Yazar "Gedik, Ender" seçeneğine göre listele

Listeleniyor 1 - 20 / 56
  • Küçük Resim
    Öğe
    % 0.5 Ropivakain İle İnterskalen Blok Sonrası Konvülsiyon Ve Solunum Depresyonu (Olgu Sunumu)
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2005) Köroğlu, Ahmet; Gedik, Ender; Çiçek, Müslüm; Özgül, Ülkü; Ersoy, M. Özcan
    Bu olgu sunumunda %0.5 ropivakain ile yapılan interskalen brakiyal pleksus bloğu (ISB) sonrası konvülsiyon ve solunum depresyonu meydana gelen bir olguyu tartışmayı amaçladık. 35 yaşında, 70 kg ağırlığında, 174 cm boyundaki erkek olgu sağ radiyal sinir onarımı için operasyona alındı. Periferik sinir sitümülatörü kullanılarak 40 mL %0.5 ropivakain ile interskalen blokaj yapıldı. ISB yapıldıktan 3 dk sonra yüz kaslarında klonik kasılmalar ve solunum depresyonu meydana geldi. Konvülsiyon ve hipotansiyon herhangi bir müdahaleye gerek kalmadan kendiliğinden düzeldi, bradikardi görülmedi. Sonuç olarak; ISB işlemi sırasında hasta ile sürekli diyalog halinde olunarak yavaş enjeksiyon yapılmalıdır. Ayrıca, aspirasyon ve test dozu negatif olsa bile lokal anestezik enjeksiyonu sonrası kardiyovasküler ve santral sinir sistemi komplikasyonlarına karşı hazırlıklı olunması gerektiğini düşünüyoruz.
  • Küçük Resim Yok
    Öğe
    The 2 stage liver transplant 3 clinical scenarios
    (Experimental and Clinical Transplantation, 2015) Gedik, Ender; Bıçakçıoğlu, Murat; Otan, Emrah; Toprak, Hüseyin İlksen; Işık, Burak; Aydın, Cemalettin; Kayaalp, Cüneyt; Yılmaz, Sezai
    The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We describe our experience of 3 patients with 3 different clinical conditions. A 57-year-old man was retransplanted successfully with this technique due to hepatic artery thrombosis. However, a 38-yearold woman with fulminant toxic hepatitis and a 5-year-old-boy with abdominal trauma had poor outcome. This technique could serve as a rescue therapy for liver transplant patients who have toxic liver syndrome or abdominal trauma. These patients required intensive support during long anhepatic states. The transplant team should decide early whether to use this technique before irreversible conditions develop.
  • Küçük Resim Yok
    Öğe
    The 2-Stage Liver Transplant: 3 Clinical Scenarios
    (Baskent Univ, 2015) Gedik, Ender; Bicakcioglu, Murat; Otan, Emrah; Toprak, Huseyin Ilksen; Isik, Burak; Aydin, Cemalettin; Kayaalp, Cuneyt
    The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We describe our experience of 3 patients with 3 different clinical conditions. A 57-year-old man was retransplanted successfully with this technique due to hepatic artery thrombosis. However, a 38-year-old woman with fulminant toxic hepatitis and a 5-year-old-boy with abdominal trauma had poor outcome. This technique could serve as a rescue therapy for liver transplant patients who have toxic liver syndrome or abdominal trauma. These patients required intensive support during long anhepatic states. The transplant team should decide early whether to use this technique before irreversible conditions develop.
