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    Angiotensin II and angiotensin II receptor 2 levels can predict shock and mortality in septic patients
    (Edizioni Minerva Medica, 2022) Ozer, Ayse B.; Bicakcioglu, Murat; Baykan, Seyma; Bulut, Nilufer; Kalkan, Serkan; Demircan, Selcuk; Korkmaz Disli, Zeliha
    BACKGROUND: The aim of this study was to evaluate the place of angiotensin II and its receptors in the prognosis of septic patients. METHODS: Patients with sepsis and septic shock were included in the study group. The control group consisted of patients who were followed up in the ICU and had no sepsis/septic shock. Plasma angiotensin II, angiotensin receptor-1 and 2 (AT-1, AT-2) levels were evaluated first and third days.RESULTS: Angiotensin II levels were significantly lower in the septic shock and non-survivor. AT-1 levels were lower in all septic patients on the first day compared to the control. While AT-1 levels on the third day decreased in the septic shock group, it increased in the sepsis group. AT-2 levels were significantly higher in sepsis, and lower in septic shock compared to controls on the first day. Angiotensin II (95%, 82%) and AT-2 levels (100%, 87%) were observed to have high sensitivity and specificity in demonstrating the presence of shock in septic patients. Angiotensin II and AT-1/AT-2 ratios were observed to have high sensitivity and low specificity in the development of mortality.CONCLUSIONS: In septic patients, angiotensin II, AT-2 and AT-1/AT-2 levels can predict the probability of shock development and mortality. (Cite this article as: Ozer AB, Bicakcioglu M, Baykan S, Bulut N, Kalkan S, Demircan S, et al. Angiotensin II and angio-tensin II receptor 2 levels can predict shock and mortality in septic patients. Minerva Anestesiol 2022;88:1021-9. DOI: 10.23736/S0375-9393.22.16566-1)
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    Effect of troponin I and coagulation parameters on mortality in COVID-19 patients
    (Marmara Univ, Fac Medicine, 2023) Dag, Meral; Bulut, Nilufer; Taskapan, M. Cagatay
    Objective: Our aim is to determine the levels of troponin-I and some coagulation markers (D-dimer, fibrinogen and International Normalized Ratio (INR)) in coronavirus disease 2019 (COVID-19) patients and to investigate the effects of these markers on mortality.Patients and Method: It is planned as a descriptive, cross-sectional and analytical study. The study was conducted by retrospectively scanning the files of COVID-19 patients who applied to Inonu University Turgut Ozal Medical Center between 01.03.2020 and 31.12.2020. Levels of cardiac troponin I markers and coagulation parameters (D-dimer, fibrinogen and INR) were detected.Results: The results of a total of 1858 patients were obtained. One thousand, three hundred and twenty-six patients with only troponin I and D-dimer results (Group 1), 606 patients with only troponin I and fibrinogen results (Group 2), and 1308 patients with only troponin I and INR results (Group 3) were included. Troponin I levels were significantly higher in all patients who died. 96.6% of the patients with high D-dimer levels died in Group 1, 85.5% of the patients with high fibrinogen levels died in Group 2 and 77.3 % of the patients with high INR levels died in Group 3.Conclusion: Measurements of troponin-I and coagulation markers such as D-dimer, fibrinogen and INR can help predict clinical severity and mortality in COVID-19 patients.
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    Hydrocortisone may act through the angiotensin II receptor-2 level in patients with catecholamine-resistant septic shock
    (Edizioni Minerva Medica, 2023) Baykan, Seyma; Bicakcioglu, Murat; Bulut, Nilufer; Yucel, Neslihan; Ersoy, Yasemin; Uysal, Nermin Kibrislioglu; Ozer, Ayse B.
    BACKGROUND: This study aimed to compare the serum angiotensin II and its receptor levels (AT1, AT2) in septic patients with catecholamine-responsive or resistant. The effect of hydrocortisone treatment on angiotensin II levels in the catecholamine-resistant septic patients was evaluated.METHODS: This prospective observational study enrolled 40 patients diagnosed with septic shock based on sepsis-3 cri-teria. Patients were divided into two groups according to the noradrenalin infusion rate required to keep the mean arterial pressure above 65 mmHg: control group and hydrocortisone group (control group: below 0.5 mu g/kg/min, hydrocortisone group: above 0.5 mu g/kg/min). Serum angiotensin II, AT1, AT2 levels were measured at the time of diagnosis (A), one hour after hydrocortisone treatment (B), and three days later (C).RESULTS: In the catecholamine-resistant group, angiotensin II and AT1 levels were higher than the catecholamine-responder group in all periods. The sensitivity and specificity of AT-1 was observed to be high in all periods. AT2 levels decreased after hydrocortisone treatment in the catecholamine-resistant group and cut-off value was found 11%.CONCLUSIONS: It was concluded that angiotensin II and AT1 can be used as a biomarker of refractory septic shock and hydrocortisone may provide their blood pressure correcting effect by reducing AT2 level in these patients. AT2 can be a therapeutic target in the catecholamine-resistant septic shock patients.