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1. A case of severe babesiosis treated successfully with exchange transfusion

Author

Esra Tanyel, Nil Guler, Murat Hokelek, Fatma Ulger, and Mustafa Sunbul

Subjects
Babesia divergens, Severe babesiosis, Treatment, Exchange transfusion, Infectious and parasitic diseases, RC109-216
Abstract

Babesiosis is a zoonotic disease that may be asymptomatic or result in severe clinical conditions, with severe hemolysis, hepatic, and renal failure, in humans. Clinical symptoms depend on the species and immune status of the host. The disease is especially severe in those of advanced age, those with an immune deficiency, and the splenectomized. A severe case of babesiosis that developed in a splenectomy patient is presented here; the patient was admitted from a rural region with severe anemia and a deterioration in her general condition, with an initial diagnosis of malaria. In such situations, an exchange transfusion (ET), in addition to antimicrobial treatment, could be lifesaving.

Published
2015
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2. Red blood cell transfusion and hemoglobin level on neurological outcome in the first 24 hours of traumatic brain injury

Author

Ozgür Komurcu, Burhan Dost, Emine Ozdemir, Mustafa Aras, and Fatma Ulger

Subjects
Hemoglobins, Intensive Care Units, Brain Injuries, Traumatic, Emergency Medicine, Humans, General Medicine, Erythrocyte Transfusion, Retrospective Studies
Abstract

Target hemoglobin (Hb) level is not clearly determined in patients followed up in the intensive care unit (ICU) for traumatic brain injury (TBI). This study aims to investigate the impact of red blood cell (RBC) transfusion and Hb level on the neurological outcome in the first 24 h in patients with TBI.In this retrospective study, we reviewed the 2-year organizational database. We evaluated data from patients who underwent RBC transfusion and whose Hb values were 7-9 g/dL and9 g/dL in the first 24 h. We considered that a Glasgow Outcome Score (GOS) of 1-3 at the time of discharge from the ICU was a poor neurological outcome (PO) and that a GOS3 was a good neurological outcome (GO).A total of 147 patients were included in the study 28.6% of whom were discharged from the intensive care unit with PO. The Hb (g/dL) values of PO patients in the first 24 h were lower compared to those of GO patients (median [interquartile range]; 9.2 [2.5] vs 11 [3.4], p0.01). RBC transfusion of PO patients in the first 24 h was also less compared to that of GO patients (median [interquartile range]; 15 [35.7] vs. 19 [18.1], p = 0.038). In logistic regression analyses, neither RBC transfusion (OR [95%CI]; 0.786 (0.108-5.740), p = 0.81) nor Hb level (OR [95% CI]; 0.50 (0.057-4.362), p = 0.53) was an independent risk factor for PO.In patients followed up in the ICU due to TBI, RBC transfusion and Hb values in the first 24 h are not associated with PO at the time of discharge from the ICU.

Published
2022

3. Neuromuscular Electrical Stimulator as a Protective Treatment against Intensive Care Unit Muscle Wasting in Sepsis/Septic Shock Patients

Author

Gunes Comba, Cebeci, Halil, Cebeci, Mehtap Pehlivanlar, Kucuk, Ahmet Oguzhan, Kucuk, Ilkay Koray, Bayrak, and Fatma, Ulger

Subjects
Intensive Care Units, Muscles, Sepsis, Humans, Prospective Studies, Shock, Septic
Abstract

To investigate the efficacy of neuromuscular electrical stimulation (NMES) application in preventing muscle wasting in intensive care unit (ICU) patients diagnosed with sepsis/septic shock.A single-centre, unblinded, parallel-group, prospective, randomised clinical study.Ondokuz Mayıs University, Faculty of Medicine Hospital, Level 3 ICU, between October 28th 2018, and October 1st, 2020.Eighty patients from a single centre who were diagnosed with sepsis/septic shock, followed up at level 3 ICU, and met the criteria were included. The patients were evaluated in 2 groups: One who received physiotherapy alone (n=40) and the other who received physiotherapy + NMES (n=40). The development of intensive care unit-muscle wasting was evaluated in patients of both groups. Muscle wasting was identified by anthropometric and ultrasonographic measurements. The day the patients were diagnosed with sepsis was determined as the first day and the bilateral anthropometric and ultrasonographic measurements of the biceps brachii and rectus femoris muscles were obtained on days 3, 7, 14, 21, and 28.There was no significant difference between the groups in the ultrasonographic and anthropometric measurements on days 1, 3, and 7 (p0.005). However, the ultrasonographic measurements of the group that received physiotherapy + NMES demonstrated a significantly lower loss in the upper extremities on days 14 and 21 compared to the group that received physiotherapy alone (p=0.003 and p=0.028, respectively). No significant difference was found in the anthropometric measurements.The NMES, which have been increasingly used as new treatment protocols in the prevention of ICU-AW, yield favourable results in patients with sepsis/septic shock.Intensive care unit, Acquired weakness, Neuromuscular electrical stimulation, Muscle wasting, Sepsis.

Published
2022

4. The Effect of Fluid Challenge Test on Optic Nerve Sheath Diameter

Author

Ozgur, Komurcu, Burhan, Dost, Neslihan Unal, Akdemir, and Fatma, Ulger

Subjects
Intracranial Pressure, Turkey, Humans, Optic Nerve, Intracranial Hypertension, Ultrasonography
Abstract

To investigate the effect of the fluid challenge test on the optic nerve sheath diameter (ONSD) change.Quasi-experimental study.Department of Anesthesiology and Reanimation, Ondokuz Mayis University Hospital, Samsun, Turkey, from January to November 2021.A fluid challenge was defined as a 500 mL crystalloid infusion administered over 10 minutes, and fluid responsiveness was defined as a subsequent increase in stroke volume of at least 15% administered to the ICU patients. The ONSD and hemodynamic variables were measured by ultrasonography before (T0), at the end (T1), and 30 min after the fluid challenge (T2). The primary outcome of the study was the change in ONSD measurements associated with the fluid challenge, and the secondary outcome was the relationship between fluid responsiveness and the change in ONSD.A total of 60 patients were included. The ONSD (mm) value was significantly higher at T1 compared to T0 (mean ± standard deviation: 5.12±0.30 mm vs. 5.10±0.32 mm; p=0.011). However, at T2, the ONSD was similar to that at T0 (5.10±0.31 mm vs. 5.10±0.32 mm; p=0.662). The stroke volume (mL) was also significantly higher at T1 and T2 compared to T0 [median IQR 60 (6) mL vs. 60 (4.7) mL vs. 52 (5) mL, respectively, p0.01]. No significant relationship was found between the ONSD and the change in fluid responsiveness (p=0.621).The fluid challenge test increases ONSD and may cause an increase in intracranial pressure.Fluid therapy, Stroke volume, Intracranial pressure, Ultrasonography, Optic nerve sheath diameter.

Published
2022

5. Is intraoperative remifentanil infusion associated with early postoperative hypertension in intracranial tumor surgery?