  • Küçük Resim
    Öğe
    Akut demir zehirlenmesi olgularına klinik yaklaşım: olgu serisi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Erdoğan, Mehmet Ali; Özgül, Ülkü; Aydoğan, Mustafa Said; Kaçmaz, Osman; Gedik, Ender; Toğal, Türkan
    Amaç: Akut demir zehirlenmesi çocukluk yaş grubunda daha sık görülse de; her yaşta rastlanabilen önemli bir klinik durumdur. Akut demir zehirlenmesi; gastrointestinal kanama, kardiyovaskuler kollaps, mental durum bozukluğu, karaciğer ve böbrek yetmezliğine neden olabilir. Bu çalışmada, yoğun bakım ünitemizde akut demir zehirlenmesi nedeniyle yatırılan hastaların demografik özellikleri değerlendirildi, tanı ve tedavi yaklaşımlarını tartışıldı. Gereç ve Yöntem: Ocak 2010- Aralık 2011 arasında yoğun bakım ünitemize akut demir zehirlenmesi nedeniyle kabul edilen 8 hasta incelendi. Hastaların yaş, cinsiyet, zehirlenmenin nedeni, alınan ilaç veya ilaçlar, alınma yolu, daha önce zehirlenme öyküsünün varlığı, ilacın alınmasından yoğun bakım yatışına kadar geçen süre, bilinç durumu, Glaskow Koma Skoru, yoğun bakımda kalış süresi, laboratuvar tetkik sonuçları ile uygulanan tedavi yöntemleri değerlendirildi. Bulgular: Akut demir zehirlenmesi nedeniyle yoğun bakımda takip edilen 8 hastanın tamamı kadındı ve yaş ortalaması 22±5,4 yıl idi. Hastaların zehirlenme nedenleri intihar amacıyla yüksek doz ilaç alımıydı. Hastalarda görülen en sık semptom karın ağrısı (n=7), kusma (n=5), diyare (n=4) idi. Alınan elementer demir miktarı ortalama 30,25±11,4mg/kg’dır. Hastaların hiçbirinde biyokimya ve koagülasyon parametrelerinde klinik olarak önemli bir değişiklik olmadı. Tüm hastaların nazogastrik sondaları acil serviste takılmış ve mide lavajları yapılmıştı. Serum demir düzeyi 500 ?g/dL’den yüksek olmadığından desferroksamin tedavisi uygulanmadı. Hastaların gastrointestinal şikayetleri ortalama 4-5 saat sürdü, 2 gün takipleri yapılan hastalardan biri psikiyatri kliniğine devir edilirken 7 hasta taburcu oldu. Sonuç: Ölümcül seyredebilen akut demir zehirlenmesinde erken laboratuar ve klinik takiple ciddi komplikasyonların önüne geçilebilir. Temel destek tedavisi ile barsak irrigasyonu ve desferroksamin tedavisi zamanında yapılmalıdır.
  • Küçük Resim
    Öğe
    Akut Demir Zehirlenmesi Olgularına Klinik Yaklaşım: Olgu Serisi
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2014) Erdoğan, Mehmet Ali; Özgül, Ülkü; Aydoğan, Mustafa Said; Kaçmaz, Osman; Gedik, Ender; Toğal, Türkan
    Aim: Although acute iron poisoning is more common in the pediatric age, it may be seen at any age and is an important clinical condition. In this study, we aimed to evaluate the etiological factors and diagnosis and discuss treatment approaches in the acute iron poisoning. Material and Methods: Eight patients who were admitted to the intensive care unit due to acute iron poisoning were analyzed. Data regarding demographic features, cause of poisoning, toxic agents, the route of exposure, a history of previous toxicity, the time between exposure and intensive care unit admission, the owner of the poisoning agent (the patient or someone else), consciousness status on arrival, Glasgow coma score, the length of the intensive care unit stay, the result of laboratory tests, methods of treatment, and outcome were evaluated. Results: All 8 patients were female and the mean age was 22±5,4 years. The most common symptoms were abdominal pain, vomiting and diarrhea. The amount of received elemental iron was 30,25±11,4mg/kg. Nasogastric catheters were inserted and gastric lavages were performed to all the patients in the emergency department. Deferoxamine treatment was not implemented because of serum iron levels were not higher than 500 mg / dL. After observing all patients for two days, one patient was transferred to psychiatric clinic, 7 patients were discharged with full recovery. Conclusions: In potentially fatal acute iron poisoning, serious complications can be avoided with early laboratory and clinical follow-up. The basic supportive therapy with gastric lavage and desferroksamine therapy should be managed on time.
