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This article provides a general overview of the pathway to become an intensivist in the United States of America (USA). It begins with a detailed description of the current structure of critical care training in the USA and the application process to fellowship training programs. There is then a presentation of the general structure of critical care units within the USA and how intensive care unit physicians fit into it. The article concludes with a discussion of how American critical care fits globally within international critical care societies.

Objective: The aim of this study is to evaluate the effectiveness of radiation safety training developed for nurses working in intensive care units (ICUs). Materials and Methods: This study was carried out on a total of 144 nurses working in the neonatal and pediatric ICUs of two different hospitals. The radiation safety training developed for the nurses of the ICU for the nurses in the training group (n=62) was given face-to-face in 7 sessions in groups of 8-10 people. The data were collected through the descriptive information form and the radiation safety information form, as well as the observations made by the researcher. Results: As a result of the observations, the development of protective behaviors against ionized radiation of the nurses in the training group increased significantly both compared to the control group and pre-training case (p

Objective: The purposes of our study were to determine the relationship between coronavirus disease (COVID) pneumonia and mortality and immunization status of patients and to present our first extracorporeal membrane oxygenation (ECMO) experiences by retrospectively evaluating pregnant women. Materials and Methods: The research was conducted by screening the files of 37 pregnant/postpartum COVID-2019 cases monitored and treated in the intensive care unit between March 1, 2020 and December 1, 2021. The patients’ ages, systemic comorbidities, vaccination details, and clinical and laboratory features were recorded and analyzed. The patients were divided into two groups as survivors (group 1; n=17) and exitus ones (group 2; n=20); and the results were compared statistically. Results: Of 37 patients, 17 (45.9%) survived (group 1) and 20 (54.1%) died (group 2) with a median of 31 gestational weeks and 9 days length of stay in the ICU. ICU admission time [which day of polymerase chain reaction (PCR)+] and cesarean time (which day of PCR+) were 8 days. Nine (24%) patients received ECMO and mechanical ventilation, with 6 (66.6%) exitus and 3 (33.3%) survivors who were discharged from the hospital without sequelae. Of 37 pregnant/postpartum patients, 36 were unvaccinated. Conclusion: Vaccination should be given priority in pregnant women, and ECMO may be effective in the recovery of oxygenation in pregnant COVID-19 patients.

Objective: This study was conducted to determine the opinions of nurses working in surgical intensive care units (S-ICU) about the participation of family members (FM) in the care of patients during the dying process. Materials and Methods: Ethical approval was obtained before starting the research. The study was conducted in descriptive type with 81 nurses working in the S-ICU of a training and research hospital between 15 March and 15 April 2022. The data were collected through the descriptive information form and the nurse's opinion determination form created by the researcher. STROBE checklist was used in reporting the research. A p

Objective: We postulated that adding tube resistance compensation (TRC) to pressure support ventilation (PSV) would have beneficial effects on metabolic parameters in patients scheduled for weaning. Here, the PSV and PSV+TRC were compared by measuring oxygen consumption (VO2), energy expenditure (EE), and carbon dioxide production (VCO2). Materials and Methods: This was a prospective, randomised, crossover study. Seventy-eight adult patients were randomised to receive either PSV or PSV+TRC. Group 1 consisted of patients that started with PSV initially and then switched to PSV+TRC, whereas Group 2 first received PSV+TRC and then switched to PSV. After 30 minutes of monitoring and stabilization, an indirect calorimeter was connected and metabolic parameters measurement was taken every 5 minutes for 30 minutes, and the last measurement values were recorded at the 30th minute. The patient was then switched to the second treatment mode, and the procedure was repeated. Results: TRC+PSV ventilation had no clinical effects on metabolic parameters compared with PSV (EE, 1746 vs. 1763, respectively; VO2, 255 vs. 260, respectively; VCO2, 206 vs. 208, respectively; all p > 0.05). Conclusion: Adding TRC to PSV did not cause any changes in gas exchange, haemodynamic variables, or metabolic parameters in patients for weaning.

Objective: In this retrospective and cross-sectional study, it was aimed to evaluate the efficacy of tocilizumab (TCZ) treatment in critical COVID-19 patients who were hospitalized in the intensive care unit (ICU) and developed cytokine storm. Materials and Methods: The study included 219 critically ill COVID-19 patients followed in the ICU and treated with TCZ. All patients received 2 doses of 400 mg/day TCZ treatment during their stay in the ICU. Clinical conditions, laboratory data, inotrope requirement and chest radiographs before and after TCZ treatment were compared. Mortality rates at the 7th day, 28th day and total mortality rates of the patients were recorded. Results: It was observed that there was a significant decrease in CRP values over time after TCZ treatment. There was a significant increase in leukocyte, lymphocyte, lactate, urea, creatinine, AST, D-dimer, LDH and PCT values. The 7-day mortality of the patients was 21%, the 28-day mortality was 64.8%, and the total mortality rate was 65.3%. Conclusion: It was determined that after TCZ treatment, only CRP levels, which are among the inflammatory parameters, decreased significantly in patients, and the mortality rates were still high with the increase in the values of kidney and liver function tests of the patients.

Objective: Myroides species are mostly low-grade opportunistic pathogens and infect immunocompromised patients. Reports of Myroides spp. increased from clinical samples due to unique developments in molecular microbiology. However, clinical importance of this microorganism in intensive care units’ patients is debated. We aimed to determine whether Myroides spp. strains isolated from urinary catheter cultures of patients in intensive care units are led to an infection or colonization by examining the risk factors of the patients between January 2018 and December 2022. Materials and Methods: In a university hospital, the patients who Myroides spp.isolated from urine cultures in intensive care units between January 2018 and December 2022 were included in the study. The method and reasons of taking urine samples, the presence of a urinary catheter, blood cultures samples in terms of urinary sepsis, the antimicrobial susceptibility of the isolates, and hospital stay were evaluated retrospectively. Also, control culture samples were taken after 24 and 72 hours by changing the urinary catheters of these patients. Results: Thirty-six patients were enrolled to the study. Urine cultures were taken for investigate the source of infection in 23 patients, and nine for control urinary culture and in three patients for macroscopic urine blurred and in one patient to detect colonization before urinary surgery. There was not any blood culture positivity found. All Myroides spp. isolated patients had urinary catheter. Average length of hospital stay was determined as 41.3 days (7-355). A total 34 of the 36 isolated Myroides spp. were pan-drug resistant. Antibacterial treatment was not initiated in any of the patients. Urinary catheters change after first isolation of Myroides spp. was recommended in all patients. After the patients’ urinary catheters were changed, Myroides spp. were not grown in the control culture samples taken 24 and 72 hours after. Conclusion: As a result of our study, Myroides spp. were isolated especially in patients with long hospital stays and urinary catheters. It was determined that the patients were controlled without treatment, only with urinary catheter replacement. We believe that this agent should be evaluated as having a very high rate of urinary colonization, and the urinary catheter should be changed first, urinary symptoms should be followed up, and unnecessary antimicrobial use should be avoided.

