood products in our blood center before and during the pandemic by blood type. Material and Method: In this study, we retrospectively analyzed 4,271 blood products (1,290 patients) transfused before and during the pandemic through the medical records of Kastamonu Training and Research Hospital Blood Transfusion Center. Moreover, we investigated the associations between transfusions and age, sex, blood type, and COVID-19 infection. Results: The findings revealed that the majority of the patients receiving transfusions both before and during the pandemic were A Rh (+) (41.4%). Besides, the rates of those with O Rh (+) were 28.8% and 28.7% during the pandemic. In addition, 37 products (28 erythrocyte suspensions, 7 fresh frozen plasma, 2 pooled platelet suspensions) were transfused on 17 patients with confirmed COVID-19. Conclusion: Transfusions have an important place in the treatment of critically ill patients. The blood type A Rh (+) was previously shown to be associated with an increased risk of COVID-19 infection. In this study, although we realized that products of blood type A were mostly used in general transfusions, transfusions in the pandemic were performed predominantly with blood products of infected patients with blood type O. The modern world is more likely to encounter further pandemics in the future. We think that each region should evaluate its own centers.

Background: Covid-19 disease can have many neurological complications, posterior reversible encephalopathy being one of them. Case Report: A 42-year-old female patient was admitted to the emergency department on the 4th day of PCR test positivity with decreased consciousness. Patient with a Glasgow coma score of 6 (E1M3V2). The patient's vital signs were stable and there was no abnormality in his laboratory. No pathology was found in the brain tomography to explain the loss of consciousness. In MRI evaluation, the patient was diagnosed with Posterior reversible encephalopathy syndrome (PRES) according to radiological and clinical information. The standard Covid -19 treatment added to the antiedema treatment was applied to the patient. Brain MRI was repeated four days later and previous MRI findings showed regression. The patient was discharged to the ward with stable neurological status on the 22nd day of hospitalization. Conclusion: PRES is a rare but serious complication in Covid-19. Especially in the Covid-19 intensive care unit, intubation and sedation suppress the clinical picture, and the difficulty in getting patients on magnetic resonance imaging can complicate the diagnosis. Therefore, PRES should be kept in mind in the presence of neurological symptoms such as encephalitis, meningitis, encephalopathy and cerebrovascular disease.

Introduction: In critical COVID- 19 patients, we aimed to examine the relationship mortality between the parameters and the macrocytic/microcytic erythrocyte population that are routinely evaluated in each patient admitted to the intensive care unit. Material and Method: It is a retrospective cross-sectional study and was conducted in Kastamonu University, Faculty of Medicine, a tertiary hospital intensive care units located in the North of Turkey .198 nonanemic critical COVID-19 patients treated between November 2020 and February 2021 were evaluated. The patients were divided into two groups as survival and non survival. Apache II score, saps II score and routine blood examinations of the patients were evaluated. Results: Among the groups; APACHE II score (p

Introduction: While many intoxication cases are cured with medical treatment, antidote therapy and symptomatic treatment; some cases may need hemodialysis treatment or even invasive mechanical ventilation support. We aimed to examine the place of hemodialysis in three rare intoxication cases seen in our hospital. Case Reports: 43-year-old male patient was admitted to the emergency service with metformin intoxication . The patient with type B lactic acidosis was treated with urgent hemodialysis After a session of hemodialysis, the clinical and laboratory data returned to normal. 19-year-old female patient admitted to the emergency service with theophylline intoxication. The blood theophylline level was toxic.The patient with symptoms of intoxication (tachycardia, hypokalemia, severe nausea and vomiting, etc.) regressed after a session of hemodialysis . 22-year-old mental retarded male patient was admitted to the emergency service with loss of consciousness. The patient with metabolic acidosis was taken to the intensive care unit with coma of unknown cause. 4 sessions of hemodialysis was applied to the patient who developed acute renal failure. It was learned that the patient drank ethylene glycol (antifreeze). Result: All our patients could be discharged with full recovery.Hemodialysis treatment has an important place in the treatment of intoxication cases.