  • Küçük Resim Yok
    Öğe
    Akut solunum yetmezliği bulunan hastalarda BIPAP ve BIPAP+PSV solunum modlarının alveolar gaz değişimi ve hemodinami üzerine etkisi akut solunum yetmezliğinde BIPAP ve BIPAP+PSV
    (2006) Borazan, Hale; Gedik, Ender; Ersoy, Mehmet Özcan
    Öz: Amaç: Bu çalışmada akut solunum yetersizliğinde, BIPAP ve BIPAP + PSV modlarının alveolar gaz değişimi ve hemodinami üzerine etkilerinin karşılaştırılması amaçlandı. Gereç ve Yöntem: 50 olgu, sedatize edilerek, ventilator ile solutuldu. Olgulara ilk 6 saat BIPAP, sonraki 6 saat BIPAP + 10 cmH20 PSV uygulandı. Veriler; ortalama arter basıncı (OAB), kalp atım hızı (KAH), inspiratuar basınç (PİnSp), pik basınç (Ppeak), plato basınç (Pplato), ortalama basınç (Pmean), minimum basınç (Pmin), PEEPi, toplam dakika hacmi (MVtop), spontan solunum dakika hacmi (MVspo) ve oranları, toplam solunum frekansı (ftop), spontan solunum frekansı (fspo) ve mekanik ventilasyon frekansı (fmek), inspiryum ve ekspiryum soluk hacimleri (VTinsp, VTeksp), rezistans, kompliyans, arteriyel kan gazı değerleri, Fi02 düzeyleri ve Horovitz İndeksi (Pa02/Fi02) yapay solunumun başlangıcında (Tl), ilk 6 saat BIPAP ventilasyonu sonunda (T2) ve sonraki 6 saat BIPAP + 10 cmH20 PSV uygulamasının sonunda (T3) kaydedildi. Bulgular: Olguların hemodinamik verileri, Ppeak, MVtop, VTinsp, VTeksp, havayolu rezistansı; kompliyansı, PaC02, Sa02 ve Pa02 değerlerinde istatistiksel olarak anlamlı fark bulunmadı. BIPAP + PSV ventilasyonu ile Pinsp azalırken, Pmean, spontan solunum sayısı ve toplam spontan dakika hacim artışı anlamlıydı (p<0.05). Arteryel kan'gazı analizinde, BIPAP + PSV ventilasyonu ile olguların Fi02 düzeyleri azalırken, Horovitz indeksi değerleri arttı (p<0.05). Sonuç: BIPAP modunun ve 10 cmH20 PSV eklenmesinin oksijenizasyonu olumlu etkilediği sonucuna ulaşıldı. Bileşik ventilasyonun homojen alt gruplarda ve uzun süreli ventilasyonda etkilerinin çalışılması gerektiğini düşünüyoruz.
  • Küçük Resim Yok
    Öğe
    Aort yetersizliğinin eşlik ettiği bir feokromositoma hastasında anestezi yaklaşımı (Olgu sunumu)
    (Türk Pediatri Arşivi, 2002) But, A. Kadir; Durmuş, Mehmet; Gedik, Ender; Karaaslan, Kazım; Toprak, H. İlksen; Ersoy, M. Özcan
    Abstract: Pheochromocytoma is an uncommon neuroectodermic tumour of adrenal medulla. Additional cardiac problems malta anaesthesia management of pheochromocytoma more complicated. We aimed to present the anaesthetic management of pheochromocytoma patient with aortic valve insufficiency (AVI). A 45 years-old, 6.5 kg, female patient with third degree of AVI was admitted for pheochromocytoma surgery. Before surgery, she was pre-treated with phenoxybenzamine and nicardipine for a week. In the operation room, thoracic epidural analgesia was maintained with 10 mL 0.5 % bupivacaine loading dose, followed by 5 mL 0.5 % bupivacaine for every hour during surgery. Then anaesthesia ivas induced with midazolum, droperidol, fentanyl, vecuronium, metoprolol and lidocaine. High dose fenlanyl anaesthesia ivith 0.5-1.5 % isoflurane were preferred for maintenance of anaesthesia. Haemodynamic stability was obtained with this anaesthesia management with lower dose vasodilators until, tlie resection of adrenal mass. After the resection, severe hypotension was controlled with inotropic agents. Surgery was completed uneventfully and patient was transferred to ICU. In phaeochromoytoma cases with. AVI, we think that appropriate (uiuesthetic approach is the thoracal epidural analgesia and high dose fentanyl anaesthesia with support of vasodilatators or vasoactive agents.
  • Küçük Resim Yok
    Öğe
    Approach to Acute Iron Intoxication: A Case Report
    (Galenos Yayincilik, 2011) Ozgul, Ulku; Erdogan, Mehmet Ali; Gedik, Ender; Ucar, Muharrem; Aydogan, Mustafa Said; Togal, Turkan
    In adults, the main causes of iron poisoning are intake suicide attempts and an overdose of iron during pregnancy. The severity of intoxication depends on the amount of iron. When serum iron level exceeds the iron binding capacity of the body, free radicals occurs, leading to lipid peroxidation and cellular membrane damage. In iron poisoning, especially the liver, heart, kidney, lung, and hematologic systems are affected negatively. Acute iron poisoning can cause serious complications resulting in death. Clinical, laboratory observation and early treatment are important. In this case report, we examined to approach the acute iron poisoning with the occasion of high-dose iron intake for suicide attempt.
