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    Is vitamin D deficiency associated with mortality in intensive care patients? an observational retrospective study
    (2018) Arican, Sule; Hacibeyoglu, Gulcin; Cicekci, Faruk; Topbal, Ilkay; İyisoy, Mehmet Sinan
    Aim: The objective of this study is to investigate effects of vitamin D levels in intensive care patients on length of stay in intensive care unit and duration of hospitalization, and the need for mechanical ventilation. Material and Methods: This study was conducted as a retrospective study between February 2015 and January 2016. Length of stay in the intensive care unit and duration of hospitalization, and the need for mechanical ventilation were compared among all patients who were admitted to the intensive care unit and whose 25 (OH) D levels were examined. We further investigated whether vitamin D levels have an effect on 30-day mortality. Results: A total of 155 patients were included in the study. Vitamin D deficiency was found in 123 (79%) patients, and vitamin D insufficiency in 21 (13%) patients, while vitamin D levels were evaluated as normal in the remaining 11 (7%) patients. The effects of 25(OH)D levels of the patients on the length of stay in the intensive care unit (P=0.302), duration of hospitalization (P=0.363), and the need for mechanical ventilation (P=0.150) were not statistically significant. No statistically significant difference was observed between the mortality rates according to vitamin D levels (P=0.377). Conclusion: We found that 25 (OH) D vitamin levels were significantly low in intensive care patients. Although it is difficult to achieve a clear result because of a wide range of comorbidities in intensive care unit patients, we believe that further prospective randomized studies are warranted to clarify this issue.
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    Remifentanil infusion versus propofol and remifentanil patient controlled sedation/analgesia for moderate sedation during interventional radiological procedures: A prospective randomized trial
    (2018) Arican, Sule; Sarkilar, Gamze; Reisli, Ruhiye; Otelcioglu, Seref
    Aim: The use of intravenous sedation and analgesia during interventional radiological procedures is increasing. Sedation and analgesia should minimize patients’ negative psychological reactions caused by fears and anxiety. Also they should relieve pain and provide patients a safe and comfortable environment. The aim of this study was to compare the efficacy and safety of two drugs and methods used for moderate sedation during radiological procedures. Material and Methods: Sixty patients, with American Society of Anesthesiologists scores (ASA) I-II-III, undergoing interventional radiology procedures were included in this study. The patients were administered remifentanil bolus (0.2 µg.kg-1) followed by remifentanil infusion (0.05 µg.kg-1.min-1) in Group R, 2.5mL loading dose (25 mg propofol–25 µg remifentanil) and a 1mL bolus dose (10 mg propofol–10 µg remifentanil) via patient-controlled analgesia/sedation (PCAS) device in Group PR. All the patients’ sedation levels were assessed with the Ramsey Sedation Scale (RSS), pain levels were assessed with Visual Analog Scale (VAS). Their recoveries were assessed with the modified Aldrete score (MAS) at 5 min intervals. Results: Although a significant difference was noted between the groups for RSS values at 5, 10, 20, 25, and 30th minutes during the procedure (P<0.05), there was no significant difference in VAS, anxiety levels and MAS (P > 0.05). Conclusion: Both propofol–remifentanil PCAS and remifentanil infusion provide sufficient moderate sedation.
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    Use of laryngeal mask airway in flexible bronchoscopy in children
    (2019) Arican, Sule; Pekcan, Sevgi; Hacibeyoglu, Gulcin; Tavlan, Aybars; Atay, Turgay; Kolsuz Erdem, Feyza; Tuncer Uzun, Sema
    Aim: Flexible bronchoscope is widely used by pediatric pulmonologists as a diagnostic and therapeutic tool. The objective of this study was to present our anesthesia experience in pediatric flexible bronchoscopy in which airway management was provided with laryngeal mask airway (LMA) and the complications developed.Material and Methods: This study was conducted in children aged between 2-15 years who underwent bronchoscopy for diagnosis and/or treatment between January 2017 and November 2018. Patients’ demographic data, diagnosis, anesthesia and airway management were recorded from the patient files. Times of anesthesia, operation and recovery were recorded. Complications during the procedure, awakening and recovery were recorded. Patients’ sore throat and hoarseness during resting and swallowing were recorded. Results: This study included 31 patients whose airway management was provided with LMA. The mean age was 8.58±4.14 years. Persistent cough was the most common indication for bronchoscopy (35.5%). Anesthesia time was 15.46±10.99 minutes, bronchoscopy time 12.87±10.57, awakening time 16.38±4.53 minutes, and recovery time 23.32±10.24 minutes. The most common complication was cough (45.2%). Sore throats of the patients were observed as mild and moderate at the 0th and 2th hours. Both resting and swallowing sore throats were observed as mild at the 4th hour, while no sore throat was seen in any patient at the 12th hour. Hoarseness was observed at mild level in 4 patients (12.9%) at the 0th hour.Conclusion: Providing airway with LMA in pediatric flexible bronchoscopy applications offers a safe anesthetic management, and it has a low rate of complications.Keywords: Flexible bronchoscopy; pediatric bronchoscopy; laryngeal mask airway.