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    Can lactate clearance used to as a determinant of survival in mechanical ventilation follow up of critically ill patients?
    (2019) Kibici, Ozge; Algin, Abdullah; Genc Yavuz, Burcu; Erdogan, Mehmet Ozgur; Colak, Sahin
    Aim: Serum lactate level is known to have prognostic value in critical patients. Tissue hypoxia is a cause of an increase in lactate levels. A decrease in excretion and metabolism of lactate can increase lactate levels. In this study, we have investigated whether clearance of serum lactate could be a predictor of mortality in critically ill intubated patients at the emergency room.Materials and Methods: Study Groups. Data of 205 critically ill patients requiring intubation, admitted to the emergency department of Haydarpasa Numune Training and Research Hospital between January 2011 and December 2015 have been scanned retrospectively. The intubations were performed according to the latest rapid sequence intubation protocols. Results: There were 100 (48.8%) male and 105 (51.2%) female patients. Median, minimum, and maximum age were 76,19, and 104, respectively. The number of patients who could not survive was 157 (76.6%). The median, maximum, and minimum age in the non-survivor group were 78,31, and 104, while they were 70,19, and 90 in the survivor group, respectively. The difference was statistically significant (p0.001). Final diagnoses and mortality rates of the critically ill patients requiring intubation in the emergency department are shown in Table 1. Conclusion: We have found out that lactate clearance has no statistically significant relationship with mortality (p=0.5). However, lactate levels were higher in the groups with mortality, and the difference was statistically significant for both referral time and 4th-hour blood samples (p=0.024 and 0.014, respectively).
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    A case of acute pancreatitis and acute renal failure due to aortic dissection
    (2017) Sariaydin, Mehmet; Algin, Abdullah; Bilge, Zulfukar
    Acute pancreatitis (AP) The inflammatory process of the pancreas with elevated pancreatic enzymes such as amylase, lipase and abdominal pain. The most common etiologic factors are gallstones and alcohol. Among the rare causes of acute pancreatitis are vascular problems such as dissecting aortic aneurysms. A 57-year-old male patient was admitted to the emergency room with complaints of abdominal pain, nausea and vomiting. Laboratory is in review; Amylase: 1916 U/L, Lipase 773 U/L Urea: 187 mg /dL, WBC: 15.260 / mm3, Hemoglobin: 12.06 gr / dl, Creatinine: 3.0 mg/dl, AST: 18 IU/L, ALT: 21 IU/L, Total Billerubin: 0.58 mg/dL, LDH: 473 U/L. In patient with these findings it was thought to be acute pancreatitis. Abdominal CT revealed a dissecting aortic aneurysm, involving the celiac artery, super mesenteric artery and inferior mesenteric artery. Not every acute pancreatitis causes is stone and alcohol. One of the rare causes is aortic dissection.