Objective: In the management of haemodynamically unstable patients, cardiac output (CO) measurement provides clinicians with important data on organ tissue perfusion. This measurement can be performed by pulse-induced contour cardiac output (PiCCO) using thermodilution method, which is a less invasive method, and ultrasonic cardiac output monitoring (USCOM), which is completely non-invasive. The aim of this study was to investigate the clinical relevance of CO and cardiac index measurements obtained by USCOM in patient’s with sepsis and septic shock by comparing them with the PiCCO technique, which has been used as a reference measurement method in recent years. Materials and Methods: In this prospective study, 36 patient’s with sepsis and septic shock ventilated with 8-10 mL/kg tidal volume without respiratory effort were included. Patient’s with arrhythmia, known heart failure or pulmonary embolism were excluded. Results: After averaging the PiCCO and USCOM measurements performed by different clinicians, the heart rate was found to be 3.23 L/min/m2 with PiCCO and 2.24 L/min/m2 with USCOM. When the two results were compared, the difference was statistically significant (p=0.01). Stroke volume variation was 15.80% with PiCCO and 52.89% with USCOM. When the two results were compared, the difference was statistically significant (p=0.01). Conclusion: There was no agreement between USCOM and PiCCO measurements in sepsis patient’s. In our opinion, more studies are needed for USCOM reliability.

Objective: The aims of this study was to investigate factors associated with intensive care unit (ICU) admission and prognosis following surgical treatment of gynaecological malignancy. Materials and Methods: This study was designed as a retrospective cohort analysis, which encompasses patients who were subjected to gynecologic oncological surgery and subsequently monitored in the ICU from December 1st, 2022, to December 1st, 2023. Results: Data of 57 patients who underwent gynaecological oncological surgery and were admitted to ICU during the study period were analysed. Median age was 61.47 years, median body mass index 27 kg/m2, American Society of Anaesthesiologists score 3±2.5. The most common indication for ICU admission was haemodynamic instability with 73.6% (n=42), followed by respiratory failure with 15.7% (n=9) and other reasons. Charlson comorbidity index, lactate and base deficit levels were higher and albumin values were lower in patients with ICU stay of 3 days or more (p=0.04, p=0.004, p=0.034, p=0.025). Only 2 patients (3.5%) developed mortality during the study period. Conclusion: The most common indication for ICU follow-up after elective gynaecological oncology surgery is hemodynamic instability with low ICU mortality and short length of stay in general.

Objective: Electrolyte imbalance is an important factor that is frequently observed in the ICU and affects prognosis. We analyzed the type of electrolyte imbalance on ICU admissions and its relation to prognosis, mechanical ventilation day, ICU and hospital stay, and mortality. Materials and Methods: The electrolyte values of 826 patients admitted to the ICU were analyzed. Demographic data, the type of electrolyte imbalance, mechanical ventilation day, length of stay in the ICU and hospital, APACHE-II scores, and mortality status were recorded. Results: A total of 826 patients were included. Of the patients, 252(30.5%) had dysnatremia, 193 (23%) had dyskalemia, 432 (52%) had dyscalcemia, 389 (47%) had dysmagnesaemia, and 625 (75%) had dysphosphatemia. APACHE-II score, mechanical ventilation day, and length of stay in ICU and hospital were significantly higher in hypernatremia than in normonatremia and hyponatremia. In hypokalemia, the length of stay in the ICU and mechanical ventilation day was significantly higher than in normokalemia. The mortality rate was 1.7 and 4.4 times higher in hyponatremia and hypernatremia, respectively, than in normonatremia. Mortality was 1.8 times higher in hypokalemia and 2.2 times higher in hyperkalemia than in normokalemia. Mortality was 11 times higher in hypercalcemia than in normocalcemia. Conclusion: Electrolyte imbalance is frequently observed among ICU patients. In particular, in patients with dysnatremia and dyskalemia, the prognosis is worse.

Objective: Vital signs and trauma scores of pediatric trauma patients affect morbidity and length of stay in the intensive care unit; treatment and follow-up of appropriate trauma patients in experienced centers is of great importance. This study aimed to determine the demographic data, clinical findings and scoring systems, and respiratory and circulatory support requirements of trauma patients during their follow-up in the pediatric intensive care unit(PICU) and investigate the effects of these factors on the length of PICU and hospital stay and mortality. Materials and Methods: Demographic and clinical findings of 49 pediatric patients who were hospitalized in the PICU because of trauma were prospectively recorded for 16 months. Data on the length of PICU and hospital stay, trauma mechanisms, and affected organ systems were collected. Results: The most frequent etiology of trauma was falling from heights in 36.7% of the patients. Mechanical ventilation (MV) was necessary in 18.4% of the cases, and the mean duration for MV was 48 (12-306) hours. When MV need was evaluated concerning vital findings, the findings showed that patients with bradypnea needed MV more (p=0.004). MV was needed in 66.7% of hypotensive patients, and there was a statistically significant difference between blood pressure and MV requirement (p=0.005). GCS and length of PICU stay were correlated (p=0.02). PICU (p=0.005, p=0.005, p=0.001) and hospital stay (p=0.02, p=0.01, p=0.04) were statistically significantly longer in patients who had blood products, inotropic agents and MV Conclusion: The effects of initial vital signs and trauma scores on morbidity and length of PICU stay of pediatric trauma patients, as well as the importance of treatment and follow-up of appropriate patients in experienced centers, have been shown in our study.

