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Öğe Development of a Liquid Chromatography-Tandem Mass Spectrometry Method for Quantifying Teicoplanin and Its Application in Critically Ill Patients(Doc Design Informatics Co Ltd, 2025) Memis, Hasan; Cakir, Ahmet; Gun, Zeynep Ulku; Saracoglu, Hatice; Karakukcu, Cigdem; Esmaoglu, Aliye; Dogan, ZaferObjective: Teicoplanin, a glycopeptide antibiotic, is used to treat infections caused by Grampositive pathogens. Trough-level monitoring of teicoplanin is recommended in specific patient populations, including critically ill patients. This study aimed to develop and validate a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify teicoplanin in human plasma and adapt the method to a critically ill patient sample. Materials and Methods: Teicoplanin trough levels were measured using a newly validated LC-MS/MS method. Analysis was conducted using a C18 column with an inner diameter of 2.7 mu m (50.0 x 3.0 mm), and vancomycin hydrochloride was used as the internal standard. The method's run time per sample was 5.5 minutes. Non-parametric tests were used for statistical analysis. Univariate and multivariate logistic regression were performed to identify teicoplanin target attainment factors. A p-value of <0.05 was considered statistically significant. Results: The method demonstrated linearity between 1.56-100 mg/L teicoplanin concentration and had a lower limit of detection and quantification of 0.33 mg/L and 1.00 mg/L, respectively. Precision, accuracy, recovery rate, and carry-over effects were all within acceptable limits, according to the U.S. Food and Drug Administration (FDA) guidance. Twenty patients were included in the study. The target teicoplanin trough level (>= 10 mg/L) attainment rate was 50%. The patient's laboratory values did not significantly change after teicoplanin treatment (p>0.05), except for erythrocyte count, haemoglobin, and haematocrit values, which decreased significantly (p<0.05). Multivariate analysis revealed no significant factors affecting target attainment (p>0.05). Conclusion: The LC-MS/MS assay validated in this study is high-throughput, robust, and quick enough to be implemented in clinical therapeutic drug monitoring (TDM) laboratories. More large-scale studies are needed to understand better the relationship between teicoplanin trough levels and patient-related factors.Öğe Does COVID-19-related viral sepsis stimulate angiotensin II levels more than bacterial sepsis?(Bayrakol Medical Publisher, 2023) Demircan, Selcuk; Bulut, Niluefer; Kalkan, Serkan; Duzenci, Deccane; Bicakcioglu, Murat; Ozden, Mehmet; Dogan, ZaferAim: Angiotensin II and its receptors play a role in both COVID and bacterial sepsis. The aim of this study was to compare the levels of serum angiotensin II and its receptors in viral sepsis due to COVID-19 with the levels in bacterial sepsis.Material and Methods: The study included 62 sepsis patients (n=31 COVID and n=31 non-COVID) with similar disease severity in the tertiary ICU. The serum angiotensin II, angiotensin II receptors 1 and 2 (ATR1, ATR2) and other inflammatory parameters were measured. Demographic data and 28-day mortality were recorded.Results: Angiotensin II level was significantly higher in COVID patients than in non-COVID patients (p<0.05). ATR1 and ATR2 did not differ between the two groups. There was a negative correlation between angiotensin II and procalcitonin levels in all patients, and a positive correlation between ATR1 and procalcitonin, APACHE II score, and SOFA score in COVID patients (p<0.05).Discussion: Observation showed that angiotensin II levels were higher in patients with COVID-19 compared to those with bacterial sepsis, and ATR1 level was higher in COVID-19 patients who died. It was thought that the renin-angiotensin cascade could be stimulated differently in bacterial sepsis compared to viral sepsis due to COVID.Öğe Mortality predictors in earthquake victims admitted to intensive care unit in Kahramanmaras, earthquakes(Elsevier Sci Ltd, 2024) Bicakcioglu, Murat; Gok, Abdullah; Cicek, Ipek Balikci; Dogan, Zafer; Ozer, Ayse B.Background: The purpose of this study is to report the data for patients followed-up in our intensive care unit due to the 6th February 2023, earthquake in Kahramanmaras,, T & uuml;rkiye, and to investigate parameters affecting mortality. Methods: The demographic characteristics of patients followed-up in intensive care due to trauma following the earthquake, the treatments administered, developing complications, lengths of stay in the hospital and intensive care, and laboratory data were scanned retrospectively and recorded. These data were then compared between the surviving and non-surviving patients. Results: Twenty-six patients, 13 (50 %) male, were followed-up in our intensive care, 24 (92 %) due to being buried under earthquake debris, and 2 (8 %) due to falling from heights. Increased Sequential Organ Failure Assessment (SOFA) (p = 0.027), higher initial serum potassium (p = 0.043), higher initial serum phosphorus (p = 0.035), higher initial and peak serum magnesium (p = 0.004 and p = 0.001), lower initial and peak bicarbonate (p = 0.021 and p = 0.012) and higher initial and peak serum base deficit values (p = 0.012 and p = 0.009) were associated with mortality. In the subgroup with crush injuries, higher initial and peak serum potassium (p = 0.001 and p = 0.025), higher initial and peak serum magnesium (p = 0.005 and p = 0.004), lower initial and peak bicarbonate (p = 0.019 and p = 0.021) and higher initial and peak serum base deficit values (p = 0.017 and p = 0.025) were associated with mortality. Multiorgan dysfunction failure developed in nine patients, sepsis in seven, dissemine intravascular coagulation in four, and acute respiratory distress syndrome in two. Fasciotomy was performed on 2 (8 %) patients and amputation on 8 (31 %). Extremity injuries were most frequently observed. 10 (38.5 %) of the 12 (46 %) patients developing acute kidney injury required renal replacement therapy. 7 (27 %) patients died during follow-up. In logistic regression analysis, higher SOFA scores, lower initial bicarbonate and BE levels, higher serum initial potassium and magnesium levels were a risk factor for mortality. Higher SOFA scores, lower initial bicarbonate and base deficit and higher initial phosphorus values affected mortality in patients with crush syndrome. Conclusion: Not only increased SOFA, serum potassium, serum phosphorus, and serum magnesium, but also decreased bicarbonate, and base deficit were associated with mortality in earthquake victims with crush syndrome in ICU.Öğe TEICOPLANIN TROUGH LEVEL MONITORING OF ADULT CRITICALLY ILL PATIENTS: A PROSPECTIVE LONGITUDINAL STUDY(Springer, 2025) Memis, Hasan; Cakir, Ahmet; Gun, Zeynep U.; Saracoglu, Hatice; Karakukcu, Cigdem; Esmaoglu, Aliye; Dogan, Zafer[No abstract available]