Author

Ozgur Komurcu, Yavuz Cecen, Mehtap Pehlivanlar, Fatma Ulger, and Binnur Sarihasan

Subjects
General Engineering, General Earth and Planetary Sciences, General Environmental Science
Abstract

Hemodynamic instability may cause serious complications such as intracranial hemorrhage, stroke, and brain edema in the postoperative period in intracranial tumor surgery. This study investigated the relationship between remifentanil infusion used for anesthesia maintenance in intracranial tumor surgery and postoperative early hypertension. Hemodynamic parameters were recorded in the first 24 hours after intracranial tumor surgery in the postoperative intensive care unit. Hypertension rate, causes, and treatment methods of hypertension in our clinic were compared with the literature. The study included 113 patients. In 83 patients (73.4%), hypertension was detected in the first 24-hour period during the intensive care follow-up. The hypertensive attack was controlled with intravenous opioids administered in 69 (83.1%) of 83 patients with hypertension, and with additional intravenous antihypertensive in 14 (16.9%) patients. Analgesia use was higher in hypertensive patients in the first 24 hours postoperatively (83.1% vs. 30%, P

Published
2022
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6. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study

Author

Ary Serpa Neto, Carmen S V Barbas, Fabienne D Simonis, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F V Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Adam Bell, Agreta Gecaj-Gashi, Ahmet Dilek, Ahmet Sukru Denker, Akut Aytulun, Peter Kienbaum, Alastair Rose, Alessandro Bacuzzi, Alexandre Biasi Cavalcanti, Alexandre Chan, Alexandre Molin, Alison Ghosh, Alistair Roy, Amanda Cowton, Amanda Skinner, Amanda Whileman, Amy McInerney, Ana Carolina Peçanha, Andrea Cortegiani, Andrej Sribar, Andrew Bentley, Andrew Corner, Angela Pinder, Anil Hormis, Anna Walker, Barry Dixon, Ben Creagh-Brown, Carlo Alberto Volta, Carlos Munhoz, Carly Brown, Carmen Scott, Caroline Wreybrown, Catherine Plowright, Charlotte Downes, Cheryl Padilla-Harris, Chloe Hughes, Christian Frey, Christian Schlegel, Christine Boyd, Christine Ryan, Christoph Muench, Christopher Smalley, Çiler Zincircioglu, Clair Harris, Claire Kaloo, Claire Matthews, Claire Miller, Claire Pegg, Clare Bullock, Clare Mellis, Claudio Piras, Colette Seasman, Cristina Santos, Daniel Beraldo, Daniel Collins, Daniel Hadfield, Daniel Hull, Daniel Prado, David Pogson, David Rogerson, David Shaw, Davide D'Antini, Dawn Trodd Denise Griffin, Debbie Weller, Deborah Smith, Deborah Wilson, Demet Aydin, Denise Donaldson, Donatella Mestria, Eduardo Di Lauro, Eliane Bernadete Caser, Elisa Seghelini, Emanuel Cirstea, Eoin Young, Erna Alberts, Evren Senturk, Farooq Brohi, Fatma Ulger, Feda Kahveci, Fernando José da Silva Ramos, Frank Van Haren, Güldem Turan, Gabriele Sales, Gayle Clifford, Gilda Cinnella, Giovana Colozza Mecatti, Giuseppe Melchionda, Gulay Eren, Hannah Crowther, Hazel Spencer, Heather Blaylock, Helen Green, Helen Robertson, Helen Rodgers, Helen Talbot, Helen Wong, Helena Barcraft-Barnes, Helga Ceunen, Henrik Reschreiter, Hulya Ulusoy, Huseyin Toman, Iain McCullagh, Ian White, Ingeborg Welters, Ingrid van den Hul, Isabela Ambrósio Gava, Isabelle Reed, Isil Kose, Israel Maia, James Limb, Jan Máca, Jane Adderly, Jane Hunt, Jane Martin, Jane Montgomery, Jane Snell, Jean Salgado, Jenny Ritzema, Jeremy Bewley, Joanne Howe, Johan Decruyenaere, Johanna Mouland, Johanna Stickley, Johannes Mellinghoff, John Criswell, John Knighton, Jonathan Cooper, Jonathan Harrison, Jonathan Paddle, Jose Augusto Santos Pellegrini, Joseph Needleman, Julian Giles, Julie Camsooksai, Julie Furneval, Julie Toms, Karen Burt, Karen Simeson, Karen Williams, Karl Blenk, Kate Turner, Katie Lynch, Katie Sweet, Keith Hugill, Kelly Matthews, Kessia Ruas, Kevin Clarkson, Kobus Preller, Kristen Joyce, Laura Ortiz-Ruiz, Laura Youds, Lee Tbaily, Lisa Barrell, Lisa Grimmer, Lokman Soyoral, Lorenzo Peluso, Lorna Murray, Lotta Niska, Louise Tonks, Lousie Fasting, Luc DeCrop, Luca Brazzi, Lucia Mirabella, Lucy Cooper, Luis Fernando Falcão, Lynn Everett, Malcolm Watters, Mandy Carnahan, Marc Bourgeois, Marcelo Luz Pereira Romano, Marco Botteri, Marcos F Vidal Melo, Maria Faulkner, Marijana Krkusek, Marina Bahl, Mark Holliday, Mark Kol, Mark Pulletz, Marta Kozlowski, Matea Bogdanovic Dvorscak, Matija Jurjevic, Matty Koopmans, Mauricio Morales, Maximilian Schaefer, Melinda Brazier, Meredith Harris, Michael Devile, Michael Kuiper, Michael Parris, Michael Sharman, Milan Kratochvil, Mohamed Ramali, Moreno Calcagnotto dos Santos, Natalie Bynorth, Natalie Wilson, Nathalie Anquez, Nathan Huneke, Nazim Dogan, Nenad Karanovic, Nicholas Tarmey, Nicolás Carreño, Nicola Fisher, Nicola Lamb, Nicola Venner, Nigel Hollister, Nur Akgun, Osman Ekinci, Owen Boyd, Pardeep Gill, Pasquale Raimondo, Pasquale Verrastro, Paul Pulak, Pauline Fitzell, Paulo Dark, Pedro Alzugaray, Perihan Ergin Özcan, Peter MacNaughton, Petr Stourac, Phil Hopkins, Pieter Roel Tuinman, Rachel Pearson, Rachel Walker, Rafaella Souza dos Santos, Raffaele Caione, Ramprasad Matsa, Rebecca Oliver, Reni Jacob, Richard Howard-Griffin, Robert BP de Wilde, Robert Plant, Robin Hollands, Rodrigo Biondi, Rola Jaafar, Rossana Avendaño, Ruth Salt, Ryan Humphries, Sérgio Felix Pinto, Sallyane Pearson, Sam Hendry, Sandeep Lakhani, Sarah Beavis, Sarah Moreton, Sarah Prudden, Sarah Thornthwaite, Savino Spadaro, Sedat Saylan, Shailaja Chenna, Shammer Gopal, Shanaz James, Sheeba Suresh, Sian Birch, Sonja Skilijic, Stefania Aguirre, Stella Metherell, Stephanie Bell, Stephanie Janes, Stephen Wright, Steve Rose, Steve Windebank, Sue Glenn, Susan Melbourne, Susan Tyson, Susannah Leaver, Tasmin Patel, Tatjana Simurina, Terri-Ann Sewell, Tiago Macruz, Tom Hatton, Tracey Evans, Ugur Goktas, Una Poultney, Unase Buyukkocak, Vanessa Linnett, Vanessa Oliveira, Vincenzo Russotto, Vlasta Klaric, Yavuz Orak, Zerrin Demirtürk, Neto, Ary Serpa, Barbas, Carmen S V, Simonis, Fabienne D, Artigas-Raventós, Antonio, Canet, Jaume, Determann, Rogier M, Anstey, Jame, Hedenstierna, Goran, Hemmes, Sabrine N T, Hermans, Greet, Hiesmayr, Michael, Hollmann, Markus W, Jaber, Samir, Martin-Loeches, Ignacio, Mills, Gary H, Pearse, Rupert M, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Smith, Roger, Treschan, Tanja A, Tschernko, Edda M, Melo, Marcos F V, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J, Bell A, Gecaj-Gashi A, Dilek A, Denker AS, Aytulun A, Kienbaum P, Rose A, Bacuzzi A, Cavalcanti AB, Chan A, Molin A, Ghosh A, Roy A, Cowton A, Skinner A, Whileman A, McInerney A, Peçanha AC, Cortegiani A, Sribar A, Bentley A, Corner A, Pinder A, Hormis A, Walker A, Artigas-Raventós A, Neto AS, Dixon B, Creagh-Brown B, Volta CA, Munhoz C, Brown C, Barbas CSV, Scott C, Wreybrown C, Plowright C, Downes C, Padilla-Harris C, Hughes C, Frey C, Putensen C, Schlegel C, Boyd C, Ryan C, Muench C, Smalley C, Zincircioglu Ç, Harris C, Kaloo C, Matthews C, Miller C, Pegg C, Bullock C, Mellis C, Piras C, Seasman C, Santos C, Beraldo D, Collins D, Hadfield D, Hull D, Prado D, Pogson D, Rogerson D, Shaw D, D'Antini D, Griffin DTD, Weller D, Smith D, Wilson D, Aydin D, Donaldson D, Mestria D, Tschernko EM, Lauro ED, Caser EB, Seghelini E, Cirstea E, Young E, Alberts E, Senturk E, Simonis FD, Brohi F, Ulger F, Kahveci F, da Silva Ramos FJ, Van Haren F, Turan G, Sales G, Mills GH, Mills GH, Clifford G, Cinnella G, Mecatti GC, Melchionda G, Hedenstierna G, Hermans G, Hermans G, Eren G, Crowther H, Spencer H, Blaylock H, Green H, Robertson H, Rodgers H, Talbot H, Wong H, Barcraft-Barnes H, Ceunen H, Reschreiter H, Wrigge H, Wrigge H, Ulusoy H, Toman H, McCullagh I, White I, Martin-Loeches I, Welters I, van den Hul I, Gava IA, Reed I, Kose I, Maia I, Limb J, Máca J, Adderly J, Hunt J, Martin J, Montgomery J, Snell J, Canet J, Salgado J, Ritzema J, Bewley J, Howe J, Decruyenaere J, Mouland J, Stickley J, Mellinghoff J, Criswell J, Knighton J, Cooper J, Harrison J, Paddle J, Pellegrini JAS, Needleman J, Giles J, Camsooksai J, Furneval J, Toms J, Burt K, Simeson K, Williams K, Blenk K, Turner K, Lynch K, Sweet K, Hugill K, Matthews K, Ruas K, Clarkson K, Preller K, Joyce K, Ortiz-Ruiz L, Youds L, Tbaily L, Barrell L, Grimmer L, Soyoral L, Peluso L, Murray L, Niska L, Tonks L, Fasting L, DeCrop L, Brazzi L, Mirabella L, Cooper L, Falcão LF, Everett L, Watters M, Carnahan M, Bourgeois M, Abreu MG, Romano MLP, Botteri M, Melo MFV, Melo MFV, Schultz MJ, Schultz MJ, Faulkner M, Krkusek M, Bahl M, Holliday M, Kol M, Pulletz M, Hollmann MW, Kozlowski M, Dvorscak MB, Jurjevic M, Koopmans M, Morales M, Schaefer M, Brazier M, Harris M, Devile M, Hiesmayr M, Kuiper M, Parris M, Sharman M, Kratochvil M, Ramali M, Dos Santos MC, Bynorth N, Wilson N, Anquez N, Huneke N, Dogan N, Karanovic N, Tarmey N, Carreño N, Fisher N, Lamb N, Venner N, Hollister N, Akgun N, Ekinci O, Boyd O, Pelosi P, Pelosi P, Severgnini P, Severgnini P, Gill P, Raimondo P, Verrastro P, Pulak P, Fitzell P, Dark P, Alzugaray P, Özcan PE, MacNaughton P, Stourac P, Hopkins P, Tuinman PR, Pearson R, Walker R, Santos RSD, Caione R, Matsa R, Oliver R, Jacob R, Howard-Griffin R, Wilde RB, Plant R, Hollands R, Biondi R, Smith R, Smith R, Determann RM, Jaafar R, Avendaño R, Pearse RM, Salt R, Humphries R, Pinto SF, Hemmes SNT, Pearson S, Hendry S, Jaber S, Lakhani S, Beavis S, Moreton S, Prudden S, Thornthwaite S, Spadaro S, Saylan S, Chenna S, Gopal S, James S, Suresh S, Birch S, Skilijic S, Aguirre S, Metherell S, Bell S, Janes S, Wright S, Rose S, Windebank S, Glenn S, Melbourne S, Tyson S, Leaver S, Treschan TA, Treschan TA, Patel T, Simurina T, Sewell TA, Macruz T, Hatton T, Evans T, Goktas U, Poultney U, Buyukkocak U, Linnett V, Oliveira V, Russotto V, Klaric V, Schmid W, Orak Y, Demirtürk Z., Neto, A, Barbas, C, Simonis, F, Artigas-Raventos, A, Canet, J, Determann, R, Anstey, J, Hedenstierna, G, Hemmes, S, Hermans, G, Hiesmayr, M, Hollmann, M, Jaber, S, Martin-Loeches, I, Mills, G, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Smith, R, Treschan, T, Tschernko, E, Melo, M, Wrigge, H, de Abreu, M, Pelosi, P, Schultz, M, Russotto, V, Intensive Care Medicine, Other departments, and Anesthesiology