Objective: Tocilizumab (TCZ) is a recombinant humanized anti-IL-6 receptor monoclonal antibody that is beneficial in critically ill COVID-19 patients. However, the clinical efficacy and safety of immunosuppressants (including tocilizumab, sarilumab and anakinra) in COVID-19 patients are not yet known. These treatments may predispose patients to infection. The aim of this study was to find any connection between the use of tocilizumab and increased secondary bacterial infections. Materials and Methods: In this study, we conducted retrospective analyses of secondary bacterial infections in COVID-19 patients in the intensive care unit. This study included patients with laboratory-confirmed COVID-19 infection or clinically and radiologically confirmed COVID-19 infections who were admitted to the university hospital adult ICUs between March 2020 and January 2022. Demographic data, recent exposure and travel history, clinical symptoms or signs, laboratory findings, and comorbidities were recorded. Microbial cultures from tracheal aspirates, blood, and urine were obtained at admission and throughout the hospital stay. The patients who received tocilizumab treatment noted and analyzed for seconder infections. Blood cultures were taken at least 48 h after the first dose of tocilizumab. Results: We found that 80 patients (%37) had positive culture samples at admission, and most of these cases were admitted to the ICU from various hospital wards. The analyzed data showed that the tocilizumab group had a higher incidence of positive culture samples (%75 vs %35, p=0,0001). The results showed that culture of tocilizumab taken patients had more incidence with metisilin resistance S. aureus, Klebsiella spp., and Acinetobacter spp. (p=0,0001). Infection and mortality rates were much higher than those in the usual care group. Conclusion: Secondary infections and sepsis are major risk factors for mortality. The pathogens detected were drug resistant and had a lower chance of treatment. The benefit of tocilizumab treatment was lost in these patients because of secondary infections. Future studies are needed to help determine the risks of tocilizumab treatments.

Objective: In this study, we investigated whether scoring systems determine COVID- 19 severity. Materials and Methods: COVID-19 patients hospitalized between 01.09.2020 and 31.04.2021 were retrospectively assessed. The National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), Quick Sequential Organ Failure Assessment Score (q-SOFA), CURB-65, MuLBSTA, and ISARIC 4C scores on admission day were calculated. Scoring systems’ ability to predict mechanical ventilation (MV) need, intensive care unit (ICU) admission, and 30-day mortality were assessed. Results: A total of 292 patients were included; 137 (46.9%) were female, and the mean age was 62.5±15.4 years. 69 (23.6%) patients required ICU admission, 45 (15.4%) needed MV, and 49 (16.8%) died within 30 days. No relationship was found between qSOFA and MV need (p=0.167), but a statistically significant relationship was found between other scoring systems and MV need, ICU admission, and 30-day mortality (p5.5) and NEWS (optimal cut-off >3.5) had the highest area under the curve in ROC curve analyses, whereas qSOFA had the lowest. Conclusion: The severity of COVID-19 could be estimated by using these scoring systems, especially ISARIC-4C and NEWS, at the first admission. Thus, mortality and morbidity would be reduced by making the necessary interventions earlier.

Objective: This study investigated the effects of psychological distress on the work ability of intensive care nurses during the COVID-19 pandemic in Turkey. Materials and Methods: The sample size of this descriptive and cross-sectional study was determined to be at least 220 nurses, with a level of significance of 0.05, a confidence interval of 99%, and the ability to represent the population of 80%. The research was completed with 233 nurses. A Participant Information Form, the COVID-19-related Psychological Distress Scale, and the Work Ability Index were used to collect data online using Google Forms and email or social media accounts. In the analysis of data, Pearson and Spearman correlation analysis was used along with descriptive statistics. Results: A statistically significant positive correlation was found between the nurses’ length of time working in the profession and their WAI scores (r=0.132, p=0.043), and a negative correlation was found with their COVID-19 PDS scores (r=-0.162, p=0.013). A statistically significant difference was found about WAI total scores in the effect on work ability of the working conditions of the COVID- 19 pandemic (p

Objective: By comparing viral sepsis caused by SARS CoV-2 with pneumosepsis caused by other pathogens, we aimed to compare the pathogen– host relationship, organ damage affecting the clinic, and similar and different features of the two types of sepsis. Materials and Methods: A total of 414 patients diagnosed with critical COVID-19 between 2019 and 2021 and 303 pneumosepsis cases that met the diagnostic criteria for sepsis-3 between 2016 and 2019 admitted to the Anesthesiology and Reanimation Intensive Care Unit (ICU) were retrospectively screened. The patient’s demographic data, mortality rates, length of stay in the intensive care unit, development of secondary organ dysfunction, presentation values of laboratory and mechanical ventilation, and changes within the 1-week follow-up were compared. Results: The SOFA scores were significantly higher in the COVID-19 sepsis group at presentation (8.2±2.9 vs.7.2±3.7; p

Objective: Hypercoagulopathy related to hyperinflammation may be responsible for mortality and organ failure in coronavirus disease-2019 (COVID-19) patients. Abnormal coagulation profiles were associated with poor outcomes. In this study, we aimed to evaluate the prognostic value of antithrombin (AT) levels in critically ill COVID-19 patients on the intensive care unit (ICU) admission. Materials and Methods: Four hundred ten critically ill COVID-19 patients were retrospectively analyzed. Inflammatory and conventional coagulation parameters as well as AT activity levels were recorded on the ICU admission. The clinical outcomes of patients were analyzed. Results: AT levels on the ICU admission were significantly lower in non-survivors than survivors (77.9% vs. 82.5%; p=0.027). Besides AT, D-dimer values of non-survivors were significantly higher than survivors (2775 vs. 1495 µg/L; p

Fournier’s gangrene is a mortal surgical emergency characterized by rapidly spreading soft tissue necrosis between fascial planes in the perineum and genital area. The goal of treatment is early debridement of necrotic tissues to improve tissue oxygenation. In the treatment of this case, somatic oximetry monitoring, which is a non-invasive method, was applied in addition to hemodynamic monitoring to evaluate the effectiveness of fluids, antibiotics and debridements more closely. In the efficacy of the treatment, it was observed that rSO2 values correlated with other laboratory and follow-up parameters.

