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Öğe Accuracy of non-invasive hemoglobin monitoring by pulse CO-oximeter during hepatectomy in living liver donors(2021) Colak, Yusuf Ziya; Demiroz Aslan, DuyguAim: To evaluate the accuracy and agreement of the measurements made with the Masimo Rad7 device in living donor hepatectomy (LDH). Materials and Methods: A total of 63 living liver donors (LLDs) with ASA I-II scores who scheduled for LDH were included in the study. The Masimo noninvasive measurement probe was inserted to measure SpHb (mg/dL), pleth variability index (PVI, %) and perfusion index (PI,%). Heart rate, mean artery pressure, SpO2, body temperature, BIS, PVI, SpHb, and PI were recorded as basal, after anesthesia induction, post-intubation, post-intubation plus 5 min, 10 min, and plus 1, 2, 3, 4, 5, 6 and 7h. In addition blood samples were collected for laboratory hemoglobin (Hblab) before the surgery incision and after the surgical procedure, and the values were recorded simultaneously with the other values. Results: Fifty-five LLDs age between 18 and 55 years were assessed. The mean PI value increased in all measurements compared to baseline, and it was statistically significant at the 5th minute (p<0.05). This value prominently decreased after the 20th minute and dropped below the baseline value at the 7th hour. This decrease was statistically significant at the 2nd hour measurements (p<0.05). A significant correlation was observed between SpHb and LabHb before the surgical incision (r=0.694, p<0.001). Correlation decreased in after surgery measurement. In addition, there was a statistically significant difference between the before surgery and after surgery PI measurements (p<0.001). Conclusion: We think that in LDH procedures, surgical process leads to a decrease in PI and reduces the accuracy of SpHb measurement, and thus, intraoperative SpHb monitoring should be evaluated together with PI value.Öğe Can Preoperative Parameters of Inflammation be Used to Predict Acute Kidney Injury in Pediatric Liver Transplant Recipients? A Single-Center Retrospective Study(Galenos Publ House, 2024) Demiroz, Duygu; Ozdes, Oya Olcay; Colak, Yusuf Ziya; Erdogan, Mehmet Ali; Gazioglu, Tugce; Karakas, Serdar; Tasolar, Sevgi DemirozIntroduction: Inflammation is one of the factors involved in the occurrence and progression of acute kidney injury (AKI). We evaluated the relationship between preoperative systemic inflammatory markers and early postoperative AKI development in pediatric liver transplantation (LT) patients. Methods: Data from 190 pediatric patients were retrospectively analyzed. The preoperative neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels were calculated. AKI was classified according to the Kidney Disease: Improving Global Outcomes staging. Patients who did not develop AKI in the early postoperative period were classified as group 0, patients with stage 1 AKI were classified as group 1, and patients with stage 2-3 AKI were classified as group 2. The relationship between the inflammatory parameters and AKI was evaluated. Results: AKI developed in 20% of patients, and 16.31% of these patients had severe AKI. The NLR, SII, and PIV values were significantly higher in patients with severe AKI (p<0.001). Preoperative high PIV values were found to be an independent predictor of AKI development. Conclusion: High preoperative PIV values may be used as a predictive factor for the development of early AKI in patients undergoing pediatric LT.Öğe Correction of Financial Disclosure(2019) Miniksar, Okkes Hakan; Colak, Yusuf ZiyaÖğe Determination of Absence of Right Internal Jugular Vein During Ultrasonographic Guided Central Venous Cannulation(Aves, 2017) Erdogan, Mehmet Ali; Colak, Yusuf Ziya; Kacmaz, Osman; Kolu, Mehmet; Toprak, Huseyin Ilksen[Abstract Not Available]Öğe Does Rocuroinum Dose Adjusted Due to Lean Body Weight Provide Adequate Intubation Conditions?: A Prospective Observational Study(Wiley-Hindawi, 2022) Demiroz, Duygu; Colak, Yusuf Ziya; Iclek, Sumeyye Koc; Erdogan, Mehmet Ali; Yagci, Neslihan Altunkaya; Durmus, Mahmut; Gulhas, NurcinIntroduction and Aim. There is no consensus on the weight parameters to use when titrating the dosage of the neuromuscular blocking agents during intubation. In our study, we administered rocuronium, based on either the lean body weight (LBW) or the total body weight in patients with body mass index (BMI) of 18.5 to 34.9 and compared the duration of action of the drug and its effects on tracheal intubation conditions and hemodynamic