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Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world., Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure., Study Design: Retrospective, observational cohort., Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded., Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2/FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050)., Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.

Background/aims: When conservative methods fail, neostigmine is recommended in the pharmacological treatment of acute colonic pseudo-obstruction (ACPO). The objective of this study was to analyze the response of patients to different neostigmine protocols., Materials and Methods: Patients diagnosed with ACPO in the intensive care unit between January 2015 and September 2017 were retrospectively studied. Either of the two neostigmine protocols, the bolus dose (BD) or continuous infusion (CI), was applied to the ACPO patients who were unresponsive to conservative treatments, and the results were analyzed., Results: In 79 of 122 (64%) patients, the resolution of symptoms was observed with conservative treatments. Of 43 patients who did not respond to conservative treatments, 20 were applied neostigmine as BD, and 23 were applied by CI. A total of 55% of patients in the BD group and 60.9% patients in the CI group responded to neostigmine therapy after the first dose. The group-specific protocols were reapplied in patients unresponsive to the first dose. A total of 25% in the BD group and 8.7% in the CI group responded to the second dose treatment. As a result, 80% of patients from the BD group and 69.6% from the CI group responded to neostigmine therapy. Although an overall response rate was higher in the BD group, there was no significant difference between groups (P=0.322). Colonic complications were observed in 2 patients, 1 from each group. There were no major side effects requiring treatment cessation., Conclusion: The safety and effectiveness of both neostigmine protocols applied to ACPO patients were similar. Clinical and radiological responses were obtained without serious side effects with CI.

Objectives: We aimed to compare the effects of ketamine and tramadol administered intraoperatively on postoperative pain and analgesic demand in children undergoing tonsillectomy operations., Methods: Ninety children undergoing tonsillectomy, aging 5-15 years old, with ASA I - II , were included in this study. Cases were arranged in three groups and given standardized general anesthesia. After coagulation, ketamine (0.5 mg.kg-1) was administered intravenously (iv) in the ketamine group, and tramadol iv (2 mg.kg-1) was given in the tramadol group and the control group received a physiologic iv. The duration of anesthesia, duration of operation, and length of stay in the PACU were recorded. NRS and CHEOPS scales were used to assess postoperative pain. Paracetamol (15 mg.kg-1) was given rectally in the first 6 hours (hrs) and orally over the subsequent 6 hrs, if NRS greater than 3 and CHEOPS greater than 8 were observed. All data were recorded concerning the initial and total dosage of analgesic and the presence of complications within 24 hrs., Results: Demographic data, duration of anesthesia, duration of operation, and duration of stay in the PACU were similar between groups (p>0.05). The number of patients requiring additive analgesic was higher in the control group. No differences were found between the tramadol and ketamine groups (p>0.05). Additional analgesic was given earlier in the control group (p<0.05), but the need for additional analgesic was similar in tramadol and ketamine groups (p>0.05). Paracetamol dosage was significantly higher in the control group (p<0.05), but similar between the tramadol and ketamine groups (p>0.05). The frequency of nausea and vomiting was found to be significantly higher in tramadol and ketamine groups compared to the control group (p<0.05)., Conclusion: Postoperative pain was effectively managed using 2 mg.kg-1 tramadol and 0.5 mg.kg-1 ketamine in pediatric tonsillectomies.