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Objective: To evaluate the overseas experiences of our intensive care unit doctors and to determine out the reasons for our doctors who couldnot go and what support they wanted. Materials and Methods: The created questionnaire was delivered to the doctors via the internet. The survey consisted of three main parts. They were asked in the first part, sociodemographic characteristics; in the second part, how long they went abroad, how they choose the center, from whom they received support; in the third part, the reasons why our physicians who donot have been abroad experienced could not go, on which subject/center they want to gain professional experience, and how to get support in this regard. Results: 31.4% of the 156 participants had professional abroad experience. 55% of those who went stated that they found the center with their own efforts, and very few (13 people, 26%) stated that they received support from the education/administrative unit of the institution they worked during the admission. In academically titled physicians, the level of foreign language and the importance given to education abroad were quite high. It was determined that the frequency of reading articles was correlated only with the duration of the profession. The most common reasons for physicians who couldnot get a chance to go was not being able to find a clinic/scholarship program to go to/not being informed (63.5%) and high accommodation/living fees (48.4%). Conclusion: Professional overseas experience has a high contribution to our physicians and our health system. The biggest obstacle for our physicians who cannot attend is not being able to find a center/clinic to go to. We think that the institutions/associations to which they are affiliated can support this issue.

Objective: The aim of this study was to evaluate the change in methicillin resistance and antibiotic susceptibility of staphylococcal strains isolated from various clinical samples of patients hospitalized in intensive care units over the years. Materials and Methods: A total of 5144 staphylococcal strains isolated from various clinical specimens of inpatients in intensive care units in a university health practice and research hospital medical microbiology laboratory between January 2018 and December 2021 were (96.51%) included in the study. Bacteria identification and antibiotic susceptibility tests were performed using conventional methods and an automated systems. Results: Of the total 5144 staphylococci strains, 4503 were identified as coagulase-negative staphylococci (CNS) (87.54%) and 641 as Staphylococcus aureus (S. aureus) (12.46%). Of these strains, 1451 (28.21%) were isolated from anesthesiology and reanimation intensive care unit, and 4573 (88.90%) from blood samples. The most dramatic increase in both S. aureus and CNS in 2021 occurred in levofloxacin (S. aureus 100%; CNS 99.45%) and ciprofloxacin (S. aureus 100%; CNS 98.54%). While a high rate of resistance to fusidic acid (96.51%) was observed in CNSs, the resistance, which was over 65% in S. aureus strains, decreased significantly (5.40%) in 2021. The lowest antibiotic resistance was in daptomycin, linezolid, and teicoplanin in both bacterial groups. Methicillin resistance, which was 62.31% in 2018 in S. aureus strains, decreased to 33.10% in 2021, while it decreased from 86.68% to 75.06% in CNSs. The rate of resistance to all the examined antibiotics were found to be significantly higher in CNSs. Conclusion: To prevent the development of resistance, antimicrobial resistance profiles should be determined through effective surveillance studies, and each hospital should establish its own antibiotic use policy. Additionally, it is important to ensure the rational use of antibiotics and to take effective infection control measures.

Objective: Our study aimed to evaluate publications originating from Turkey in the field of “intensive care” in the journals with Science Citation index (SCI) and SCI-Expanded (SCI-E). Materials and Methods: Journals related to "Intensive Care" in the SCI-E database of "Thomson Reuters Web of Science" were scanned. The Institute for Scientific Information Web of Science search engine was used in advanced mode by typing “IS = ISSN number” to identify publications in the journal. By typing “IS = ISSN number and CU = Turkey”, articles related to intensive care originating from Turkey were found. Mann-Whitney U test was used to statistically evaluate the percentages and annual averages of publications in journals originating from Turkey and grouped according to different criteria. The relationship between the impact factors of the journals and the percentage and annual publication average of publications originating from Turkey was analyzed with the Pearson correlation test. A p value of less than 0.05 was considered a significant difference. Results: According to the percentage of publications in the field of intensive care, the three journals with the highest publications originating from Turkey were determined as "Burns", "Journal of Burn Care & Research", "Journal of Critical Care". While Turkey ranked 22nd between 1975 and 2021, it rose to 19th place in the last decade and the last five years. The total number of publications originating from Turkey, the average number of annual publications and the percentage of publications are significantly higher in journals published in English than in journals published in other languages (p

Objective: In this study, it was aimed to evaluate the practices of physicians working in intensive care units about post-resuscitation care in patients whose spontaneous circulation returned with cardiopulmonary resuscitation. Materials and Methods: In this cross-sectional study, a web-based questionnaire containing 28 questions was applied to physicians working in an intensive care units. Results: A total of 118 specialist physicians participated in the study. The mean arterial pressure target after resuscitation was mostly (91.5%) 65-75 mmHg, and the most preferred inotropic agent was noradrenaline (81.2%). It was determined that 52.1% of the participants applied targeted temperature management and continued for 24 h. Neuroprognostic evaluation was performed after 24 h, and most commonly Glasgow coma scale (96.6%), pupillary and corneal reflexes (92.2%), and computerized brain tomography (60.3%) were used. However, it was observed that biomarkers and neurophysiological methods were used less frequently. Conclusion: In this study, it was observed that there were differences in practices according to hospital conditions in post-resuscitation care, but physicians generally followed international guidelines. Simultaneously, it is considered that in addition to the international guidelines, national guidelines are necessary in accordance with the conditions of our country, and training was needed for standard applications.

Objective: This study aims to determine the risk factors affecting the development of pressure injuries for inpatients in the intensive care unit, to determine the nursing interventions conducted to prevent pressure injuries, and to detect healing of the pressure injuries. Materials and Methods: This follow up-longitudinal type study was conducted with 48 patients at an Intensive Care Unit in a public hospital between 01.09.2018 and 30.11.2018. Study data were collected using the Braden scale for predicting pressure injury risk, pressure injury assessment form, and pressure injury healing assessment form. Results: Patients who had a hospitalization duration of 15 or more days, were supported with mechanical ventilators, were unconscious, were fed enterally, were immobile in bed, had an albumin level of 2.5 g/dL or below, or had a hemoglobin level of 10 g/dL or below had significantly more pressure injuries (p0.05). Conclusion: The main risk factors for developing pressure injuries in inpatients in the intensive care units were enteral feeding, consciousness or unconsciousness, and level of hemoglobin. More pressure ulcers occurred on patients who were positioned and whose skin was moistened because nurses applied interventions to patients with a high risk of pressure ulcers. Additionally, there was no improvement in the healing of the compression injuries.