parameters. Methods. This is a prospective, observational study. Patients between the ages of 18 and 65 with BMI of 18.5-34.9, who are expected to be under general anesthesia for less than 6 hours, were divided into 3 groups according to their BMI (Group 1 BMI = 18.5-24.9, Group 2 BMI = 25-29.9, Group 3 BMI = 30-34.9). These groups were randomly divided into 2 subgroups: Groups LBW; 1 LBW, 2 LBW, and 3 LBW were given rocuronium intubation dosages based on their LBW while control groups; 1K, 2K, and 3K were given 0.6 mg/kg rocuronium according to their total body weight. The data on the duration of action of rocuronium and its effects on the endotracheal intubation conditions were evaluated. Results. In Group 1, T1 time was found to be significantly longer (p=0.001). Intubation score and the use of additional rocuronium dose were found to be significantly higher in Group 1 LBW than in Group 1K (p=0.001). In Group 1, an additional rocuronium dose was needed to achieve optimal intubation conditions for subgroup 1 LBW. Rocuronium duration of action was found to be significantly longer in control groups 2 and 3, that received TBW-based dosage. Conclusion. In adult patients with a BMI of 18.5 and 24.9 BMI, we report optimal intubation conditions with the LBW-adjusted rocuronium dosage.Öğe The effects of sedation with propofol and propofol- ketamin combination on postoperative cognitive function in elderly patients undergoing spinal anesthesia(2021) Colak, Yusuf Ziya; Ozgul, Mustafa; Demiroz Aslan, Duygu; Cumurcu, Hatice; Colak, Cemil; Durmus, MahmutAim: Elderly patients frequently require surgery. Postoperative cognitive dysfunction (POCD) is an adverse event and reduces the patient’s quality of life. We aimed to compare the effects of sedation applied with propofol or propofol-ketamine (ketofol) combination on hemodynamics and POCD during spinal anesthesia in elderly patients undergoing urological surgery. Materials and Methods: Study was performed on 60 ASA I-III patients over 65 years of age. Before the operation (standardized Mini Mental Test) sMMT was applied by a blind researcher. The cases were randomly divided into two groups as propofol (Group P, n=30) and ketofol (Group K, n=30). ECG, SpO 2 , Bispectral Index (BIS), noninvasive blood pressure (NIBP) was monitored. After spinal anesthesia, group P received propofol 0.5 mg/kg IV bolus and then 1.5 mg/kg/hour infusion. Group K received propofol 0.4 mg/ kg and ketamine 0.1 mg/kg IV bolus and then propofol 1.2 mg/kg/hour and ketamine 0.3 mg/kg/hour infusion. Hemodynamic and respiratory data were recorded. The sedation level was monitored by RAMSAY sedation score. sMMT was repeated by the researcher who performed the initial test at postoperative first 24 hours and postoperative 3rd day. Results: Significant decreases were observed for heart rate, SAP, and MAP in both groups compared with baseline values. No statistically significant difference was detected between the groups in sMMT values at postoperative 1 st and 3 rd days. Within- group comparisons revealed significant differences between preoperative sMMT and postoperative 1 st day sMMT and between postoperative 1 st and postoperative 3 rd day sMMT (p< 0.001). No difference was detected between preoperative and postoperative 3 rd day sMMT (p< 0.25). In Group P, there was statistically significantly higher injection pain (p<0.05). Conclusion: In this study we found that the recovery period of the patients was longer and BIS values were higher in group K, but no significant difference could be found in hemodynamic and cognitive functions.Öğe Efficacy of Intravenous Ibuprofen and Intravenous Paracetamol in Multimodal Pain Management of Postoperative Pain After Percutaneous Nephrolithotomy(Elsevier Science Inc, 2022) Ucar, Muharrem; Erdogan, Mehmet Ali; Sanli, Mukadder; Colak, Yusuf Ziya; Aydogan, Mustafa Said; Yucel, Aytac; Ozgul, UlkuPurpose: Many different techniques, including multimodal analgesia, have been used for the management of postoperative pain after Percutaneous nephrolithotomy (PCNL). Ketorolac, intravenous (IV) paracetamol, rofecoxib, and IV ibuprofen have been used as a part of a multimodal analgesic approach in different surgical procedures. However, the efficacy of IV ibuprofen has not been well elucidated in adult patients undergoing elective PCNL. The aim of the study was to examine the efficacy of IV ibuprofen compared to IV paracetamol after elective PCNL. Design: This was a prospective randomized clinic study. Methods: The study was conducted with 50 patients scheduled for