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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 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 Effect of oxygen administration with double nasal cannula on respiratory complications in gastrointestinal endoscopy(2025) Demiroz, Duygu; Sanli, Mukadder; Gülhas, Nurçın; Arslan, Ahmet Kadir; Atayan, Yahya; Toplu, Hacı OsmanIn the present study, the purpose was to investigate the effect of oxygen therapy applied with a double nasal cannula on desaturation and respiratory complications in cases planned for gastrointestinal endoscopy. A total of 300 patients with ASA I-II, between the ages of 18-65, who were scheduled to undergo gastrointestinal endoscopy, were included in the study. Following routine monitoring, the patients were randomized into 3 groups using the envelope method. Group TK5 (n=100) was administered 5 liters/minute (L/min) preoxygenation with a nasal oxygen cannula for 5 minutes during the procedure and afterwards, 5 L/min oxygen in the same manner. Group TK15 (n=100) was administered 15 L/min preoxygenation with a nasal oxygen cannula for 5 minutes during the procedure and afterwards, 15 L/min oxygen in the same manner. Group CK30 (n=100): 30 L/min preoxygenation with a double nasal oxygen cannula for 5 minutes, and 30 L/min oxygen in the same manner during and after the procedure. The incidence of desaturation was found to be significantly lower in GTK15 (7%) and GCK30 (2%) compared to GTK5 (31%) (p<0.05). Advanced desaturation was not detected in any patient in GTK15 and GTK30, while it was detected in 18% of the GTK5 group (p<0.05). Severe desaturation was detected in 11% of the GTK5 group, while there was no severe desaturation in the other groups (p<0.05). The duration of desaturation was longer in GTK5 than in the other groups. The time to reach 99% oxygen saturation was significantly shorter in the G15 and G30 groups compared to the G5 group (p < 0.05). This time was significantly shorter in GCK30 than in GTK15 (p<0.05). However, there was a burning sensation in the nose in 30% of the patients in double nasal cannula oxygen applications (p<0.05). It was found that oxygen administration with a double nasal cannula had similar effectiveness to single nasal cannula 15 L/min flows in preventing respiratory complications in sedation applications performed for gastrointestinal system endoscopies, and that respiratory complications were significantly reduced at both flow rates compared to 5 L flow rates. It was also found that a single cannula 15 L/min application was better in terms of patient comfort.Öğe Effects of Sugammadex on the Coagulation Profile of Living Liver Donors Undergoing Hepatectomy: A Case-Control Study(Mdpi, 2025) Demiroz, Duygu; Colak, Yusuf Ziya; Akbulut, Sami; Ozdes, Oya Olcay; Ucar, Muharrem; Erdogan, Mehmet Ali; Karakas, SerdarBackground: The most important concern regarding living donor liver transplantation is the safety of living liver donors, of which anesthesia management is an important part. Sugammadex, which has recently been used frequently for the reversal of neuromuscular blockade, is known to cause adverse effects on the coagulation profile. This study seeks to assess the impact of neostigmine and sugammadex on coagulation parameters in living liver donors following hepatectomy. Methods: We compared the demographic, clinical, and coagulation parameters of 209 living liver donors who received sugammadex (2 mg/kg) for neuromuscular blockade reversal during donor hepatectomy procedures from January 2018 to July 2022, with 209 patients who received neostigmine (50 g/kg) for the same purpose during the same timeframe. We compared the following parameters: age, gender, prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), hemoglobin (Hb), platelet count, ICU stay, hospital stay, and relaparotomy for bleeding and other causes. Results: Demographic data and preoperative biochemical values were similar in both groups. PT (p = 0.004) and aPTT (p < 0.001) values were significantly longer in the postoperative period in both groups; the difference between preoperative and postoperative PT (p = 0.009) and aPTT (p < 0.001) was significantly higher in the sugammadex group. However, neither group showed any elongation beyond the reference range. The sugammadex group had an elevated postoperative platelet count (p = 0.040). The duration of patients' stay in the ICU was significantly shorter in the sugammadex group (p < 0.001). Conclusion: The prolonged aPTT and PT associated with sugammadex did not lead to any postoperative bleeding complications. The sugammadex group significantly reduced the duration of ICU stays, while the hospital stays remained comparable. Further multicentric prospective randomized studies should support our study's findings, which demonstrate the safe use of low-dose sugammadex.