Extracorporeal membrane oxygenation (ECMO) increases circulating volume of distribution, leading to capillary leakage and temporarily altering renal function. Therefore, this may affect pharmacokinetics. In this review, factors affecting pharmacokinetics and pharmacodynamics in veno-arterial and venovenous ECMO, the causes of drug sequestration that may occur in the ECMO circuit, the effects of physicochemical parameters of drugs in the ECMO circuit, and ECMO variable dose optimization have been reviewed from the studies in the current literature. Data reported on the limitations, indications and complications of ECMO are also mentioned. The limited use of ECMO in the coronavirus disease-2019 pandemic, its use in reported cases, and which symptoms it is usually used to support the treatment of are described.

Objective: This study developed a prediction model that can predict the intensive care admission of coronavirus disease-2019 (COVID-19) pregnant and postpartum women. Materials and Methods: The study was retrospective and single-center and was conducted with pregnant and postpartum patients 18 years of age and older who had been diagnosed with COVID-19 and were admitted to the obstetrics clinic between April 2020 and December 2021. The clinical and radiological featuresand laboratory values of the patients were recorded to develop a prediction model. Two different multivariate logistic regression models and the Naive Bayes classification algorithm were used for estimation. The results of the developed prediction models were summarized with the nomogram, and the prediction successes were evaluated with the receiver operating characteristic (ROC) curve. Results: The study included 436 pregnant and postpartum patients. Twelve of 51 patients admitted to the intensive care unit died. The specificities of the three different classification models that we developed to determine the risk factors for intensive care admission were found to be over 95% and their sensitivities were 70.6%, 86.3%, and 87%, respectively. Additionally, the area under the ROC values were found to be 0.94, 0.941 and 0.978 for the models, respectively. High procalcitonin level, fever, dyspnea, and moderate-to-severe radiological involvement were determined as risk factors for admission to intensive care in pregnant and postpartum women patients. Conclusion: It is thought that the risk models we have developed will be easy to implement and will help identify pregnant women who are at risk of severe COVID-19 disease in the early period and to take measures.

Objective: This study was conducted experimentally to examine the effect of music therapy and sound isolation on the comfort of mechanically ventilated patients. Materials and Methods:The study was conducted in the anesthesiology and reanimation intensive care unit of a university hospital between November 2019 and January 2020. Three different interventions were applied to n=24 patients who constituted the research sample. Each patient listened to Western Classical Music and Nihavend magam Turkish Classical Music separately for 60 minutes (min) and received an intervention of sound isolation for 60 min through a special headset. Results: The mean age of the patients participating in the study was 64.88±14.05. Of the patients, 66.7% were male, 79.2% were married, and 45.8% were illiterate. Patients’ systolic and diastolic blood pressures, pulse rate, respiratory rate, Critical-Care Pain Observation Tool score, and scores on agitation and anxiety sub-dimensions of the American Association of Critical Care Nurses Sedation Assessment scale were influenced by Western Classical Music, Nihavend maqam Turkish Classical Music, and sound isolation. No difference was found among the three different implementation interventions. Conclusion: Music therapy and sound isolation interventions administered to mechanically ventilated patients positively affected the hemodynamic parameters of the patients and reduced the severity of pain perceived by the patients and the need for sedation. In this context, the most important finding of the study was that an intervention that eliminates noise in the intensive care environment for mechanically ventilated patients increases the comfort level of the patients. Another important and critical result of this research was that music therapy also acts as an intervention without noise stimuli.

Objective: The importance of prone positioning has increased with the density of coronavirus disease-2019-related acute respiratory distress syndrome (C-ARDS) during the pandemic process. It is aimed to investigate the effect of prolonged duration of prone positioning in C-ARDS patients on the blood gas parameters at the time after supine positioning (post-prone effect), the feasibility, the safety, and the mortality for 28 days. Materials and Methods: This study was a single-center prospective observational study with 1000 beds, 432 of which were intensive care units. Severe and moderate ARDS; the blood gas parameters (PaO2/FiO2, PaO2, SpO2 etc.) of the patients who were applied the standard prone (16 hours) and the extended prone (36 hours) position were compared. Results: It was observed that PaO2/FiO2 PaO2 and SpO2 values measured at the 8th hour (t4) (post-prone) after the prone was placed in the supine position in the prolonged prone group were higher than before the prone (t1) (p

Due to the significantly increased consumption of energy drinks worldwide, reports of toxicity and adverse events related to these beverages are emerging in the literature. We report a 40-year-old male patient who consumed eight to ten cans (2000 to 2500 mL) of taurine-containing energy drinks per day during the two weeks prior to hospitalization. The patient applied at the hospital with loss of consciousness and in the physical examination, petechia is detected in whole body. Laboratory values except platelet count were normal. We applied the plasmapheresis with a platelet count of 1300 mm3. On the fourth day, we extubated the patient whose clinical findings improved. On the sixth day, we measured the platelet count was 136,000 mm3, and transferred the patient to the hematology service. In conclusion, clinicians need to be aware of any potential side effects from using energy drinks.

Objective: Pressure ulcers (PU) are common in patients admitted to palliative care clinics (PCC). Pregressive nutritional deficiency, incontinence, and limitation of movement increase the risk of new PU formation. Purpose: To examine the risk of PU in patients hospitalized in PCC andthe rate of wounds on admission. Materials and Methods: We retrospectively analyzed patients hospitalized between 2017 and 2019 in a PCC integrated into a tertiary health institution. Patients with demographic and clinical data, data on the region, number, and stage of PU, and Norton and Braden pressure risk scores were enrolled. Patients with scores 11 on the Norton scale and 18 on the Braden scale were considered to be at higher risk for PU. Results: The final analysis included 566 patients [mean age: 68 years, male: 328 (58%)]. On admission, PU was recorded in 181 patients (32%) (sacrum: 80%). According to the Norton scale, 269 (47.5%) of all cases were under the risk of PU and 48.7% (n=131) of them already had PU. According to the Braden scale, 475 (83.9%) patients were at risk of PU, and 37.5% (n=178) of them already had PU. Among subjects with a low Norton score (n=297), 16% (n=50) already had PUs. Among subjects with PUs, the Norton score was not high 27.6%. Only 3.3% (n=3) of 91 patients whose Braden score was not low already had a PU. The sensitivity and specificity of the Norton score in the prediction of PU were 48.9% and 83.2%, respectively. The sensitivity and specificity of the Braden score in the prediction of PU were 66.9% and 99.0%, respectively. Conclusion: Physical PU examination on admission to PCC and during follow-up can identify a significant number of cases. The utility of Norton and Braden scores to estimate the occurrence of PUs may be limited in the palliative care setting or patients.