  • Küçük Resim Yok
    Öğe
    Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle that contains endotracheal tube with subglottic drainage and cuff pressure monitorization
    (Elsevier Brazil, 2017) Akdogan, Ozlem; Ersoy, Yasemin; Kuzucu, Cigdem; Gedik, Ender; Togal, Turkan; Yetkin, Funda
    The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients. The study was conducted at the Anesthesiology Intensive Care Unit 1 and 2 (10 beds each) in a 898-bed university hospital. Occurrence of VAP and compliance with the parameters of the VAP prevention bundles were assessed daily. Patients intubated with the standard endotracheal tube were recruited as controls, mainly in the first six months of the study as ETT-SD and cuff pressure monometer had not yet been implemented. In the second term, patients intubated with ETT-SD were included as cases. Occurrence of VAP, mortality, and compliance with VAP prevention bundles were monitored. A total of 133 patients, 37 cases and 96 controls were recruited. VAP incidence declined from 40.82 to 22.16 per 1000 ventilator days among controls and cases, respectively (p < 005). On average, VAP occurred 17.33 +/- 21.09 days in the case group and 10.43 +/- 7.83 days in the control group (p = 0.04). However, mortality of cases and controls at the 14th and 30th days was not different. VAP prevention bundles including the utilization of ETT-SD, monitoring cuff pressure, and oral care with chlorhexidine were efficient in reducing the rate of VAP. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
  • Küçük Resim
    Öğe
    Assessment of the effectiveness of a ventilator associated pneumonia prevention bundle thatcontains endotracheal tube with subglottic drainage and cuff pressure monitorization
    (Elsevıer brazıl, r sete setembro, 111-16, rıo de janeıro, rj 20050-006, brazıl, 2017) Akdogan, Ozlem; Ersoy, Yasemin; Kuzucu, Cigdem; Gedik, Ender; Togal, Turkan; Yetkin, Funda
    The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients. The study was conducted at the Anesthesiology Intensive Care Unit 1 and 2 (10 beds each) in a 898-bed university hospital. Occurrence of VAP and compliance with the parameters of the VAP prevention bundles were assessed daily. Patients intubated with the standard endotracheal tube were recruited as controls, mainly in the first six months of the study as ETT-SD and cuff pressure monometer had not yet been implemented. In the second term, patients intubated with ETT-SD were included as cases. Occurrence of VAP, mortality, and compliance with VAP prevention bundles were monitored. A total of 133 patients, 37 cases and 96 controls were recruited. VAP incidence declined from 40.82 to 22.16 per 1000 ventilator days among controls and cases, respectively (p < 005). On average, VAP occurred 17.33 +/- 21.09 days in the case group and 10.43 +/- 7.83 days in the control group (p = 0.04). However, mortality of cases and controls at the 14th and 30th days was not different. VAP prevention bundles including the utilization of ETT-SD, monitoring cuff pressure, and oral care with chlorhexidine were efficient in reducing the rate of VAP. (C) 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda.
  • Küçük Resim Yok
    Öğe
    Blood Glucose Regulation During Living-Donor Liver Transplant Surgery
    (Baskent Univ, 2015) Gedik, Ender; Toprak, Huseyin Ilksen; Koca, Erdinc; Sahin, Taylan; Ozgul, Ulku; Ersoy, Mehmet Ozcan
    Objectives: The goal of this study was to compare the effects of 2 different regimens on blood glucose levels of living-donor liver transplant. Materials and Methods: The study participants were randomly allocated to the dextrose in water plus insulin infusion group (group 1, n = 60) or the dextrose in water infusion group (group 2, n = 60) using a sealed envelope technique. Blood glucose levels were measured 3 times during each phase. When the blood glucose level of a patient exceeded the target level, extra insulin was administered via a different intravenous route. The following patient and procedural characteristics were recorded: age, sex, height, weight, body mass index, end-stage liver disease, Model for End-Stage Liver Disease score, total anesthesia time, total surgical time, and number of patients who received an extra bolus of insulin. The following laboratory data were measured pre- and postoperatively: hemoglobin, hematocrit, platelet count, prothrombin time, international normalized ratio, potassium, creatinine, total bilirubin, and albumin. Results: No hypoglycemia was noted. The recipients exhibited statistically significant differences in blood glucose levels during the dissection and neohepatic phases. Blood glucose levels at every time point were significantly different compared with the first dissection time point in group 1. Excluding the first and second anhepatic time points, blood glucose levels were significantly different as compared with the first dissection time point in group 2 (P < .05). Conclusions: We concluded that dextrose with water infusion alone may be more effective and result in safer blood glucose levels as compared with dextrose with water plus insulin infusion for living-donor liver transplant recipients. Exogenous continuous insulin administration may induce hyperglycemic attacks, especially during the neohepatic phase of living-donor liver transplant surgery. Further prospective studies that include homogeneous patient subgroups and diabetic recipients are needed to support the use of dextrose plus water infusion without insulin.
