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Öğe The effect of low flow anesthesia on hemodynamic and peripheral oxygenation parameters in obesity surgery(Saudi Med J, 2021) Oterkus, Mesut; Donmez, Ilksen; Nadir, Aysu H.; Rencuzogullari, Ibrahim; Karabag, Yavuz; Binnetoglu, KenanObjectives: To investigate the effects of low-flow anesthesia on hemodynamic parameters and recovery from anesthesia in obese individuals undergoing laparoscopic surgery. Methods: This randomized-controlled and prospective study included 44 obese patients who underwent laparoscopic sleeve gastrectomy operation. The patients were randomly allocated into 2 groups as low-flow and high-flow anesthesia. Further, the groups compared in terms of hemodynamic parameters, anesthesia recovery times, operation times, and arterial blood gas parameters. Results: The groups were similar with respect to demographic data. Heart rate, peripheral oxygen saturation, arterial blood pressure measurements, endtidal, and CO2, lactate levels measurements were similar in both groups during the entire procedure. There was also no statistically significant difference in terms of arterial blood gas parameters or anesthesia recovery periods. Conclusion: Low-flow anesthesia in laparoscopic obesity surgery seems to be safer compared to high-flow anesthesia in terms of the adequacy of tissue perfusion, depth of anesthesia, and postoperative recovery.Öğe Evaluation of hypoxia pathway genes and serum parameters in new coronavirus pneumonia (COVID-19)(Elsevier, 2025) Oterkus, Mesut; Pala, Mukaddes; Yilmaz, Senay Gorucu; Tanriverdi, Elif Seren; Gunduz, Ayten; Delen, Leman Acun; Ozturk, Dilara AltayBackground: Coronavirus disease-2019 (COVID-19) causes severe hypoxemia. Unlike normal pneumonia, pneumonia due to COVID-19 causes oxygen deprivation without breathing difficulties (i.e., silent hypoxia). We evaluated the relationship between COVID-19 and hypoxemia and examined possible mechanisms of pneumonia from the perspective of gene expression (HIF1A, vascular endothelial growth factor [VEGF], NF-kB, MEKK1, and EGFR) using real-time PCR and ELISA for serum parameters. Methods: We evaluated 100 individuals (50 patients and 50 controls). The patients were individuals with respiratory symptoms and pneumonia who were (COVID)-D-center dot-19 positive. The relative quantification of standardized samples wa s calculated according to the formula 2-Delta Delta CT. Receiver operating curve (ROC) analysis was made to define the diagnostic power of the genes. The expression changes of four genes in the hypoxia pathway were significant (excluding VEGF) and upregulated in the patients' serums. Results: The fold change values of the HIF1A, VEGF, NF-kB, MEKK1, and EGFR genes were 0.048, 0.688, 0.168, 0.207, and 0.171, respectively, in the cases checked against to the controls. The areas under the ROC values indicating the diagnostic power of the genes were 0.727, 0.538, 0.815, 0.734, and 0.936, respectively. Some serum parameters were significant (age, PCR, urea, LDH, WBC, ferritin, and pO2). Conclusions: The upregulation of some genes in the hypoxia pathway in COVID-19 pneumonia shows that these genes and protein products are candidates for treatment targets. At the same time, the high discriminative power of two genes (NF-kappa B and EGFR) in patients compared to controls indicates their diagnostic potential in serum samples.Öğe Koronavirüs Hastalığıyla İlgili Akut Solunum Yetmezliği Sendromu'nda Non İnvaziv Solunum Desteği Tedavilerinin Başarısı ve NIRS'nin Başarısını Etkileyen Faktörler Üzerine Retrospektif Gözlemsel Kohort Bir Çalışma(2025) Oterkus, Mesut; İnceoğlu, Feyza; Kasapoglu, Umut Sabri; Mızrak, Zeynep KoyluAmaç: Non-İnvaziv solunum desteği, şiddetli vakalarda tedavinin önemli bir parçası olarak yaygın olarak kullanılmaktadır. Covid-19ile ilişkili Akut Solunum Sıkıntısı Sendromu vakalarında NIRS'nin başarısını etkileyen faktörleri belirlemeyi amaçladık. AraçlarveYöntem: Ağustos 2020 ile Mayıs 2021 tarihleri arasında hastanemizin yoğun bakım ünitesinde yatan şiddetli Covid-19enfeksiyonu olan 209 hasta çalışmaya dahil edildi. Hastaların demografik bilgileri, Akut Fizyoloji ve Kronik Sağlık DeğerlendirmesiII (APACHE-II) ve Sıralı Organ Yetmezliği Değerlendirmesi (SOFA) skorları, kalp hızları, asidoz, bilinç, oksijenasyon, solunum hızları ve laboratuvar sonuçları kaydedildi ve analiz edildi. Bulgular: İleri yaş, HT, kronik obstrüktif akciğer hastalığı, yüksek APACHE ve SOFA skorları, düşük albümin seviyeleri, yüksek LDH seviyeleri ve düşük PaO2/FiO2'nin NIRS başarısını azaltan faktörler olduğu bulundu. Ek olarak, düşük PaO2/FiO2 ve SatO2 ve kan Ph'ının erken evre başarısızlığını artırdığını belirledik. Sonuç: SonuçlarımızNIRS'nin Covid-19 hastaları için etkili bir tedavi yöntemi olabileceğinive hastalığınerken evrelerinde uygulanan NIRS'nin entübasyon ve mortalite riskini azaltabileceğini göstermiştir.Öğe PROGNOSIS OF GERIATRIC COVID-19 PATIENTS ADMITTED TO INTENSIVE CARE UNIT ACCORDING TO VACCINATION STATUS(Gunes Kitabevi Ltd Sti, 2022) Aydin, Ahmet; Kacmaz, Osman; Koca, Erdinc; Kutlusoy, Sevgi; Kasapoglu, Umut Sabri; Oterkus, MesutIntroduction: As of June 27, 2022, the COVID-19 pandemic has caused over 540 million infections and 6.3 million deaths. We aimed to investigate the effect of the vaccine on the clinical course of elderly patients hospitalized in the intensive care unit and to determine the prognosis of the patients according to their vaccination status. Materials and Methods: The study included 157 patients over the age of 65. Patients were divided into two groups. The first group consisted of patients who were vaccinated with two doses of CoronaVac, and the second group consisted of patients who were not vaccinated. Demographic data of the patients, prehospital clinical frailty scales, Charlson Comorbidity Indexes, APACHE II scores, laboratory values, and patient prognoses were recorded. Results: Of the 157 patients, 93 (59.2%) were female, and the median age was 76 years (65-99). 96 (61.1%) patients were vaccinated and 61 (38.9%) patients were unvaccinated. Patients were grouped as survivors (n=26) and deceased. We found that APACHE II, prehospital clinical frailty scales, and Charlson Comorbidity Indexes scores were higher in patients who died. There was a significant difference between blood lymphocyte and ferritin levels and survival. The 28-day survival rate was higher and intensive care unit overall survival time were longer in the vaccinated group. Conclusions: We observed that the vaccinated patients had higher survival times and lower mortality rates than those who were not vaccinated. We think that it is important to vaccinate elderly patients and that additional doses may be needed.