Subjects
Male, Pediatrics, ARDS, medicine.medical_treatment, law.invention, Positive-Pressure Respiration, 0302 clinical medicine, law, Risk Factors, Prevalence, ventilator–induced lung injury, Prospective Studies, Hospital Mortality, Prospective cohort study, Tidal volume, education.field_of_study, Respiratory Distress Syndrome, Acute respiratory distress syndrome, tidal volume, ARDS, critically ill, ventilation, Middle Aged, Intensive care unit, Intensive Care Units, Critical Illne, Female, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Critical Illness, Population, Intensive Care Unit, Lung injury, mechanical ventilation, NO, 03 medical and health sciences, Intensive care, medicine, Acute respiratory distress syndrome, mechanical ventilation, ventilator–induced lung injury, tidal volume, positive end–expiratory pressure, Humans, MED/41 - ANESTESIOLOGIA, education, Aged, Mechanical ventilation, business.industry, Risk Factor, Respiratory Distress Syndrome, Adult, 030208 emergency & critical care medicine, medicine.disease, Respiration, Artificial, Mechanical ventilation Acute respiratory failure Acute respiratory distress syndrome, Prospective Studie, 030228 respiratory system, Emergency medicine, positive end–expiratory pressure, business
Abstract

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were receiving mechanical ventilation in participating ICUs during a 1-week period between January, 2014, and January, 2015, were enrolled into the study. The Lung Injury Prediction Score (LIPS) was used to stratify risk of ARDS, with a score of 4 or higher defining those at risk of ARDS. The primary outcome was the proportion of patients at risk of ARDS. Secondary outcomes included ventilatory management (including tidal volume [VT] expressed as mL/kg predicted bodyweight [PBW], and positive end-expiratory pressure [PEEP] expressed as cm H2O), development of pulmonary complications, and clinical outcomes. The PRoVENT study is registered at ClinicalTrials.gov, NCT01868321. The study has been completed. Findings Of 3023 patients screened for the study, 935 individuals fulfilled the inclusion criteria. Of these critically ill patients, 282 were at risk of ARDS (30%, 95% CI 27–33), representing 0·14 cases per ICU bed over a 1-week period. VTwas similar for patients at risk and not at risk of ARDS (median 7·6 mL/kg PBW [IQR 6·7–9·1] vs 7·9 mL/kg PBW [6·8–9·1]; p=0·346). PEEP was higher in patients at risk of ARDS compared with those not at risk (median 6·0 cm H2O [IQR 5·0–8·0] vs 5·0 cm H2O [5·0–7·0]; p

Published
2016

7. COVİD-19 Akut Respiratuvar Distres Sendromu Fenotiplerinde Mekanik Ventilasyon

Author

Özgür Kömürcü, Sercan Küllaç, Abdurrahman Yılmaz, and Fatma Ülger

Subjects
covid-19, acute respiratory distress syndrome, mechanical ventilation, phenotype, Medicine, Internal medicine, RC31-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objective: Coronavirus disease-2019 (COVID-19)-related acute respiratory distress syndrome (ARDS) phenotypes in lung compliance have been described in patients with COVID- 19-related ARDS. Our study examined mechanical ventilation support and its results in patients with COVID-19-related ARDS. Materials and Methods: The retrospectively planned study was performed in patients with COVID- 19-associated ARDS who were determined to have three phenotype subgroups based on the calculated static compliance (Cstat) value [type high (H) = Cstat

Published
2022
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8. Mortality in Non-COVID-19 Intensive Care Unit During the Pandemic