Objective: The benefit of medical interventions applied in terminal patients who have no hope of recovery and whose death is thought to be approaching is still a controversial issue. In this study, it was aimed to analyze the terminal stage patients hospitalized in the intensive care unit. Materials and Methods: The general characteristics and laboratory results of 61 end-stage patients admitted to the adult intensive care unit of university hospital between December 2016 and may 2017 were examined. Life expectancy, mortality rates, factors affecting mortality, and costs per patient were evaluated according to the palliative prognostic index (PPI) and palliative care admission score (PCAS) of the patients. Results: Exitus patients had an average of 13.83 days of intensive care stay and patients who survived had a mean 30.69 days (p

Objective: Organ donation (OD) still cannot reach the desired level in our country. A new form of OD is being implemented in the world. OD can be performed with family consent from patients with circulatory death (CD). This study was conducted to measure the attitudes and knowledge levels of Turkish physicians about organ donation after circulatory death (DCD). Materials and Methods: Three-part survey questions were sent to specialist physicians via e-mail. In the first part, their sociodemographic characteristics, in the second part their attitudes and behaviors about OD, and in the third part, their knowledge levels about DCD were measured. Results: 51.9% of the 258 participants were female and 48.1% were male. 52.3% specialized in surgery, 47.7% specialized in internal medicine. 39.1% were working in the intensive care unit, 25.9% were working in the emergency room, and 21.3% were working in the operating room. All physicians agreed on the importance of OD. Although OD rates were low, this rate was found to be significantly higher in surgical branches compared with internal branches (p=0.02). Most organ donors shared this situation with their families (respectively, surgical physicians 83.3%, internal physicians 66.6%). The percentage of surgical branches receiving education on brain death or organ transplantation was high. However, the definition of DCD in both groups was little known (2.9%, 0.8%, respectively). When their knowledge levels were examined, only five questions (these were propositions about OD and donor care) were higher for the surgical physicians to answer correctly. Theoretical knowledge propositions about CD were answered incorrectly in both groups. Conclusion: To increase the awareness of Turkish physicians about DCD, which has been known since 1995, there is a need for new research and medical education to include current issues. Therefore, as soon as the legislation is enacted in our country, the number of ODs will increase.

Objective: Patients in pediatric intensive care units are more likely to develop serious nosocomial infections due to comorbidities, longer and more invasive procedural treatments, and the development of immunosuppression. We described Candida infections, management, morbidity and mortality in critically ill pediatric patients. Materials and Methods: A retrospective single-center study includes patients aged 1 month-18 years treated against candidemia from January to December 2021. This included those who had blood cultures of Candida species growth. We excluded patients with infection Candida in endotracheal aspiration and/or urinary specimens, etc. The demographic characteristics, medical histories, comorbidities, length of stay, need for mechanical ventilation supports, laboratories, relationship use of catheters and total parenteral nutrition, treatment periods, antifungal response/resistance, duration of treatment and adverse effects, morbidities/mortalities. Results: In this study, the total mortality rate was 40.7%, and the mortality rate due to candidemia was detected at 44.4%, but the correlation between candidemia and mortality was not significant (p=0.975). However, 18.5% of them are caused by nosocomial. The mortality risk did not change for subtypes (p=0.975). No significant correlation was found when mortality (p=0.07) and central venous catheter infection (p=0.563) were compared using total parenteral nutrition. Conclusion: In our study, in which 27 patients were followed up for nosocomial candidemia, the rate of candidemia was found to be higher in patients with comorbidity, long-term mechanical ventilation support, central venous catheter use, long hospital stay, parenteral nutritional support, and high Pediatric Risk of Mortality III score. C. parapsilosis was detected most frequently in our Candida subtype unit with a rate of 59.3%. The fluconazole 8 (29.6%), amphotericin B 18 (66.7%) and voriconazole 1 (3.7%) patients were initiated. At this treatment time, only 4 (14.8%) patients developed organ failure. In our study, we detected a total mortality rate of 40.7%. However, 18.5% of them were caused by nosocomial candidemia. Considering all these reasons, we believe that our risk factors, diagnosis, treatment, follow-up, and management process will contribute to the literature.

Objective: This study was conducted to investigate the relationships between workload perception and the work-life balance of intensive care nurses working during the pandemic. Materials and Methods: Descriptive and cross-sectional research was conducted with 325 intensive care nurses who were members of the Turkish Intensive Care Nurses Association. Data were collected via WhatsApp using Google Surveys for a Nurse Information form, the Individual Workload Perception scale, and the Work-Life Balance scale. Pearson’s correlation and regression analyses were used for the data analysis in addition to descriptive statistics. Results: The total average score of the Personal Workload Scale of the intensive care nurses was 3.26±0.60 [minimum (min): 1.71; maximum (max): 4.87] and the total average score of the Work-life Balance scale was 2.79±0.710 (min: 1.3; max: 4.9). The Workload scale total average score significantly increased the Work-life Balance total average score (β=0.658). Daily work time in the intensive care unit significantly decreased the work-life balance total average score (β=-0.160). Conclusion: Intensive care nurses’ workload perception and work-life balance were at a moderate level. Workload and long working hours deteriorate the work-life balance of intensive care nurses. Administrative and organizational regulations to enhance the work-life balance of the intensive care nurses by decreasing the workload can be effective in reaching the desired patient care results.