Öğe Evaluation of Anesthesia-related Knowledge and Concerns of Patients According to Their Education Levels: A Survey Study(Galenos Publ House, 2023) Ferlengez, Ayse Gul; Demiroz, DuyguIntroduction: The adequate level of anesthesia practices in the community and the role of aids in the hospital could not be reached. In this study, the purpose was to evaluate the relationship between the education level of patients receiving anesthesia, their knowledge, and fears about anesthesia. Methods: The educational status of the patients was evaluated by questioning their age, educational status, and concerns about anesthesia. Results: It was concluded that the level of knowledge about anesthesia increased as the level of education of patients increased, but the fears of patients related to anesthesia were similar. Conclusion: As the education level of the patients increases, their level of knowledge about anesthesia increases. We think that communication with anesthesiologists in the preoperative period will reduce patients' fears about anesthesia.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 Living Liver Donor Paired Exchange: Can Anaesthesia Management Challenge?(Galenos Publ House, 2025) Erdogan, Mehmet Ali; Ucar, Muharrem; Colak, Yusuf Ziya; Demiroz, Duygu; Ozdes, Oya Olcay[No abstract available]Öğe Regional Anaesthesia Management in a Patient with Leprosy: Rare Case with Rare Application(Aves, 2016) Ucar, Muharrem; Sanli, Mukadder; Ozkan, Ahmet Selim; Demiroz, Duygu; Erdogan, Mehmet Ali; Durmus, MahmutLeprosy is a chronic infectious disease that is caused by Mycobacterium leprae and affects the skin and nerves. Patients with leprosy having related peripheral neuropathy and involvement of other organs may have cardiac, respiratory dysautonomia and autonomic dysfunctions. There are very few studies regarding anaesthetic management of patients suffering from leprosy. Moreover, very few studies concerning regional anaesthesia in patients with lepromatous leprosy have been reported. In this study, we aim to assess regional anaesthesia management with combined spinal epidural anaesthesia in a patient who had been followed up with a diagnosis of leprosy for a long time and was scheduled for operation because of a femoral neck fracture.Öğe The Effect of Rocuronium Dosage on Intubation Conditions in Liver Transplant Recipients(Galenos Publ House, 2025) Iclek, Sumeyye Koc; Demiroz, Duygu; Colak, Yusuf Ziya; Yagci, Neslihan Altunkaya; Ozdes, Oya Olcay; Erdogan, Mehmet Ali; Gulhas, NurcinIntroduction: Neuromuscular blockers (NMB) play an important role in improving conditions in orthotopic liver transplantation (OLT). Depending on clinical conditions, diseases, and pharmacological interactions, the effective NMB dose for complete NMB varies. Our study investigated the effects of rocuronium used during rapid sequence intubation. The effects of this drug on onset of action and intubation conditions were studied in a control group and in an OLT patient group. Methods: The study is prospective, involving 90 patients over the age of 18. The 45 patients scheduled to undergo OLT were assigned to Group 1, while the 45 patients without liver dysfunction scheduled to undergo a 4-6-hour surgery under general anesthesia were assigned to Group 2. Groups were dosed with 1.2 mg/kg rocuronium based on ideal body weight, and the effect on the time to reach a train-of-four (TOF) value of zero (TOF 0), time to intubation scores, and hemodynamic parameters was evaluated. Results: The demographic data across the groups were comparable. No significant differences were observed between the groups concerning TOF 0 time (p=0.806), intubation times (p=0.987), and intubation scores (p=0.898). However, when evaluating OLT patients individually, a statistically significant correlation was found between TOF 0 time and Child score (p=0.029, p<0.05). Conclusion: In patients with end-stage liver disease undergoing OLT, administering rocuronium at a dosage of 1.2 mg/kg based on ideal body weight, during rapid sequence intubation results in sufficient intubation conditions. Furthermore, there were no delays noted in the onset of rocuronium's action.