Author

Özgür Kömürcü, Müzeyyen Beldağlı, and Fatma Ülger

Subjects
covid-19 pandemic, mortality, intensive care unit, Medicine, Internal medicine, RC31-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objective:The coronavirus disease-2019 (COVID-19) pandemic has had a negative impact on all healthcare services. We investigated how the intensive care mortality rate, an important quality indicator of intensive care units, was affected during the pandemic at our center.Materials and Methods:In a retrospective single-center internal surgery setting with a 20-bed intensive care unit, patients without COVID-19 were admitted. The mortality rates over a 6-month time period pre- and postpandemic were compared.Results:During the pandemic, the mortality rate at our intensive care unit has increased. We also observed that there was a significant relationship between mortality and the indication for admission to the intensive care unit (postsurgical admission, postadmission for medical reasons, and post-traumatic) and the place of admission to the intensive care unit (emergency department, different hospital) (p

Published
2022
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9. The effect of preemptive airway pressure release ventilation on patients with high risk for acute respiratory distress syndrome: a randomized controlled trial

Author

Mehtap Pehlivanlar Küçük, Çağatay Erman Öztürk, Nazan Köylü İlkaya, Ahmet Oğuzhan Küçük, Dursun Fırat Ergül, and Fatma Ülger

Subjects
Acute respiratory distress syndrome, APRV ventilation mode, Bi-level continuous positive airway pressure, intensive care unit, Ventilation modes, Anesthesiology, RD78.3-87.3
Abstract

Background and objectives: The objective of this study was to investigate the use of early APRV mode as a lung protective strategy compared to conventional methods with regard to ARDS development. Methods: The study was designed as a randomized, non-blinded, single-center, superiority trial with two parallel groups and a primary endpoint of ARDS development. Patients under invasive mechanical ventilation who were not diagnosed with ARDS and had Lung Injury Prediction Score greater than 7 were included in the study. The patients were assigned to APRV and P-SIMV + PS mode groups. Results: Patients were treated with P-SIMV+PS or APRV mode; 33 (50.8%) and 32 (49.2%), respectively. The P/F ratio values were higher in the APRV group on day 3 (p = 0.032). The fraction of inspired oxygen value was lower in the APRV group at day 7 (p = 0.011).While 5 of the 33 patients (15.2%) in the P-SIMV+PS group developed ARDS, one out of the 32 patients (3.1%) in the APRV group developed ARDS during follow-up (p = 0.197). The groups didn’t differ in terms of vasopressor/inotrope requirement, successful extubation rates, and/or mortality rates (p = 1.000, p = 0.911, p = 0.705, respectively). Duration of intensive care unit stay was 8 (2–11) days in the APRV group and 13 (8–81) days in the P-SIMV+PS group (p = 0.019). Conclusions: The APRV mode can be used safely in selected groups of surgical and medical patients while preserving spontaneous respiration to a make benefit of its lung-protective effects. In comparison to the conventional mode, it is associated with improved oxygenation, higher mean airway pressures, and shorter intensive care unit stay. However, it does not reduce the sedation requirement, ARDS development, or mortality.

Published
2022
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10. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

