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Objective:Intensive care unit (ICU) readmission is a common and unwanted situation. Mortality rates, length of stay in ICU and treatment expenses are also higher in readmitted patients. This study aimed to examine the hospital/ICU readmission rates and risk factors among patients discharged from the ICU.Materials and Methods:Patients older than 18 years who were hospitalised in the ICU between January 1, 2012 and October 31, 2016 and were re-admitted to the hospital/ICU within 30 days after discharge were retrospectively analysed.Results:A total of 510 patients met the inclusion criteria, of whom 91 (17.84%) patients were readmitted to the ICU. The average age was higher (p=0.002) among the readmitted patients. The acute physiology and chronic health evaluation-II and sequential organ failure assessment scores at admission and discharge, stability and workload index for transfer (SWIFT) scores at discharge and comorbid disease rates were higher among readmitted patients (p

Tricyclic antidepressant intoxication is frequently encountered among children and adults due to widespread use of the drugs. Amitriptyline is among the major tricyclic antidepressants. It affects the cardiovascular, respiratory and central nervous system. In the treatment of amitriptyline intoxication, various treatments such as gastric lavage, activated charcoal, bicarbonate infusion, antiarrhythmic, and anticonvulsant drug usage were applied. Here, we reported a patient with severe amitriptyline intoxication who did not respond to these treatments but dramatically improved with hemoperfusion. A 33 year-old woman applied to the emergency service half an hour later ingesting 2000 mg of amitriptyline as a suicide attempt. On admission, her Glasgow coma scale (GCS) was 10, blood pressure was 100/60 mmHg, heart rate was 160 beats/min. Wide QRS and ventricular tachycardia was seen in the Electrocardiography (ECG) results. Having her GCS regressed to 7, she was intubated and admitted to intensive care unit after the initial treatments. Hemoperfusion was commenced within half an hour. While hemoperfusion was continuing, her ECG was seen to turn to sinus tachycardia. Her cardiovascular and neurological status returned to normal on the 2nd day and she was discharged from the intensive care unit on the 4th day. Besides hemoperfusion is not recommended due to high protein binding and large volume of distribution in classical treatment of amitriptyline overdose, current reports representing efficacy of hemoperfusion are also accumulating. After ingestion, tricyclic antidepressants are absorbed rapidly and reach to their effective concentration in the tissues, especially by the lung, the brain and the heart. Hence, hemoperfusion performed in early stage of ingestion is an effective treatment and in cases that do not respond to conventional therapies, it should be considered that this method can be used in the early period.

Delirium is an acute organic brain syndrome of different physical and pathophysiological etiologies characterized by a disturbance in consciousness with accompanying change in cognition. Delirium causes prolonged length of stay in hospital and intensive care unit, also increased morbidity and mortality. Thyroid storm is a severe, life-threatening type of thyrotoxicosis and is one of a few endocrine disorders that cause delirium. It is mostly occured suddenly after acute infection, surgical stress or trauma. This condition occurs due to excess production of thyroid hormone and 20-50% mortality rate depends on early diagnosis and treatment. In this study it was aimed to present the diagnosis and treatment of a previously unknown hyperthyroid patient who underwent suspension laryngoscopy under general anesthesia and was post-operatively admitted to the intensive care unit because of pulmonary edema and proceeded to develop severe delirium caused by hyrotoxicosis.

Objective: Anemia is very common problem in critically ill patients, and it has many deleterious effects of morbidity and mortality, decreased in oxygen carrying capacity. Phlebotomy is an important factor contributing to anemia and the need for transfusion. We aimed to evaluate the volumes of blood drawn for laboratory tests from critically ill patients, and effect on anemia and transfusion practices. Materials and Methods: The study was conducted on 60 critically ill patients. Data were recorded daily including volume of the withdrawn blood, hemoglobin (Hb), indication for transfusion, and number of units transfused. Acute Physiology and Chronic Health Evaluation (APACHE) II ve Sequential Organ Failure Assessment (SOFA) scores, the length of stay (LOS) in the intensive care unit (ICU). Results: Thirty six of the patients (60%) that transfused had significantly higher admitting APACHE II and SOFA scores (p