Objective: Management of the intensive care process by family caregivers and high levels of hope may have positive effects on the recovery process of the intensive care unit (ICU) patients. This study analyzes the relationship between the levels of hope and anxiety in family caregivers of patients in ICUs. Materials and Methods: Family caregivers of the patients, who were hospitalized at seven adult ICUs in city İstanbul, constituted the universe of the study. A sample of the study comprised 99 voluntary family caregivers. Descriptive and sociodemographic Information form, the Dispositional Hope scale, and State-Trait Anxiety scale were used for data collection. One-Way analysis of variance, independent sample t-test, and Pearson’s correlation was used for data analysis. Results: In the study, the hope levels of the participants were found to be “high” and their anxiety levels were found to be “moderate.” Patients’ age, and the family caregivers’ marital status, and levels of education and income did not affect the levels of hope and anxiety. However, age, the changes in family relations and life at home, and being sufficiently informed about the patient’s condition influenced the levels of anxiety and hope in family caregivers. Conclusion: There was a negative relationship between the levels of hope and anxiety in family caregivers of the adult ICU patients.

Objective: This study investigated the association between coronaphobia, job satisfaction, and languishing levels in intensive care nurses. Materials and Methods: This cross-sectional and correlational study was conducted with 106 intensive care nurses. The coronavirus disease-2019 phobia scale, Mental Health Continuum-Short form, and Nurse Job Satisfaction scale were used for data collection. Results: The total score of coronaphobia was 49.41±12.39, 36.57±13.60 for the mental health continuum, and 94.28±12.82 for nurse job satisfaction. There was a weak correlation between coronaphobia and emotional well-being. There was no relationship between coronaphobia and nurse job satisfaction. However, there was a moderate positive relationship between the mental health continuum and nurse job satisfaction. Conclusion: Intensive care nurses had a moderate mental health continuum in languishing. Psychosocial support and psychological counseling should be provided to intensive care nurses to eliminate feelings of emptiness, improve their concentration and motivation, and increase their working capacity.

Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy.

Published data suggest that encephalitis is one of the most fatal neurologic manifestations of coronavirus disease-2019 (COVID-19) involving both adult and pediatric patients. Herpes simplex virus (HSV) encephalitis is one of the most common causes of sporadic encephalitis. There have been cases of systemic and pulmonary reactivation of HSV due to immune dysregulation following COVID-19 infection. An 88-year-old woman diagnosed with Alzheimers disease was admitted to the intensive care unit (ICU) with fever and general condition disorder. On admission, the patient with fever and neck stiffness was found to be positive for HSV DNA in the cerebrospinal fluid (CSF) sample studied with lumbar puncture (LP) and positive for COVID polymerase chain reaction (PCR) in the nasopharyngeal swab sample taken together. While the COVID PCR test was positive in the CSF sample studied with LP performed on the 9th day of intensive care hospitalization, HSV DNA was found to be negative in the patient whose acyclovir treatment was continued. The COVID PCR test was also positive in the nasopharyngeal swab sample taken at the same time. Cardiac arrest occurred after sudden desaturation, and the patient was resuscitated for 6 min on the 11th day of ICU admission. Left frontotemporal epileptic activity in bedside electroencephalography was evaluated in favor of focal disorganization. In addition to frontotemporal lobe involvement, which is common in HSV and COVID-19 encephalitis, we want to report the coexistence of these two viruses. We believe that this case report should help professionals remind co-infections of HSV and severe acute respiratory syndrome coronavirus-2 to cure the morbidity appropriately.

Objective: Intensive care subspecialty programs have been opened in many medical faculties and training-research hospitals in our country, and intensivists who have graduated are working in the field. The aim of this study aimed to collect information about the status of intensive care subspecialty education and the working conditions of intensive care specialists working in the field. Materials and Methods: After obtaining the ethics committee approval, three questionnaires for intensive care subspecialty educational staff (ES), research assistants (RA), and graduated specialists (PG) were prepared through the Google Survey and published on social media. In the questionnaires, the status of education and working conditions in the field after graduation were questioned. The descriptive statistics method was used for analysis. Results: The questionnaires were answered by 38 ES, 99 RA, and 46 PG. Fifty-four percent of the ES were between the ages of 51 and 60 and 65.8% were women. Fifty-one percent of ES were working in a university hospital. Forty-seven percent of full-time ES were working in the department of anesthesiology and reanimation subdepartment of intensive care, and the rate of participation of all partner clinics in the program was 86.5%. Twenty-seven (71.1%) of the ES thought that the TUKMOS core training program should be changed. The main specialty of 54.5% of RAs were anesthesiology and reanimation, and 52% of them were studying at a state university. The rate of those who were on duty at the hospital was 87.8%, and the rate of those who described the rotation training as “medium” was 36.5%. Sixty-five percent of the PGs were anesthesiology and reanimation specialists, and 64.4% said that they would like to primarily work in training and research hospitals in terms of efficiency and qualit; 87% of them stated that intensive care specialists should be able to work in any kind of intensive care unit, 69.6% thinks that the education they receive is sufficient. Conclusion: We believe that evaluating and sharing the data of this study may cause positive changes in intensive care subspecialty education and post-graduate working conditions.

The diagnosis of brain death has medical, legal and ethical aspects. While the main determinant is the medical approach of the physician in terms of ethics, legal situations are also effective in the process. Non-harm, beneficence, respect for autonomy and justice are the principles that are widely accepted and form the basis of medical ethics. Understanding these principles is a must in order to talk about the ethics of brain death and organ transplantation. In the process of diagnosis and management of brain death, the physician should convey the process to the relatives of the patients in a clear and understandable language and in accordance with the educational-cultural levels of the relatives of the patients. The fact that the concept of brain death is misunderstood in the society or lack of knowledge creates social ethical problems. Special training should be given to health professionals for brain death awareness and early diagnosis, and their ability to resolve ethical problems should be strengthened. Human resources are of great importance in the diagnosis of brain death and in the process of organ transplantation from a cadaver. Communication skills are the mainstay of interaction within the clinic. Organ transplant coordinators should run the process smoothly by creating a bridge between the physician responsible for the case and the intensive care physicians. Such an approach will reduce ethical issues and ensure a successful diagnosis and donation process.

After brain death, a family interview is required to discuss organ donation requests and procedures with the donor’s relatives. This interview process requires knowledge, communication skills and experience for the interviewers. Effective and sincere communication is the main key to a successful family interview. A family interview should be planned and a method with certain characteristics should be followed and it should be pre-structured and include a conscious dynamism regarding the content and direction of the interview and the possibility of organ donation.