Author

Víctor Daniel Rosenthal, Dennis George Maki, Yatin Mehta, Hakan Leblebicioglu, Ziad Ahmed Memish, Haifaa Hassan Al-Mousa, Hanan Balkhy, Bijie Hu, Carlos Alvarez-Moreno, Eduardo Alexandrino Medeiros, Anucha Apisarnthanarak, Lul Raka, Luis E. Cuellar, Altaf Ahmed, Josephine Anne Navoa-Ng, Amani Ali El-Kholy, Souha Sami Kanj, Ider Bat-Erdene, Wieslawa Duszynska, Nguyen Van Truong, Leonardo N. Pazmino, Lucy Chai See-Lum, Rosalia Fernández-Hidalgo, Gabriela Di-Silvestre, Farid Zand, Sona Hlinkova, Vladislav Belskiy, Hussain Al-Rahma, Marco Tulio Luque-Torres, Nesil Bayraktar, Zan Mitrev, Vaidotas Gurskis, Dale Fisher, Ilham Bulos Abu-Khader, Kamal Berechid, Arnaldo Rodríguez-Sánchez, Florin George Horhat, Osiel Requejo-Pino, Nassya Hadjieva, Nejla Ben-Jaballah, Elías García-Mayorca, Luis Kushner-Dávalos, Srdjan Pasic, Luis E. Pedrozo-Ortiz, Eleni Apostolopoulou, Nepomuceno Mejía, May Osman Gamar-Elanbya, Kushlani Jayatilleke, Miriam de Lourdes-Dueñas, Guadalupe Aguirre-Avalos, Diego Marcelo Maurizi, Adriana Montanini, Maria Laura Spadaro, Lorenzo Santiago Marcos, Priscila Botta, Florencia Maria Jerez, Maria Constanza Chavez, Lucia Ramasco, Maria Isabel Colqui, Maria Silvia Olivieri, Ana Silvia Rearte, Gladys Edith Correa, Paola Deolinda Juarez, Paola Fabiana Gallardo, Miriam Patricia Brito, Gabriel Horacio Mendez, Julia Rosa Valdez, Lorena Paola Cardena, Jose Maria Harystoy, Gustavo Jorge Chaparro, Claudia Gabriela Rodriguez, Rodolfo Toomey, Maria Caridi, Monica Viegas, Marisa Liliana Bernan, Adriana Romani, Claudia Beatriz Dominguez, Luis Kushner Davalos, Rosana Richtmann, Camila Almeida Silva, Tatiane T. Rodrigues, Amaury Mielle Filho, Ernandi Dagoberto Seerig Palme, Aline Besen, Caroline Lazzarini, Caroline Batista Cardoso, Francisco Kennedy Azevedo, Ana Paula Fontes Pinheiro, Aparecida Camacho, Braulio Matias De Carvalho, Maria Jose Monteiro De Assis, Ana Paula Vasconcelos Carneiro, Maria Lilian Maciel Canuto, Keyla Harten Pinto Coelho, Tamiris Moreira, Agamenon Alves Oliveira, Marcela Maria Sousa Colares, Marcia Maria De Paula Bessa, Tereza De Jesus Pinheiro Gomes Bandeira, Renata Amaral De Moraes, Danilo Amâncio Campos, Tânia Mara Lima De Barros Araújo, Maria Tereza Freitas Tenório, Simone Amorim, Manuela Amaral, Julianne Da Luz Lima, Lindalva Pino Da Silva Neta, Caphiane Batista, Fabio Jorge De Lima Silva, Maria C. Ferreira De Souza, Katia Arruda Guimaraes, Julia Marcia Maluf Lopes, Karina M. Nogueira Napoles, Lorena Luiza Silva Neto Avelar, Lilian Aguiar Vieira, Luis Gustavo De Oliveira Cardo, Christianne F.V. Takeda, Glaydson A. Ponte, Fco Eduardo Aguiar Leitão, Ricardo De Souza Kuchenbecker, Rodrigo Pires Dos Santos, Erci Maria Onzi Siliprandi, Luiz Fernando Baqueiro Freitas, Ianick Souto Martins, Daiane Casi, Maria Angela Maretti Da Silva, Sergio Blecher, Margarete Villins, Reinaldo Salomao, Solange Regina Oliveira Castro, Daniela V. Da Silva Escudero, Mariana Andrade Oliveira Reis, Marcelo Mendonca, Valter Furlan, Antonio Claudio do Amaral Baruzzi, Tarquino Eristidesg Sanchez, Marina Moreira, Wania Vasconcelos de Freitas, Leonardo Passos de Souza, Velmira Angelova Velinova, Michael M. Petrov, Dimitar Georgiev Karadimov, Emil D. Kostadinov, Violeta Jivkova Dicheva, Chaohua Wang, Xiuqin Guo, Xihua Geng, Shufang Wang, Jinzhi Zhang, Ling Zhu, Shufang Zhuo, Chunli Guo, Tao Lili, Li Ruisheng, Liu Kun, Xuesong Yang, Li Yimin, Mao Pu, Li Changan, Yiang Shumei, Wu Kangxiong, Lin Meiyi, Guxiang Ye, Xu Ziqin, Suo Yao, Song Liqiang, Luis Marino Cañas Giraldo, Elsa Margarita Trujillo Ramirez, Paola Andrea Rios, Juan Carlos Torres Millan, Edwin Giovanny Chapeta Parada, Andres Eduardo Mindiola Rochel, Andres H. Corchuelo Martinez, Ana Marãa Perez Fernandez, Nayide Barahona Guzman, Alfredo Lagares Guzman, Marena Rodriguez Ferrer, Yazmin Leon Vega, Heidi Johanna Munoz, Germán Camacho Moreno, Sandra Liliana Romero Torres, Herlidia Taboada Hernandez, Ismael A. Valderrama MarquezClaudia Linares, Monica Espinosa Valencia, Lusayda Sanchez Corrales, Sandra Milena Bonilla, Jorge Ivan Marin Uribe, David Yepes Gomez, Javier Ospina Martinez, Luz Dary Burgos Florez, Johanna Osorio, Dagoberto Santofimio, Lorena Matta Cortes, Wilmer Villamil-Gomez, Gabriel Munoz Gutierrez, Adela Arguello Ruiz, Carlos Gonzalez Fuentes, Antonio Solano Chinchilla, Ivar Calvo Hernandez, Olber Chavarria Ugalde, Humberto Guanche Garcell, Clara Morales Perez, Selin Bardak, Sumru Ozkan, Nepomuceno Mejia, Adrian M. Puello Guerrero Glenny Mirabal, Margarita Delgado, Ramona Severino, Eliesel Lacerda, Gilda Tolari, María Marcela Bovera, Diego Barahona Pinto, Pedro Fernández González, Gasdali Santacruz, Nelly Alquinga, Celso Zaruma, Nelson Remache, Diego Morocho, Mario Arboleda, Mario Cadena Zapata, Maria Fernanda Garcia, Fabricio Picoita, Jorge Velez, Marcia Valle, Estuardo Salgado Yepez, Diego Morocho Tutillo, Ricardo Arteaga Mora, Andrea Peña Padilla, Mayra Chango, Karina Cabezas, Shirley Tenorio López, Ana Lucía Bonilla Escudero, Gladys Tatiana Sánchez, Hugo Alberto Gonzalez Flores, Islam Abdullorziz Ghazi, Mohamed Hassan, Ghada A. Ismail, Reham Hamed, Mona Mohiedden Abdel-Halim, May Abd El-Fattah, Doaa Abdel-Aziz, Zeinab Salah Seliem, Rasha Hamed Elsherif, Reham Ali Dewdar, Abeer Ahmed Mohmed, Lamiaa Abdel-Fatteh Ahmed, Lilian De Jesus Machuca, Concepcion Bran De Casares, Prokopis Kithreotis, Maria Daganou, Dimitrios Veldekis, Maria Kartsonaki, Achilleas Gikas, Marco Tulio Luque Torres, Denis Padgett, Doris Maribel Rivera, Namita Jaggi, Camilla Rodrigues, Bhagyesh Shah, Keyur Parikh, Jigar Patel, Riya Thakkar, Murali Chakravarthy, B.N. Gokul, R. Sukanya, Leema Pushparaj, Thejas Vini, Sukanya Rangaswamy, Saroj Kumar Patnaik, Vempati Venkateshwar, Biju John, Shamsher Dalal, Suneeta Sahu, Samir Sahu, Banambar Ray, Sudhiranjan Misra, Nisith Mohanty, Biraj Mohan Mishra, Prafulla Sahoo, Naresh Parmar, Sanghamitra Mishra, Basanta Kumar Pati, Santosh Singh, Bhabani Shankar Pati, Aparajita Panda, Swarna Banergee, Dipankar Padhihari, Soumya Samal, Karthikeya Varma, Velu Pandi Suresh Kumar, Ram Gopalakrishnan, Nagarajan Ramakrishnan, Babu Kuruvilla Abraham, Senthilkumar Rajagopal, Ramesh Venkatraman, Ashwin Kumar Mani, Dedeepiya Devaprasad, Lakshmi Ranganathan, Thara Francis, Kotturathu Mammen Cherain, Bala Ramachandran, Ravikumar Krupanandan, S. Muralidharan, Murali Karpagam, Baby Padmini, S. Saranya, Siva Kumar, Nirav Pandya, Rajesh Kakkar, Tenzin Zompa, Narinder Saini, Srinivas Samavedam, Ganshyam Jagathkar, Suhas Nirkhiwale, G.S. Gehlot, Shefali Bhattacharya, Sanjeev Sood, Suman Singh, Sanjeev Singh, Subhash Kumar Todi, Mahuya Bhattacharyya, Arpita Bhakta, Susmita Basu, Anuradha Agarwal, Manoj Agarwal, Mohit Kharbanda, Sankar Sengupta, Anirban Karmakar, Debkishore Gupta, Ajoy Krishna Sarkar, Rimita Dey, Chandramouli Bhattacharya, Mammen Chandy, V.R. Ramanan, Aseem Mahajan, Manas Roy, Sanjay Bhattacharya, Saswati Sinha, Indranil Roy, Umesh Gupta, Sujoy Mukherjee, Mrinmoy Bej, Purnima Mukherjee, Sumana Baidya, Afzal Azim, Asmita Sagar Sakle, Jehangir Soli Sorabjee, Mrunalini Subhash Potdar, Vaibhavi R. Subhedar, F.E. Udwadia, Hena Francis, Arpita Dwivedy, Sheena Binu, Suvin Shetty, Pravin Kumar Nair, Devendra K. Khanna, Felcy Chacko, Seelas Blessymole, Preeti Rajeev Mehta, Tanu Singhal, Sweta Shah, Vatsal Kothari, Reshma Naik, Mayur Harshadrai Patel, Deepesh Gokulchand Aggarwal, Burhanuddin Qutbuddin Jawadwala, Niketa Kaul Pawar, Shoeb Nizamuddin Kardekar, Abizer Nuruddin Manked, S.N. Myatra, J.V. Divatia, R. Kelkar, S.K. Biswas, V. Raut, S. Sampat, Alka Thool, Anil Karlekar, Sumi Nandwani, Sudhir Gupta, Sanjay Singhal, Madhu Gupta, Purva Mathur, Subodh Kumar, Kavita Sandhu, Arnab Dasgupta, Abhijeet Raha, Padmalatha Raman, Ashoo Wadhera, Binesh Badyal, Sarika Juneja, Bikas Mishra, Sunil Sharma, Megha Mehrotra, Jayant Shelgaonkar, Vikram Padbidri, Rohini Dhawale, Sheena Mary Sibin, Dileep Mane, Hanamant Kashinath Sale, Mohammad Mukhit Abdul Gaffar Kazi, Supriya Chabukswar, Anju Mathew, Dipti Gaikwad, Amol Harshe, Gita Nadimpalli, Sunil Bhamare, Soniya Thorat, Omnarayan Sarda, Pattabhiramarao Nadimpalli, Angelina Mendonca, Sujata