  • Küçük Resim Yok
    Öğe
    Cedecea lapegei’nin neden olduğu bir pnömoni olgusu
    (Mikrobiyoloji Bülteni, 2008) Yetkin, Gülay; Ay, Selma; Kayabaş, Üner; Gedik, Ender; Güçlüer, Nilay; Çalışkan, Ahmet
    Öz: Enterobacteriaceae ailesi üyelerinden olan Cedecea cinsi bakteriler, çoğunlukla balgamdan izole edilmelerine rağmen klinik önemleri ve enfeksiyonlardaki rolleri tam olarak bilinmemektedir. Bu raporda Cedecea lapagei'riın etken olduğu bir pnömoni olgusu sunulmaktadır. Bilinci kapalı olarak inönü Üniversitesi Tıp Fakültesi Acil Servisine başvuran 38 yaşında erkek hasta, subaraknoid kanama ön tanısı ile beyin cerrahi servisinde operasyona alınmıştır. Reanimasyon yoğun bakım ünitesine yatırılan ve bilinç kapalılığı devam eden hastaya trakeostomi açılmış ve ventilatöre bağlanmıştır. Hikayesinden kronik obstrüktif akciğer hastalığı olduğu tespit edilen hastanın, hastaneye yatışının üçüncü gününde ateşi 39°C, beyaz küre sayısı ise 27.000/ml'dir. Akciğer filminde sağ alt lobda yaygın opasite görülmüş ve operasyondan sonra iki gün boyunca trakeal entübasyon uygulanan hastada mukoid trakeal sekresyon başlamıştır. Bronko-alveoler lavaj (BAL) örneğinden hazırlanan yaymada bol miktarda lökosit ve gram-negatif basiller saptanmış; BAL kültüründe üreyen bakteri Phoenix 100 (Becton Dickinson, ABD) ve API 20E (BioMerieux, Fransa) sistemleri ile C.lapagei olarak tanımlanmıştır. Intravenöz amikasin (1 x 1 g) ve meropenem (3 x 1 g) tedavisi verilen hasta, enfeksiyon semptomlarının gerilemesine rağmen, yatışının 12. gününde subaraknoid kanama nedeniyle kaybedilmiştir. Entübe edilen hastamızda C.lapagei pnömonisinin gelişmesinde, odağın balgam olduğu ve üst solunum yolları sekresyonunun aspire edilmesiyle enfeksiyonun ortaya çıktığı düşünülmüştür. Literatürde Cedecea türlerinin neden olduğu enfeksiyonlar bildirilmekle birlikte, olgumuz, ulaşılabilen kaynaklara göre sunulan ilk C.lapagei pnömonisi olgusudur.
  • Küçük Resim Yok
    Öğe
    The Changes with the New Legislations
    (Galenos Publ House, 2023) Bicakcioglu, Murat; Gedik, Ender
    Organ transplantation is the most important option for the treatment of end-stage diseases. However, there is a large difference between the number of patients on the waiting list and the number of transplants performed. The gradual increase in this difference creates ethical problems related to organ transplantation. Ethical problems and other limitations require organ transplantation to be controlled by legal regulations. In our country, organ transplantation practice is carried out under the supervision of the state. Organ Transplant Practice Regulation has been updated by being published in the Official Gazette dated 09.12.2022 and numbered 32008. Possible end-of-life decisions in brain death are stated in accordance with the conditions of our country. In cases where brain death is diagnosed, the organ preservation protocols applied are terminated in the absence of family or legal guardian approval regarding organ donation. In case of organ donation by the family or legal guardian, the organ preservation protocols needed for donor care are continued during the period until the transplantation of the organ to the waiting patient, and a solution has been presented to the intensive care physicians for the prognosis of the cases that donated or could not be donated.In the regulation in which the prerequisites of the brain death diagnostic criteria are specified, it is stated that the central body temperature should be =36 degrees C. With the new regulation, end-of-life decisions on brain death and changes made in relation to central body temperature have brought convenience in the diagnosis and follow- up process.