PNCL between the ages of 18 and 65. IV ibuprofen 800 mg infusion was used for Group I, and 1 g IV paracetamol infusion Group P. IV tramadol infusion was administered with a Patient Controlled Analgesia device for postoperative analgesia. The primary outcome was 24-hour tramadol consumption. Secondary outcomes were pain intensity and side effects of the drugs. All outcomes were recorded in the 30th minute in the PACU and in 2, 4, 6, 12, 24 hours postoperatively. Findings: Total postoperative tramadol consumption was significantly lower in Group I compared with Group P (P = .031). There was also a significant decrease in the cumulative tramadol consumption between the two groups in the 2nd and 24th hours (P < .012). In all measurement periods, pain intensity, sedation score, nausea and vomiting, itching, additional analgesia, and satisfaction with pain management were similar between the two groups. Conclusion: IV ibuprofen, used as a part of multimodal tramadol-based analgesia reduced tramadol consumption compared with IV paracetamol in the first 24 hours postoperatively after elective PCNL. The IV ibuprofen-tramadol combination seems appeared superior to a paracetamol-tramadol combination. (C) 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.Öğe The Hemodynamic Effects of Dexmedetomidine and Esmolol in Electroconvulsive Therapy A Retrospective Comparison(Lippincott Williams & Wilkins, 2013) Aydogan, Mustafa Said; Yucel, Aytac; Begec, Zekine; Colak, Yusuf Ziya; Durmus, MahmutAim: Acute hemodynamic responses, including transient hypertension and tachycardia, to electroconvulsive therapy (ECT) predispose vulnerable patients to significant cardiovascular complications. Many drugs have been used in an attempt to attenuate these responses. To date, no comparative study of the acute hemodynamic effects of dexmedetomidine and esmolol in ECT has been published. Hence, this retrospective study aimed to compare the effects of dexmedetomidine and esmolol on acute hemodynamic responses in patients undergoing ECT. Materials and Methods: The anesthesia records for 66 patients who underwent a total of 198 ECT treatments performed between July 2009 and January 2010 were analyzed retrospectively. For each case, 1 seizure with 1-mg/kg propofol as control (group C), 1 seizure with 1-mu g/kg dexmedetomidine combined with propofol (group D; total volume, 30 mL for 10 minutes), and 1 seizure with 1-mg/kg esmolol combined with propofol were compared (group E; total volume, 30 mL for 10 minutes). Anesthesia was induced with 1-mg/kg propofol, and then intravenous succinylcholine, 0.5-mg/kg, was administered. Heart rates and systolic and mean blood pressures were recorded at baseline (T-0) and 1, 3, and 10 minutes after the seizure (T-1, T-2, and T-3, respectively). The electroencephalographic (EEG) tracing motor seizure duration, and recovery times (spontaneous breathing, eye opening, and obeying commands) were recorded. Results: The baseline hemodynamic measurements were similar between the groups. Heart rates at T-1, T-2, and T-3 were lower in group D than those in groups E and C (P < 0.05). Systolic blood pressures at T-1, T-2, and T-3 were lower in group D than those in groups C (P < 0.05). In addition, systolic blood pressure at T-3 was lower in group D than that in group E (P < 0.05). The mean blood pressure at T3 was significantly lower in group D than those in groups E and C (P <0.05). The electroencephalographic tracing, motor seizure durations, and recovery times were similar between the groups. Conclusion: Dexmedetomidine administration before anesthesia induction reduced the acute hemodynamic response compared with esmolol administration in the early period of ECT. Therefore, dexmedetomidine may be effective in preventing acute hemodynamic responses to ECT.Öğe Hemolysis, elevated liver enzymes, and low platelet syndrome: Outcomes for patients admitted to intensive care at a tertiary referral hospital(Taylor & Francis Inc, 2017) Gedik, Ender; Yucel, Neslihan; Sahin, Taylan; Koca, Erdinc; Colak, Yusuf Ziya; Togal, TurkanPurpose: The aim was to assess outcomes for pregnancies in which hemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome develops and the patient requires transfer for critical care. Materials and Methods: The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. Results were compared for the surviving and non-surviving patients. Results: Among the 77 women with HELLP syndrome, maternal mortality rate was 14% and 24 (30%) of 81 fetuses and newborns died in the perinatal period. The