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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 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 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.