  • Küçük Resim
    Öğe
    Characteristics and outcomes of adult patients receiving mechanical ventilation due to acute poisoning
    (Türk Yoğun Bakım Dergisi, 2013) Erdoğan, Mehmet Ali; Aydoğan, Mustafa Said; Özgül, Ülkü; Gedik, Ender; Togal, Türkan; Durmuş, Mehmet; Çolak, Cemil; Uçar, Muharrem
    Öz: ÖZET Amaç: Zehirlenme, yoğun bakım ünitelerine (YBÜ) kabulün önemli bir nedenidir ve yoğun bakımda kalış süresini uzatır. Zehirlenme nedeniyle YBÜ ye kabul edilen hastalar mekanik ventilasyona (MV) ihtiyaç duyabilirler. Uzamış MV gereksinimi YBÜ de kalış süresini ve mortaliteyi artırır. Zehirlenme nedeniyle MV uygulanan hastaların özellikleri ve sonuçlarının değerlendirilmesi, klinik yönetimde yararlı olabilir ve hastalar ile ailelerine daha iyi danışmanlık sağlayabilir. Bu geriye dönük çalışmanın amacı zehirlenme nedeniyle YBÜ ye yatırılan hastaların demografik ve etiyolojik özellikleri ile MV ihtiyacı arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Ocak 2010 - Aralık 2011 tarihleri arasında YBÜ ye kabul edilen 211 değerlendirildi. Yaş, cinsiyet, zehirlenme oluşumu ile YBÜ ye kabulüne kadar geçen süre, zehirlenmenin tipi, maruz kalınan toksik ajanlar, alınma yolu, daha önceki zehirlenme öyküsü, başvurudaki bilinç durumu, YBÜ de kalış süresi, MV ihtiyacı. MV ile ilişkili komplikasyonlar, Glasgow koma skoru ve sonuçları incelendi. Bulgular: Değerlendirilen 211 hastanın 143 ü (%67,8) kadındı. Zehirlenmenin en sık nedeni intihar (%87,7) idi ve oral yol ile (%93,4) gerçekleşmişti. Hastaların en çok maruz kaldığı ajanlar ilaçlardı (%74,4). İlaçlarla oluşan zehirlenmenin en sık nedeni antidepresanlar (trisiklik antidepresanlar dahil) (%38,3) idi. MV ihtiyacı hem cinsiyet (p=0,04), hem de alınma yolu ile anlamlı şekilde ilişkiliydi. MV ihtiyacı zehirlenmenin tipi (p=0,01) ve toksik ajanlar (p<0,001) ile de anlamlı şekilde ilişkiliydi. İlaçlarla zehirlenme ile cinsiyet (p=0,002) ve zehirlenme tipi ile cinsiyet (p=0,006) arasında oldukça güçlü bir ilişki vardı. Sonuç: Bu çalışmada MV ihtiyacı ile cinsiyet, zehirlenmenin tipi, toksik ajanlar, alınma yolu ve YBÜ de kalış süresi arasında anlamlı bir ilişki olduğu gösterildi. MV ihtiyacı ventilatöre bağlı komplikasyonların sıklığı ve daha uzun süre YBÜ de yatışı ile ilişkili olarak kötü prognoza öncülük edebilir.
  • Küçük Resim Yok
    Öğe
    Controlled Hypotension with Remifentanil, Nitroglycerine, and Esmolol on Blood Loss during Living Donor Hepatectomy
    (Wiley-Blackwell, 2011) Aslan, Sibel; Yucel, Aytac; Toprak, Huseyin I.; Gedik, Ender; Koc, Elif; Ersoy, Mehmet O.
