Search

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. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Hellp sendromu karaciğer enzimlerinde artış, tromositopeni, hemolitik anemiyle seyreden, ağır preeklampsili gebeliklerin %10- 20’sinde görülebilen, maternal ve perinatal mortaliteye sebep olabilen ciddi bir hastalıktır. Hastalarda karaciğer enfarktı, hematomu, batın içi kanama, intrakraniyal kanama, plevral effüzyon, renal yetmezlik ve nadir de olsa perikardiyal tamponad tablosu gelişebilmektedir. Biz 26 haftalık gebeliği şiddetli preeklampsi sebebiyle ölü doğumla sonuçlanan, Hellp sendromuyla yoğun bakım ünitesinde takibimiz sırasında perikardiyal tamponad tanısı koyduğumuz hastayı sunmayı amaçladık. Olgu: Mide bulantısı, kusma, baş ağrısı, el ve ayaklarda ödem, vajinal kanama şikayeti olan 24 yaşında 26 haftalık gebe şiddetli preeklampsiye bağlı olarak eks fetus abortu sonrası Hellp sendromu tanısıyla yoğun bakım ünitemize alındı (Hb: 8,2 hct: 25,1 Plt: 39 bin AST: 352 ALT: 436 fibrinojen: 340 mg/dL). Sıvı kısıtlaması, force diürez uygulanan hastanın tansiyon regülasyonu sağlandı, trombosit defisiti replase edildi. Yatışının 6. saatinde batıcı göğüs ağrısı tarifleyen hastanın akciğer grafisinde KTİ >0,5, bilateral kostadiafragmatik sinüslerinde silinme, EKG’de sinüs taşikardisi, elektriksel alternans saptanması üzerine acil kardiyoloji konsültasyonu istendi. Ekokardiyografide perikardiyal tamponad tespit edildi, anjiyo ünitesine alınıp perkütan perikardiyosentez uygulandı ve 950 cc seröz mayi drene edildi. Light kriterleri açısından incelendi. Eksüda vasfındaki sıvının mikrobiyolojik örneklemesinde üreme olmadı. Hastanın 48 saat sonra yapılan kontrol ekokardiyografisinde effüzyon saptanmadı. Transaminazları gerileyen, trombositopeni tablosu düzelen hasta yatışının 3. günü kadın doğum kliniğine devredildi. Ancak serviste 2 gün sonra ani gelişen hipotansiyon sebebiyle ekokardiyografik incelemesi yapılan hastada perikadial effüzyonun arttığı, tamponad tablosunun tekrarladığı görüldü. Hastada perikardiyosentez sırasında kardiyak arrest gelişti. Resusitasyona yanıt alınamayan hasta eks oldu. Sonuç: Perikardiyak tamponad şiddetli preeklampsi ile nadiren birliktelik gösteren, yüksek mortalite ile seyreden bir durumdur. Ani gelişen göğüs ağrısı, dispne, takipne, hipotansiyon durumunda ayırıcı tanıda mutlaka düşünülmelidir. Akciğer grafisinde kardiyomegali, EKG’de sinüs taşikardisi ve alternan ritm tanıyı desteklemekte TTE ile tanı kesinlestirilmektedir. Şiddetli preeklamside tedavi doğum eyleminin gerçekleşmesi olsa da, postoperatif dönemde yakın takip gereklidir. Kardiyak tamponad doğumdan sonra da tekrarlayabilir ve maternal kayba sebep olabilir. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: This study compared the rates of acute respiratory failure, reintubation, length of intensive care stay and mortality in patients in whom the non-invasive mechanical ventilation (NIMV) was applied instead of the routine venturi face mask (VM) application after a successful weaning., Methods: Following the approval of the hospital ethics committee, 62 patients who were under mechanical ventilation for at least 48hours were scheduled for this study. 12 patients were excluded because of the weaning failure during T-tube trial. The patients who had optimum weaning criteria after the T-tube trial of 30minutes were extubated. The patients were kept on VM for 1hour to observe the hemodynamic and respiratory stability. The group of 50 patients who were successful to wean randomly allocated to have either VM (n=25), or NIV (n=25). Systolic arterial pressure (SAP), heart rate (HR), respiratory rate (RR), PaO 2 , PCO 2 , and pH values were recorded., Results: The number of patients who developed respiratory failure in the NIV group was significantly less than VM group of patients (3 reintubation vs. 14 NIV+5 reintubation in the VM group). The length of stay in the ICU was also significantly shorter in NIV group (5.2±4.9 vs. 16.7±7.7 days)., Conclusions: The ratio of the respiratory failure and the length of stay in the ICU were lower when non-invasive mechanical ventilation was used after extubation even if the patient is regarded as "successfully weaned". We recommend the use of NIMV in such patients to avoid unexpected ventilator failure., (Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)