Malik, Asmita Kamble, Nilakshi Kumari, Sohini Arora, Nita Munshi, Deepa Ganesh Divekar, Maithili Satish Kavathekar, Anuja Kedar Kulkarni, Madhupriya Vijay Suryawanshi, Madhavi Latha Bommala, Anil Bilolikar, Kashmira Limaye Joshi, Charulata Pamnani, Harvinder Wasan, Sonali Khamkar, Leena Steephen, Arjun Rajalakshmi, Anzar Thair, Aisha Mubarak, Swathy Sathish, Suresh Kumar, H. Sunil, Sujith Sujith, null Dinesh, Nagamani Sen, Nitin Shinde, Masoud Alebouyeh, Somayeh Jahani-Sherafat, Mohammad Reza Zali, Mohammad Reza Sarbazi, Nahid Mansouri, Elahe Tajeddin, Maryam Razaghi, Simasadat Seyedjavadi, Marjan Rashidan, Mansoor Masjedi, Behzad Maghsudi, Golnar Sabetian, Anahita Sanaei, Atefeh Yousefipour, Abdullah Mufareh Assiri, Elaine Mari Furukawa-Cinquini, Areej Dhafer Alshehri, Alysia Faye Giani, Nadia Lynette Demaisip, Elizabeth Laungayan Cortez, Analen Fabros Cabato, Jerlie Mae Gonzales Celiz, Ibrahim A.M. Al-Zaydani Asiri, Yassir Khidir Mohammed, Mohammed Abdullah Al Raey, Ali Omer Abdul Aziz, Saeed Ali Al Darani, Misbah Rehman Aziz, Roaa Hasan Basri, Duaa Khalil Al-Awadi, Syed Zahid Bukhari, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Apsia Musa Molano, Hessa Abdullah Al Enizy, Celia Flores Baldonado, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Avigail M. Tan, Sonia Joseph, Deepa Sasidharan Nair, Nabeela Abdullah Al-Abdullah, Grace Sindayen, Annalyn Amor Malificio, Diaa Abdullah Mohammed, Hanan Mesfer Al Ghamdi, Ameurfina Curioso Silo, Marianina Brenda V. Valisto, Nektarios Foteinakis, Sameeh Salem Ghazal, Mercy V. Joseph, Ahmed Hakawi, Antigona Hasani, Ismet Jusufi, Gazmend Spahija, Nehat Baftiu, Agreta Gecaj-Gashi, Nasser Yehia Aly, Mohammad El-Dossoky Noweir, Suga Thomas Varghese, Ruby Jose Ramapurath, Amna Mostafa Mohamed, Sneha Mary George, Anu Kurian, Amani Fouad Sayed, Mona Foda Salama, Abeer Aly Omar, Flavie Maria Rebello, Dennis Malungcot Narciso, Nada Kara Zahreddine, Zeina Kanafani, Tala Kardas, Bassel Molaeb, Lamia Jurdi, Anwar Al Souheil, Mohamad Ftouni, Hasan Ayash, Tahsine Mahfouz, Tomas Kondratas, Dovile Grinkeviciute, Rimantas Kevalas, Greta Gailiene, Algirdas Dagys, Milena Petrovska, Katja Popovska, Zaneta Bogoevska-Miteva, Katerina Jankovska, Snezana Tufekcievska Guroska, Tanja Anguseva, Wan Nurbayah Wan Yusoff, Anis Shiham Zainal Abidin, Chin Seng Gan, Hasimah Zainol, Vineya Rai, Wong Kang Kwong, Mohd Shahnaz Hasan, Sasheela Sri La Sri Ponnampala, Jeyaganesh Veerakumaran, Ojan Assadian, Doan Mai Phuong, Nguyen Gia Binh, Kerinjeet Kaur, Joelene Lim, Lian-Huat Tan, Jegathesan Manikavasagam, Yuet-Meng Cheong, Hilario Coronado Magaña, Julio Cesar Mijangos Méndez, Federico Corona Jiménez, Sergio Esparza-Ahumada, Rayo Morfin-Otero, Eduardo Rodriguez-Noriega, Susana Gutierrez-Martinez, Hector Raul Perez-Gomez, Gerardo León-Garnica, Christian Mendoza-Mujica, Martha Cecilia Culebro Burguet, Jorge Horacio Portillo-Gallo, Fernando Aguilera Almazán, Gaspar Iglesias Miramontes, Maria del Rosario Vázquez Olivas, Lucio Alberto Aguilar Angel, Marisol Sanchez Vargas, Angel Orlando Flores Alvarado, Roberto Carlos Mares Morales, Luis Carlos Fernandez Alvarez, Hector Armando Rincon Leon, Karla Reyna Navarro Fuentes, Yuri Mariela Perez Hernandez, Gabriela Martinez Falcon, Angel Gonzalez Vargas, Marco A. Trujillo Juarez, Antonio Martinez Mulia, Paulina Alma Ulloa Camacho, Martha Y. Martinez-Marroquin, Marco Montell Garcia, Araceli Martinez Martinez, Elena Leon Sanchez, Guadalupe Gomez Flores, Marisela del Rocío González Martínez, Jesús Alfonso Galindo Olmeda, Georgina Olivarez, Enrique Barbachano Rodriguez, María Magdalena Gutierrez Castillo, María Guadalupe Villa González, Isaura Beatriz Sauceda Castañeda, Jaime Martínez Rodriguez, Otgon Baatar, Byambadorj Batkhuu, Kabiri Meryem, Barkat Amina, Rédouane Abouqal, Amine Ali Zeggwagh, Tarek Dendane, Khalid Abidi, Naoufel Madani, Syed Faisal Mahmood, Badaruddin A. Memon, Gul Hassan Bhutto, Nadeem Paul, Azra Parveen, Aun Raza, Amjad Mahboob, Summiya Nizamuddin, Faisal Sultan, Hammad Nazeer, Ashraf Ali Khan, Arifa Hafeez, Lydia Lara, Trudell Mapp, Balkys Alvarez, Magda Ivonne Rojas-Bonilla, Elizabeth Castano, Daisy A. De Moros, Roberto Espinoza Atarama, Maria Elena Calisto Pazos, Alfredo Paucar, Marlene Tasayco Ramos, Jenny Jurado, Dafne Moreno, Marãa E. Cruz Saldarriaga, Eliza Ramirez, Carlos Enrique La Hoz Vergara, Walter Enrique Prudencio Leon, Luis Isidro Castillo Bravo, Katya Fernanda Aibar Yaranga, Janet E. Pichilingue Chagray, Vanessa A. Marquez Mondalgo, Socorro Torres Zegarra, Nazario Silva Astete, Francisco Campos Guevara, Javier Soto Pastrana, Carlos F. Linares Calderon, Manuel Jesus Mayorga Espichan, Luis Martin Santivanez Monge, Maria V. Changano Rodriguez, Zoila Rosa Diaz Tavera, Fernando Martin Ramirez Wong, Selene Manga Chavez, Teodora Atencio-Espinoza, Victoria D. Villanueva, Maria Teresa Blanco-Abuy, Arnefelina S. Tamayo, Lailane D. Bergosa, Cristina Mari Jean P. Llames, Marilou F. Trajano, Suzette A. Bunsay, Jessica C. Amor, Regina Berba, Maria Carmen Sg Buenaflor, Ever Labro, Myrna T. Mendoza, Ofelia P. Javellana, Lilibeth G. Salvio, Rhoda Gay Rayco, Vanessa Bermudez, Andrzej Kubler, Marzena Zielinska, Magdalena Kosmider-Zurawska, Barbara Barteczko-Grajek, Ewa Szewczyk, Barbara Dragan, Malgorzata Anna Mikaszewska-Sokolewicz, Tomasz Lazowski, Elsie Cancel, Monica Sorina Licker, Liliana Alina Dragomirescu, Victor Dumitrascu, Dorel Sandesc, Ovidiu Bedreag, Marius Papurica, Delia Muntean, Igor Kotkov, Vladimir Kretov, Vladimir Shalapuda, Alexander Molkov, Sergey Puzanov, Ivan Utkin, Alexander Tchekulaev, Valentina Tulupova, Ljubica Nikolic, Goran Ristic, Jelena Eremija, Jelena Kojovic, Dragana Lekic, Sladjana Vasiljevic, Anna Lesnakova, Alzbeta Marcekova, Katarina Furova, May Osman Gamar Elanbya, Malik Abdo Ali, Shobhana Kumari Kadankunnel, Suwara Somabutr, Rungratchanee Pimathai, Suthinee Wanitanukool, Montri Luxsuwong, Namphon Supa, Pornpheth Prasan, Visanu Thamlikitkul, Silom Jamulitrat, Nonglak Suwalak, Parichart Phainuphong, Bouziri Asma, Borgi Aida, Bel Hadj Sarra, Khaldi Ammar, Gunay Tuncer Ertem, Cemal Bulut, Cigdem Ataman Hatipoglu, Fatma Sebnem Erdinc, Ali Pekcan Demiroz, Menekse Ozcelik, Basak Ceyda Meco, Mehmet Oral, Necmettin Unal, Cigdem Yildirim Guclu, Tanıl Kendirli, Erdal İnce, Ergin Çiftçi, Ayhan Yaman, Çağlar Ödek, Adem Karbuz, Bilge Aldemir Kocabaş, Nilgün Altın, Salih Cesur, Begum Atasay, Omer Erdeve, Hasan Akduman, Dilek Kahvecioglu, Ufuk Cakir, Duran Yildiz, Atila Kilic, Saadet Arsan, Dilek Arman, Serhat Unal, Yasemin Gelebek, Humeyra Zengin, Suha Sen, Hatice Cabadak, Ayse Erbay, Ata Nevzat Yalcin, Ozge Turhan, Melike Cengiz, Oguz Dursun, Perihan Gunasan, Sehnaz Kaya, Atilla Ramazanoglu, Cemal Ustun, Aliye Yasayacak, Hayrettin Akdeniz, Fatma Sirmatel, Ali Metin Otkun, Suzan Sacar, Alper Sener, Huseyn Turgut, Hulya Sungurtekin, Dogaç Ugurcan, Ceyda Necan, Cansu Yilmaz, Davut Ozdemir, Mehmet Faruk Geyik, Nevin Ince, Ayse Danis, Selvi Yener Erdogan, Nurettin Erben, Gaye Usluer, Ilhan Ozgunes, Cengiz Uzun, Oral Oncul, Levent Gorenek, Hakan Erdem, Orhan Baylan, Asu Ozgultekin, Asuman Inan, Sibel Bolukcu, Gunes Senol, Halil Ozdemir, Zeynel Gokmen, Sonay Incesoy Ozdemir, Ali Kaya, Gulden Ersoz, Necdet Kuyucu, Sevim Karacorlu, Zeynep Kaya, Ertugrul Guclu, Gulsume Kaya, Oguz Karabay, Saban Esen, Canan Aygun, Fatma Ulger, Ahmet Dilek, Hava Yilmaz, Mustafa Sunbul, Aynur Engin, Mehmet Bakir, Nazif Elaldi, Iftihar Koksal, Dincer Yildizdas, Ozden Ozgur Horoz, Ayşe Willke, Meliha Meriç Koç, Emel Azak, Naheed Elahi, Philip Annamma, Ashraf El Houfi, Maria Catalina Pirez Garcia, Hector Vidal, Fernando Perez, Gabriel D. Empaire, Yvis Ruiz, Dulce Hernandez, Dayana Aponte, Evelyn Salinas, Claudia Diaz, María Eugenia Guzmán Siritt, Zenaida Durán Gil De Añez, Luis Montes Bravo, Nelva Orozco, Eugenia Mejías, Nguyen Viet Hung, Nguyen Quoc Anh, Ngo Quy Chau, Truong Anh Thu, Le Thi Diem Tuyet, Dang Thi Van Trang, Vo Thi Hong Thoa, Nguyen Phuc Tien, Le Thi Anh Thu, Phan Thi Hang, Tran Thi My Hanh, Tran Thi Thuy Hang, Dinh Pham Phuong Anh, Ondokuz Mayıs Üniversitesi, KILIÇ, ATİLA, and MERİÇ KOÇ, MELİHA