    [Abstract Not Available]
  • Küçük Resim
    Öğe
    Dexmedetomidine ameliorates TNBS induced colitis by inducing immunomodulator effect
    (Journal of Surgical Research, 2013) Erdoğan Kayhan, Gülay; Gül, Mehmet; Kayhan, Başak; Gedik, Ender; Özgül, Ülkü; Kurtoğlu, Elçin Latıfe; Durmuş, Mahmut; Ersoy, Mehmet Özcan
    Background: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective a2-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 mg.kg 1 and 30 mg.kg 1 ) during inflammatory bowel disease by using an experimental model, which resembles both systemic and local inflammation. Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was investigated by measuring macroscopic and microscopic parameters. We investigated proinflammatory Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic immune response. Following this, local immune response was investigated by measuring cytokine levels in the presence of dexmedetomidine in spleen cell culture. Results: Dexmedetomidine administration led to amelioration of all disease associated pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from antiinflammatory response via Th2 pathway. Moreover, we showed for the first time in the study that dexmedetomidine administration reduces IL-23, which is responsible from initiation of inflammatory response via Th17 pathway. Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative inflammatory bowel disease patients in intensive care units by down-regulating inflammatory immune response not only in systemic circulation but also in tissue-specific manner.
  • Küçük Resim Yok
    Öğe
    Dexmedetomidine ameliorates TNBS-induced colitis by inducing immunomodulator effect
    (Academic Press Inc Elsevier Science, 2013) Kayhan, Gulay Erdogan; Gul, Mehmet; Kayhan, Basak; Gedik, Ender; Ozgul, Ulku; Kurtoglu, Elcin Latife; Durmus, Mahmut
    Background: Since sedatives are often administered to immune-compromised and critically ill patients, our understanding of immunomodulation by sedation will be critical. Dexmedetomidine, a selective alpha(2)-adrenergic receptor agonist, is often used for sedation and analgesia especially in intensive care units. There are conflicting and little data concerning both the effect and the mechanism of dexmedetomidine on immune response. In our study, we aimed to investigate the effect of dexmedetomidine on immune system at two different doses (5 mu g.kg(-1) and 30 mu g.kg(-1)) during inflammatory bowel disease by using an experimental model, which resembles both systemic and local inflammation. Methods: The effect of dexmedetomidine on the course of inflammatory bowel disease was investigated by measuring macroscopic and microscopic parameters. We investigated pro-inflammatory Th1, Th2, and Th17 cytokine levels in serum samples to analyze systemic immune response. Following this, local immune response was investigated by measuring cytokine levels in the presence of dexmedetomidine in spleen cell culture. Results: Dexmedetomidine administration led to amelioration of all disease associated pathological manifestations. According to our in vitro and in vivo results, dexmedetomidine shows anti-inflammatory effect by increasing IL-4 and IL-10 levels responsible from anti-inflammatory response via Th2 pathway. Moreover, we showed for the first time in the study that dexmedetomidine administration reduces IL-23, which is responsible from initiation of inflammatory response via Th17 pathway. Conclusions: Dexmedetomidine can have beneficial effect on preoperative or postoperative inflammatory bowel disease patients in intensive care units by down-regulating inflammatory immune response not only in systemic circulation but also in tissue-specific manner. (c) 2013 Elsevier Inc. All rights reserved.
  • Küçük Resim Yok
    Öğe
    Düşük akımlı anestezide izofluran ve desfluran ile vücut ağırlığına göre uygulanan taze gaz akımlarının karşılaştırılması
    (2004) Toğla, Türkan; Ayas, Alaattin; Demirbilek, Semra; Gedik, Ender; Köroğlu, Ahmet; Karaaslan, Kazım; Ersoy, M. Özcan
    Çalışmamızda, vücut ağırlığına göre (10-20-30 mL kg-1 dk-1) hesaplanan taze gaz akımı ile uygulanan izofluran ve desfluranın hemodinami, vücut ısısı, oksijen ve kullanılan anestezik gaz konsantrasyonları üzerine etkisinin araştırılması amaçlandı. Etik kurul ve hasta onayı alındıktan sonra, elektif cerrahi geçirecek ASA I-II 60 erişkin olgu rasgele olarak izofluran ve desfluran uygulanan iki gruba ve bu iki grup da 10, 20 ve 30 mL kg-1 dk-1 taze gaz akımı uygulanan 10'ar olgu içeren 3 alt gruba ayrıldı. Standart anestezi indüksiyonundan ve entübasyondan sonra ilk 10 dk taze gaz akımı 4 L dk-1 (%50 O2:N2O) izofluran % 1.5 ve desfluran % 6 olarak uygulandı. Başlangıç fazı sonrasında izofluran % 2 ve desfluran % 8 konsantrasyona ve taze gaz akımı hızları ise gruplara göre ayarlandı. KAH, OAB, SpO2; ösefagus ısısı, vaporizör ayarı konsantrasyonu, inspire ve ekspire edilen oksijen ve gaz konsantrasyonu çalışma protokolüne göre belirli aralıklarla kaydedildi. İnspire ve ekspire edilen gaz konsantrasyonu 10 mL kg-1 dk-1 akım gruplarında diğer gruplara göre anlamlı azaldı (p<0.05). İnspire edilen oksijen konsantrasyonu (FiO2) anestezi süresine paralel olarak azaldı. İzofluran 10 mL kg-1 dk-1 akım uygulanan grupta 2 olguda, desfluran 10 mL kg-1 dk-1 akım uygulanan grupta 8 olguda FiO2 düşük saptandı (p<0.05). Sonuç olarak, izofluran ve desfluranın 10 ve 20 mL kg-1 dk-1 düşük taze gaz akımında ve güvenle kullanılabileceği ve hemodinamiği etkilemediği kanısındayız. Ancak 10 mL kg-1 dk-1 taze gaz akımında % 50/% 50 O2/N2O kullanımında inhalasyon ajanı olarak desfluran kullanılan olgularda hipoksi riski olduğu, bununla beraber hipoksinin FiO2 oranı artırılarak önlenebileceği düşüncesindeyiz.