The basis for the diagnosis of brain death (BD) is defined for the detection of a clinical condition with minimal criteria. The patient’s current condition or the presence of organ support treatments for efforts to keep the patient alive in this process may cause difficulties to brain death diagnose for clinicians. In this article, information on processes in special conditions such as extracorporeal membrane oxygenation support, pregnancy, and hypernatremia during the diagnosis of BD is shared.

Donor care consists of the treatments applied to patients diagnosed with brain death in the intensive care unit. After the diagnosis of brain death and during the procedures of organ donation, appropriate donor care with a multidisciplinary approach is critical in increasing the success of transplantation.With donor care, hemodynamic, hormonal and inflammatory disorders caused by brain death should be prevented or corrected. The main purposes should be minimizing donor loss during the care, healing of initially medically unsuitable organs, increasing the number of organs retrieved and increasing the number of the good results.

Ancillary tests are the tests those help to confirm the clinical diagnosis of brain death. These tests are in 2 groups as electrophysiological and tests for the evaluation of cerebral blood circulation. They indicate the absence of cerebral blood circulation and brain electrical activity. They should not replace clinical evaluation.

Brain death is death according to neurological criteria and is defined as the complete and permanent loss of all functions of the brain, including those of the brain stem, expressed as an unresponsive coma with loss of brain stem reflexes. Making this diagnosis both prevents the intensive care beds from being occupied in vain and is important in terms of being a donor in organ transplantation. Although there are differences between countries in the diagnosis of brain death, the prerequisites for the diagnosis should be carefully evaluated.

Acute kidney injury (AKI) is one of the important complications of the perioperative period, and associated with increased risk of chronic kidney disease, renal replacement therapy requirements, increased cost, and risk of mortality. In this overview, we summarized baseline confounders and surgical procedure related risk factors contributing to the perioperative AKI, which may serve as risk scores, improve early diagnosis, contribute to prevention, and early management of AKI. There are immediate needs for context specific clinical prediction scores and novel biomarkers to very early diagnose AKI. Preventive guidance provided by Kidney Disease: Improving Global Outcomes is a helpful practical tool for clinicians. Potential roles of novel biomarkers and their context specific contributions require further exploration and close attention. Perioperative hemodynamics and oxygenation appear to contribute to AKI. Therefore, while their optimization can be recommended, their detailed and context specific roles need further explored. Overall, decreased exposure to nephrotoxic agents is recommended to further decrease the impact of perioperative AKI.

Objective:This methodological study was conducted in order to carry out the adaptation and validation of the “PRE-DELIRIC score” prediction of delirium model in Türkiye among patients hospitalized in the intensive care unit (ICU).Materials and Methods:The research involved 172 patients treated in the intensive care units of a training and research hospital between October 2019 and April 2020. The study data were collected using (1) a data collection form to determine the participants’ descriptive characteristics, (2) the PRE-DELIRIC score, and (3) the Confusion Assessment Method for the ICU (CAM-ICU). Receiver operating characteristic (ROC) analysis and diagnostic screening tests were applied for the purpose of determining cut-off points for the groups. The scores’ sensitivity and specificity were calculated. Significance was evaluated at the p

Objective:Nurses are at the forefront of the fight against the pandemic. This study was conducted to reveal the experiences, problems, motivation and support resources of intensive care nurses in the first period of the coronavirus disease-2019 (COVID-19) pandemic.Materials and Methods:The research is a descriptive qualitative study. The sample of the study consisted of 12 intensive care nurses working in the intensive care unit of a state hospital in İzmir and caring for patients infected with COVID-19 virus.Results:Main themes (sub-themes); emotions (worry/anxiety), difficulties in patient care (aspiration, intubation), measures taken by nurses (internal isolation), effects of the pandemic on intensive care nurses (physical; back pain, psychological; sleep problems, social; exclusion), support and motivation sources of nurses (teammates support), positive contributions of the pandemic process (crisis management).Conclusion:Intensive care nurses experienced physical, psychological and social problems during the pandemic period. In this process, it was determined that they tried to strengthen with support resources and gained skills in crisis management.

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF, supportive care is essential for management. Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. This report aims to present the use of coupled plasma filtration and adsorption (CPFA) in CCHF patients. We performed CPFA on three patients with CCHF, all of which were confirmed with polymerase chain reaction. A 35-year-old female was admitted one week after tick-exposure. Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation (DIC). After CFPA, her clinic situation and laboratory results improved. A 54-year-old female was admitted to the intensive care unit due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC, we started CPFA. Patient didn’t respond to the treatment and died. A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease. Next day, patient developed alveolar hemorrhage and his liver enzymes, coagulation parameters deteriorated. We performed CFPA, however, the patient didn’t respond to treatment and died. We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients. Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity. CPFA may be an option to treat severe CCHF infection with cytokine storm. However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality.

Objective:Comparing high-flow oxygen (HFO) and non-invasive ventilation (NIV) treatment methods applied to patients hospitalized in the coronavirus disease-2019 (COVID-19) service outside the intensive care unit.Materials and Methods:Demographic characteristics, duration of hospitalization and application times, acute phase reactants, ROX index, comorbid conditions, radiological scores and results were evaluated retrospectively in patients treated with HFO (n=26) and NIV (n=23) who were hospitalized in the COVID service outside the intensive care unit of the state hospital between November 2020 and June 2021.Results:A total of 49 patients, 27 males and 22 females, were included in the study. The mean age was 55.6±14.6 years. The most common comorbidities were hypertension (n=27), diabetes (n=15). Patients in the HFO group were hospitalized for 16.6±9.4 days, HFO was applied for 6±4.6 days. Patients in the NIV group were hospitalized for 9.4±6.4 days, NIV was applied for 5.8±4.2 days. The saturation of the patients who were administered HFO (84.1±4.6) were found to be lower than those who received NIV (88.7±2). It was determined that 18.37% of 49 patients e.g. 5 of whom were treated with HFO and 4 of them were those who received NIV treatment. The ROX index was found to be significantly lower in the death group (n=9) compared to the survivors (n=40). In radiological imaging, there was no significant difference in the severity of pneumonia in patients treated with HFO and NIV. Lactate dehydrogenase and C-reactive protein from acute phase reactants at the time of hospitalization were significantly higher in the group who ex.Conclusion:It was determined that HFO or NIV was not different in terms of mortality in thr non-intensive care COVID service.