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Objective: TThe application of mechanical support devices such as extracorporeal membrane oxygenatior (ECMO) has increased with the increase in complex cardiac surgery operations in congenital heart diseases. Despite significant advances in ECMO techniques and methods, the prognosis is still poor. The aim of this study is to show the relationship between organ dysfunction and mortality in patients with veno-arterial (VA) ECMO after pediatric cardiac surgery. Method: Sixty-three patients in the pediatric cardiac ICU who had VA-ECMO and followed up up to 48 hours in our clinic, were retrospectively included in the study and two groups were formed as follows: Group 1: Patients exited within 30 days (n: 47), Group 2: Survived patients (n: 16). Along with the demographic data of the patients, ECMO placement time, creatinine, BUN (blood urea nitrogen), ALT (alanine aminotransferase), AST (aspartate aminotransferase), bilirubin, albumin and platelet counts were recorded. Results: While 36 patients (57.1%) left ECMO in our study group, 16 of these patients (16/63,25.4%) were discharged. A total of 47 patients (47/63, 74.6%) died. Although the number of patients who underwent univentricular repair (26/47,55.31%) in Group 1 was higher (n=5:31.25%) than Group 2, this difference was not significant (p>0.05). Postoperative ECMO was implanted in 27 patients (57.44%) in Group 1 and 4 patients (31.25%) in Group 2, and this difference was statistically significant (p<0.02). While levels of creatinine, BUN, ALT, AST were higher in Group 1 patients who had higher mortality rates, albumin and platelet values were lower than Group 2 (p<0.05). Conclusion: It has been determined that organ dysfunction parameters were found to be effective in showing mortality, mortality rates were higher among patients in whom ECMO was placed postoperatively. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to compare the effects of intrathecal injections of levobupivacaine with bupivacaine on hemodynamic parameters, sensorial and motor block duration and side effects in adult patients undergoing lower extremity vascular surgery. Methods: After approval of our local ethics committee and the consent of the patients who will undergo lower extremity vascular surgery were obtained, 30 ASA I-III patients aged 25-75 years were randomly selected and included in two intrathecal injection study groups as follows: Group I (n=15) 17.5 mg (3.5 mL) isobaric 0.5% bupivacaine, Group II (n=15) 17.5 mg (3.5 mL) isobaric 0.5% levobupivacaine. All patients were administered 10 ml/kg lactate Ringer infusion and baseline values (T0) were recorded. After spinal anesthesia hemodynamic parameters were recorded at 2. (T1), 4. (T2), 10. (T3), 20. (T4), 30. (T5), 60. (T6) and 90. minutes (T7). In addition, side effects such as nausea, vomiting, itching, respiratory depression, hypotension, bradycardia, arrhythmia, convulsions, and tremors were recorded. Results: No significant difference was found between groups in terms of heart rate (HR), mean arterial pressure (MAP), and cardiac index (KI) parameters. The goups were similar in terms of sensorial block onset times and time elapsed till sensory block involved dermatomes, two-segment regression times and onset time of motor block. However, time to regression, and recovery from motor block was found to be shorter in Group II (p<0.05). None of the patients had ECG changes or side effects (p>0.05). Conclusion: Levobupivacaine, affects hemodinamic status in a similar way to bupicaine, it has been concluded with these findings that this drug may be used safely as local anesthetic in patients carrying cardiovascular disease potential. [ABSTRACT FROM AUTHOR]

Objective: This study aims to analyze the effects of two different positive end- expiratory pressure (PEEP) levels during single lung ventilation with low tidal volume (TV) on respiration and hemodynamics in patients undergoing thoracotomy. Material and Methods: After the Hospital Education Planning Board approval and written consent were obtained 40 patients scheduled for thoracotomy were enrolled in the study. When all patients were intubated with double- lumen endotracheal tube and one-lung ventilation (OLV) was initiated, the patients were randomized into two groups. Group 1 (n: 20) consisted of patients who underwent lung ventilation with 6 ml/kg TV and 5 cm H2O PEEP; and Group 2 (n: 20) consisted of patients who underwent lung ventilation with 6 ml/ kg TV and 10 cm H2O PEEP. Arterial blood gas samples were obtained from the patients during the study, and mean arterial pressure, heart rate, partial oxygen pressure (pO2), partial carbondioxide pressure (pCO2), peak airway pressures (PİP), plateau pressure values were recorded at 7 different time points namely T0: Supine position, before the induction, T1: double lung ventilation after induction, T2: OLV 15 minutes, T3: OLV 30 minutes, T4: OLV 45 minutes, T5: pre-extubation, supine position, T6: Postoperative 6th hour. Results: Mean arterial pressure and heart rate values were significantly lower at T1, T2, T3 ve T4 time points in Group 2; however, this decrease was within physiological limit. Group 2 patients had significantly higher PaO2 and lower PaCO2 values. At time points of T2, T3 and T4 when the patients were under OLV, PiP and plateau pressures in Group 2 patients were significantly higher (p<0.05). Conclusion: It was concluded that delivery of low tidal volume and 10 cm H2O PEEP to the ventilated lung during thoracotomy made positive contributions to oxygenation without any adverse effects on hemodynamic, and respiratory mechanisms. [ABSTRACT FROM AUTHOR]