Subjects
Imipenem, medicine.medical_specialty, Pediatrics, Low income countries, Asia, Epidemiology, Klebsiella pneumoniae, Health care-associated infection, Antibiotic resistance, Catheter-associated urinary tract infection, Ceftazidime, Network, Bloodstream infection, Developing countries, Nosocomial infection, Intensive care, medicine, Ventilator-associated pneumonia, Humans, Hospital infection, Prospective Studies, Urinary tract infection, Cross Infection, Infection Control, biology, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Nosocomial infection control, biology.organism_classification, Device-associated infection, United States, Europe, Pneumonia, Intensive Care Units, Infectious Diseases, Latin America, Amikacin, Emergency medicine, Africa, Limited resources countries, Central line-associated bloodstream infections, Centers for Disease Control and Prevention, U.S, business, medicine.drug
Abstract

Maghsoudi, Behzad/0000-0002-1279-8799; Kritsotakis, Evangelos/0000-0002-9526-3852; Yalcin, Ata Nevzat/0000-0002-7243-7354; Mikaszewska-Sokolewicz, Malgorzata A/0000-0002-1148-7817; ALDEMIR KOCABAS, Bilge/0000-0002-6396-5243; Masjedi, Mohammad Reza/0000-0002-6871-382X; Masjedi, Mansoor/0000-0001-6175-9289; Gan, Chin Seng/0000-0002-6758-4798; Oncul, Oral/0000-0002-1681-1866; Sabetian, Golnar/0000-0001-8764-2150; YAMAN, Ayhan/0000-0002-5651-1286; Ozdemir, Halil/0000-0002-7318-1688; Leon, Hector Armando Rincon/0000-0003-0715-200X; Delia, Muntean/0000-0001-9100-4530; Atasay, Fatma Begum/0000-0002-9114-5293; Zand, Farid/0000-0003-3489-3372; Kuchenbecker, Ricardo/0000-0002-4707-3683; Medeiros, Eduardo A/0000-0002-6205-259X; ROMERO LOPEZ-ALBERCA, CRISTINA/0000-0001-5856-8668; Salomao, Reinaldo/0000-0003-1149-4598; ozdemir, sonay incesoy/0000-0003-2863-901X; Meco, Basak Ceyda/0000-0003-2951-9634; Horoz, Ozden Ozgur/0000-0001-7590-650X; Horhat, Florin George/0000-0001-6133-0204; Kazi, Mohammad Mukhit/0000-0003-3824-5540; Ciftci, Ergin/0000-0002-4955-160X; Abouqal, Redouane/0000-0002-6117-4341; Leblebicioglu, Hakan/0000-0002-6033-8543; Garcell, Humberto Guanche/0000-0001-7279-0062; Kendirli, Tanil/0000-0001-9458-2803; de Souza, Maria Cecilia B V/0000-0003-0318-3087; Sanaei Dashti, Anahita/0000-0002-2827-3575; UNAL, SERHAT/0000-0003-1184-4711; alvarez Moreno, carlos Arturo/0000-0001-5419-4494; Barahona G., Nayide/0000-0003-3559-6900; Rodriguez Ferrer, Marena Luz/0000-0002-8053-8454; Karabay, Oguz/0000-0003-0502-432X; Kaya, Sehnaz/0000-0003-0002-1517; ERDEVE, OMER/0000-0002-3193-0812; Gonzalez Martinez, Marisela del Rocio/0000-0003-1474-736X; Gikas, Achilleas/0000-0002-8455-9631; Baylan, Orhan/0000-0002-6529-7824; Mitrev, Zan/0000-0001-7859-8821; yildizdas, dincer/0000-0003-0739-5108; Ngo, Quy Chau/0000-0002-6787-2757; Duszynska, Wieslawa/0000-0002-5880-4904; KAYA, ZEYNEP/0000-0002-8468-2103; Dragan, Barbara/0000-0003-3108-4211; Gupta, Umesh/0000-0001-7717-1404; Navarro Fuentes, Karla Reyna/0000-0002-6894-8872; zali, Mohammadreza/0000-0002-9027-4560; Morocho Tutillo, Diego Rolando/0000-0002-4974-7856; El Kholy, Amani/0000-0002-0645-7664; Kanj, Souha/0000-0001-6413-3396; Assiri, Abdullah/0000-0002-5605-2876; Unal, Necmettin/0000-0002-9440-7893; Jayatilleke, Kushlani/0000-0002-3931-6630; KARABAY, OGUZ/0000-0003-1514-1685 WOS: 000341307100001 PubMed: 25179325 We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U. S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright (C) 2014 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Published
2014

11. Short-term Results of Patients with Spontaneous Subarachnoid Hemorrhage in Intensive Care Unit: Single-center Experience

Author

Mehtap Pehlivanlar Küçük, Çağatay Erman Öztürk, Ahmet Oğuzhan Küçük, Esra Turunç, and Fatma Ülger