most common maternal complications were disseminated intravascular coagulation (DIC) (n = 22; 29%), acute renal failure (n = 19; 25%), and postpartum hemorrhage (n = 16; 21%). Compared with surviving women, the non-surviving women had higher mean international normalized ratio (INR) (p < 0.0001); higher mean serum levels of aspartate aminotransferase (AST) (p < 0.0001); higher alanine aminotransferase (ALT) (p < 0.0001); higher lactate dehydrogenase (LDH) (p < 0.0001), and higher bilirubin (p = 0.040) levels; and lower platelet count (p = 0.005). Conclusion: DIC is a major risk factor for maternal outcome among patients with HELLP syndrome who require intensive care. Low platelet count; high AST, ALT, LDH, INR; and total bilirubin are associated with high mortality risk in this patient group. In addition, low platelet count; low fibrinogen level; prolonged activated thromboplastin time; high INR; and high total bilirubin, LDH, blood urea nitrogen, and creatinine are associated with high risk for complications in this patient group.Öğe Incidence and Risk Factors of Acute Kidney Injury in Pediatric Liver Transplant Patients: A Retrospective Study(Jaypee Brothers Medical Publishers Pvt Ltd, 2024) Demiroz, Duygu; Colak, Yusuf Ziya; Ozdes, Oya Olcay; Ucar, Muharrem; Erdogan, Mehmet Ali; Toprak, Huseyin Ilksen; Karakas, SerdarBackground:Acute kidney injury (AKI) significantly contributes to the mortality and morbidity rates among pediatric liver transplant (LT) recipients. Objective: Our study aimed to assess the potential factors contributing to AKI in pediatric LT patients and to analyze the impact of AKI on postoperative mortality and hospitalization duration. Materials and methods: About 235 pediatric LT patients under the age of 18 between the years 2015 and 2021 were evaluated retrospectively. The relationship between preoperative and intraoperative variables of the patients and AKI developed when the early postoperative period was assessed. Results: A correlation was found between the patients' preoperative age, albumin levels, and AKI. AKI was found to be associated with the duration of surgery and intraoperative blood transfusion. Conclusion: Our findings revealed that the severity of AKI in pediatric LT patients is linked to extended surgical durations and increased blood transfusions resulting from hemodynamically compromised blood loss. Furthermore, independent risk factors for AKI were identified as prolonged warm ischemia and the overall duration of the operation.Öğe Videolaryngoscopy versus direct laryngoscopy in without muscle relaxation intubation conditions in tympanomastoidectomy: A randomized, prospective clinical study(2019) Miniksar, Okkes Hakan; Colak, Yusuf ZiyaAim: The aim of this study was to compare the effects of direct laryngoscopy and videolaryngoscopy on the intubation conditions and hemodynamic responses, in the patients scheduled for tympanoplasty and mastoidectomy operation and intubated without muscle relaxation. Material and Methods: This randomized, prospective study was performed in 62 patients aged 18-65 years with ASA (American Society of Anesthesiologists) I-II and Mallampati score I-II and scheduled for elective tympanoplasty and mastoidectomy with general anesthesia. The patients were divided into two groups as the direct laryngoscopy group (Group D) and the videolaryngoscopy group (Group V). The induction of anesthesia was performed with 1 mg / kg lidocaine, 3 μg / kg remifentanil and 2.5 mg / kg propofol for both groups. Hemodynamic responses (heart rate, systolic arterial pressure, diastolic arterial pressure, and mean arterial pressure), number of intubation attempts, duration of laryngoscopy, duration of intubation, intubation conditions (degree of coughing, jaw relaxation, ease of laryngoscopy and position of vocal cords), and postoperative hoarseness and sore throat were evaluated. Results: Hemodynamic responses to intubation were similar in both groups. There were no statistically significant differences between the groups in terms of the number of intubation attempts and the duration of laryngoscopy. The duration of intubation was significantly longer in Group V (29.19 sec) than in Group D (22.19 sec). Intubation conditions showed no significant difference between the groups. Conclusion: In patients without intubation difficulty, McGrath® MAC video laryngoscope showed no superiority in intubation conditions compared with Macintosh direct laryngoscope, during intubation without muscle relaxants; the effects on hemodynamic responses were also similar.