  • Küçük Resim Yok
    Öğe
    Early results of surgery for acute type A aortic dissection without using neurocerebral monitoring
    (Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray; Nisanoglu, Vedat; Battaloglu, Bektas; Ersoy, Ozcan
    Background: This study aimed to determine if the routine use of unilateral antegrade cerebral perfusion during repair of acute type A aortic dissection can eliminate the need for intraoperative neurophysiologic monitoring. Methods: Between September 2000 and December 2009, 66 consecutive patients with acute type A aortic dissection underwent surgical repair in our clinic. In 57 patients (86.4%), arterial perfusion was provided through a right axillary artery cannula and in the remaining nine patients (13.6%) the arterial perfusion site was the femoral artery. Results: Postoperative hospital mortality was 13.6% (n=9). Postoperative hemorrhage or tamponade requiring resternotomy occurred in seven patients (10.6%). Nine patients (13.6%) required postoperative inotropic support. Postoperative atrial fibrillation was observed in six patients. Mean intensive care unit stay and hospital stay were 5.1 +/- 4.4 days (range, 2 to 26 days) and 10.8 +/- 8.9 days (range, 7 to 60 days), respectively. Mean extubation time was 15.4 +/- 13.9 hours (range, 7 to 74 hours). One of the surviving patients experienced new transient neurological deficits in the postoperative period. Conclusion: Unilateral antegrade selective cerebral perfusion techniques may provide reliable brain protection and reduce cerebral complication rates without the use of routine cerebral monitoring devices, even for longer periods of circulatory arrest during surgery of acute type A aortic dissection.
  • Küçük Resim
    Öğe
    Early results of surgery for acute type A aortic dissection withoutusing neurocerebral monitoring
    (Turk Gogus Kalp Damar Cerrahısı Dergısı-Turkısh Journal Of Thoracıc Andcardıovascular Surgery, 2010) Erdil, Nevzat; Gedik, Ender; Erdil, Feray Akgül; Nisanoğlu, Vedat; Battaloğlu, Bektaş; Ersoy, Özcan
    Background: This study aimed to determine if the routine use of unilateral antegrade cerebral perfusion during repair of acute type A aortic dissection can eliminate the need for intraoperative neurophysiologic monitoring. Methods: Between September 2000 and December 2009, 66 consecutive patients with acute type A aortic dissection underwent surgical repair in our clinic. In 57 patients (86.4%), arterial perfusion was provided through a right axillary artery cannula and in the remaining nine patients (13.6%) the arterial perfusion site was the femoral artery. Results: Postoperative hospital mortality was 13.6% (n=9). Postoperative hemorrhage or tamponade requiring resternotomy occurred in seven patients (10.6%). Nine patients (13.6%) required postoperative inotropic support. Postoperative atrial fibrillation was observed in six patients. Mean intensive care unit stay and hospital stay were 5.1±4.4 days (range, 2 to 26 days) and 10.8±8.9 days (range, 7 to 60 days), respectively. Mean extubation time was 15.4±13.9 hours (range, 7 to 74 hours). One of the surviving patients experienced new transient neurological deficits in the postoperative period. Conclusion: Unilateral antegrade selective cerebral perfusion techniques may provide reliable brain protection and reduce cerebral complication rates without the use of routine cerebral monitoring devices, even for longer periods of circulatory arrest during surgery of acute type A aortic dissection.