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    Auxiliary methods for percutaneous dilatational tracheotomy
    (2019) Kartal, Seyfi; Sen, Ahmet
    Aim: Patient with long-term mechanic ventilation in the Intensive care unit can be used as an adjunct to the Light styles and Fiber optic bronchoscope as a guide in percutaneous dilatation tracheotomy. In our study, we planned to investigate the effects of Light styles and Fiber optic bronchoscope on perioperative complications in percutaneous dilatation tracheotomy.Material and Methods: The study was conducted by scanning digital and written file records of 52 patients who underwent percutaneous dilatation tracheotomy between 2016 and 2018. Patients were evaluated in 3 groups using Light styles, Fiber optic bronchoscope and no additional methods.Results: In the study; percutaneous dilatation tracheotomy were performed to 52 patients who were followed up at the Intensive care unit. Mean Percutaneous dilatation tracheotomy opening day was 17.03±4.18 days, operation time was 21.23±8.45 min, 69.2% was successful in the first attempt in all groups. There were 21 patients using Light styles, 12 using Fiber optic bronchoscope and 19 with no additional methods. In 26 patients (74.3%) the use of Light styles or Fiber optic bronchoscope was facilitated. In the Light styles group endotracheal tube puncture was less common (p=0.044). More venous hemorrhage was seen in longer periods of procedure (p0.001), and more hypotension was observed in the longer Percutaneous dilatation tracheotomy administration time in all groups (p=0.012).Conclusion: The use of Light styles and Fiber optic bronchoscope can be safely used in percutaneous dilatation tracheotomy. Keywords: Lighted stile; Fiber optic bronchoscope; percutaneous dilatation tracheotomy.
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    Evaluation of colistin-associated acute renal failure in intensive care unit
    (2019) Ozdemir, Abdullah; Sen, Ahmet; Erdivanli, Basar; Hatinoglu, Neslihan
    Aim: Colistin’s parenteral use was limited due to nephrotoxicity related to decreased renal perfusion, nephrotoxins and ischemiareperfusion injury. Colistin became popular again because of multiple drug resistance. This study aimed to retrospectively evaluate the characteristics of intensive care patient groups with and without colistin-induced acute kidney injury. Material and Methods: Following approval of local ethics committee, information of the patients, who were treated in the anesthesia and surgical intensive care units between 01/01/2016 and 30/06/2017, were analyzed retrospectively. Results: Twenty patients (59%) developed acute kidney injury during colistin treatment. No statistically significant difference was observed between the groups with and without acute kidney injury in terms of age, gender and duration of stay in the intensive care unit, however, patients with acute kidney injury were found to be older and stayed in the intensive care unit for a longer period of time. The comparison made between the groups in terms of inotropic agent use showed that the duration of inotropic agent use was statistically longer in the acute kidney injury group. Discussion: Rate of colistin-induced acute kidney injury varies between 5-55%. In addition, fluid balance of patients is important in acute kidney injury development. Fluid therapy, hourly urine output and central venous pressure trends of the patients should be closely monitored particularly when nephrotoxic medicines are used. There is a need for large-scale studies with more advanced methodologies for the early detection and prevention of colistin-induced nephrotoxicity.
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    An extraordinary complication of spinal anesthesia: Brain edema
    (2019) Duman Aydin, Pinar; Asci, Sumeyra; Kalayci, Serap; Sen, Ahmet
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    A retrospective study on the effects of diabetes mellitus on perioperative fibrinogen and bleeding amount in coronary artery bypass surgery patients
    (2018) Tugcugil, Ersagun; Erdivanli, Basar; Sen, Ahmet; Besir, Ahmet
    Aim: In this study, the effects of changes in the coagulation system of diabetic patients that undergo heart surgery on postoperative bleeding amount and complications was investigated. Material and Methods: A total of 106 patients (35 females, 71 males) were retrospectively examined in the study. Patients were divided into two groups: diabetic (Group D, n = 47) and non-diabetic (Group C, n = 59). Preoperative and postoperative hematologic values, postoperative bleeding, and transfusion amounts of all groups were recorded. Results: Preoperative and postoperative fibrinogen and C-reactive protein (CRP) values in Group D were significantly higher compared to those in Group C (p< 0.05 and p< 0.01, respectively). Postoperative bleeding amount, erythrocyte, and fibrinogen transfusion need were found to be significantly lower in Group D compared to Group C (p = 0.04, p = 0.01, and p< 0.001, respectively). Conclusion: Diabetic patients had decreased amount ofpostoperative bleeding, possibly due to a thrombotic tendency caused by chronic inflammation related to diabetes mellitus.