Subjects
endovascular procedures, intensive care unit, mortality, spontaneous subarachnoid haemorrhages, subarachnoid haemorrhage therapy, subarachnoid haemorrhage surgery, Medicine, Internal medicine, RC31-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objective:Few studies have evaluated patients with spontaneous subarachnoid haemorrhage (sSAH) from an intensivist perspective. This study aimed to report the results of patients with sSAH in a high-volume centre monitored by a team experienced in the fields of brain surgery, interventional radiology and intensive care.Materials and Methods:Data of patients with sSAH followed up between January 2014 and July 2018 in the intensive care unit (ICU) were retrieved from ICU patient observation charts, file records and hospital automated information system.Results:This study enrolled 150 patients, of which 61 (40.7%) patients died despite receiving intensive care. Mortality rates between patients with (42.8%) and without (40%) vasospasm were comparable (p=0.917). Vasospasm developed in 37.8% of the 45 patients who underwent endovascular coiling and in 19.2% of those who underwent neurosurgical clipping (p=0.044). The median times that elapsed before endovascular or surgical procedures were 2.5 [interquartile range (IQR): 2-5] days in the surviving group and 2 (IQR: 1-5) days in the deceased group (p=0.164). Blood sodium and blood chloride levels were significantly higher in the deceased group from the third day onward. The median blood sodium level exceeded 142 mEq/L in the deceased group, but was lower than 142 mEq/L on the same day in the surviving group.Conclusion:The results of this study suggest that Glasgow coma scale (GCS) at admission to the ICU is one of the important factors that affect treatment success. GCS is an important independent factor in selecting the timing or type of treatment (surgical clipping/endovascular coiling) and medical treatments such as nimodipine in patients with sSAH requiring intensive care. In addition, the incidence of vasospasm was higher in patients who underwent endovascular coiling. Increased sodium and chloride values during follow-up are the only parameters significantly associated with mortality.

Published
2021
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12. Effectiveness of a multidimensional approach for prevention of ventilator-associated pneumonia in adult intensive care units from 14 developing countries of four continents: findings of the International Nosocomial Infection Control Consortium

Author

Victor D, Rosenthal, Camilla, Rodrigues, Carlos, Álvarez-Moreno, Naoufel, Madani, Zan, Mitrev, Guxiang, Ye, Reinaldo, Salomao, Fatma, Ulger, Humberto, Guanche-Garcell, Souha S, Kanj, Luis E, Cuéllar, Francisco, Higuera, Trudell, Mapp, Rosalía, Fernández-Hidalgo, Selvi, Erdogan, and Ondokuz Mayıs Üniversitesi

Subjects
Adult, Male, medicine.medical_specialty, Psychological intervention, Critical Care and Intensive Care Medicine, intensive care unit, law.invention, Cohort Studies, ventilator-associated pneumonia, law, Intensive care, medicine, Infection control, Humans, Prospective Studies, Intensive care medicine, Developing Countries, Aged, Cross Infection, Infection Control, business.industry, international multidimensional approach, Ventilator-associated pneumonia, Pneumonia, Ventilator-Associated, developing countries, Middle Aged, medicine.disease, Nosocomial infection control, Intensive care unit, International Nosocomial Infection Control Consortium, Pneumonia, Intensive Care Units, Population Surveillance, Female, business, Cohort study, Program Evaluation
Abstract

Objectives: The aim of this study was to analyze the effect of the International Nosocomial Infection Control Consortium’s multidimensional approach on the reduction of ventilator-associated pneumonia in patients hospitalized in intensive care units. Design: A prospective active surveillance before–after study. The study was divided into two phases. During phase 1, the infection control team at each intensive care unit conducted active prospective surveillance of ventilator-associated pneumonia by applying the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the methodology of International Nosocomial Infection Control Consortium. During phase 2, the multidimensional approach for ventilator-associated pneumonia was implemented at each intensive care unit, in addition to the active surveillance. Setting: Forty-four adult intensive care units in 38 hospitals, members of the International Nosocomial Infection Control Consortium, from 31 cities of the following 14 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, and Turkey. Patients: A total of 55,507 adult patients admitted to 44 intensive care units in 38 hospitals. Interventions: The International Nosocomial Infection Control Consortium ventilator-associated pneumonia multidimensional approach included the following measures: 1) bundle of infectioncontrol interventions; 2) education; 3) outcome surveillance; 4) process surveillance; 5) feedback of ventilator-associated pneumonia rates; and 6) performance feedback of infection-control practices. Measurements: The ventilator-associated pneumonia rates obtained in phase 1 were compared with the rates obtained in phase 2. We performed a time-series analysis to analyze the impact of our intervention. Main Result: During phase 1, we recorded 10,292 mechanical ventilator days, and during phase 2, with the implementation of the multidimensional approach, we recorded 127,374 mechanical ventilator days. The rate of ventilator-associated pneumonia was 22.0 per 1,000 mechani cal ventilator days during phase 1, and 17.2 per 1,000 mechanical ventilator days during phase 2.The adjusted model of linear trend shows a 55.83% reduction in the rate of ventilator-associated pneumonia at the end of the study period; that is, the ventilator-associated pneumonia rate was 55.83% lower than it was at the beginning of the study. Conclusion: The implementation the International Nosocomial Infection Control Consortium multidimensional approach for ventilator-associated pneumonia was associated with a significant reduction in the ventilator-associated pneumonia rate in the adult intensive care units setting of developing countries. (Crit Care Med 2012; 00:0–0)

Published
2012

13. The Effect of Care Bundles Based on Guidelines Over the Central Venous Catheter Infections in an Intensive Care Unit

Author

Ferdi Polat, Ali Haydar Şahinoğlu, Ahmet Dilek, Ersin Köksal, Yasemin Burcu Üstün, Cengiz Kaya, Fatma Ülger, and Şaban Esen

Subjects
Care bundle, central venous catheter infection, intensive care unit, Medicine, Internal medicine, RC31-1245, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objective: To detect the effects of care bundle that is prepared depending on guidelines for central line associated infections. Material and Method: Patients in a tertiary medical intensive care unit were followed up during one year period in terms of catheter infections. The care bundle that was prepared depending on guidelines was performed for all central catheter placements. Catheters were evaluated in terms of local or systemic bloodstream infections everyday. Data obtained were compared with the previous year’s data. Results: We concluded that age, gender or weight characteristics have no effect on central venous catheter related infections but we detected higher infection rates at patients who had higher APACHE 2 scores. Bloodstream infection rates related with central catheter were similar between catheters inserted at operation rooms or intensive care units but catheters inserted at out services had higher infections rates. It was shown that prolonged catheter duration is related with high infection levels but anatomic place of catheter has no relationship with infection rates. No relationship was found between clothing type and infection rate. Total parenteral nutrition, blood or blood product administration via central catheter has increased infection rates. Conclusion: Performing care bundles decreases central venous catheter utilization rates central line associated bloodstream infection rates.

Published
2014
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14. Impact of Education and Process Surveillance on Device-Associated Health Care-Associated Infection Rates in a Turkish ICU: Findings of the International Nosocomial Infection Control Consortium (INICC)

Author

Ahmet Dilek, Fatma Ülger, Şaban Esen, Musa Acar, Hakan Leblebicioğlu, and Victor D. Rosenthal

Subjects
Health care-associated infection, ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection, outcome and process surveillance, hand hygiene, intensive care unit, Medicine
Abstract

Objective: The aim of this study was to analyze the impact of process and outcome surveillance on rates of device-associated health care-associated infections (DA-HAI) in an intensive care unit (ICU) in Turkey over a four-year period.Material and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on 685 patients admitted to the ICU of a university hospital in Turkey from January 2004 to December 2007, implementing the methodology developed by the International Nosocomial Infection Control Consortium. DA-HAI rates were recorded according to Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) definitions. We analyzed the rates of DA-HAI, mechanical ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CAUTI), as well as microorganism profile, extra length of stay, and hand hygiene compliance. Pooled DA-HAI rates were calculated and compared by year.Results: The DA-HAI rate per 100 patients declined as follows: for 2004, the DA-HAI rate was 58.4%; for 2005, it was 38.9%; for 2006, it was 34.8%; and for 2007, it was 10.9%. The DA-HAI rate per 1,000 bed-days also declined: for 2004, it was 42.8, and for 2007 it was 10.7. The rates decreased from 25.8 to 13.4 for VAP; from 29.9 to 25.0 for CLA-BSI; and from 9.2 to 6.2 for CAUTI cases per 1,000 device-days during the study period. Conclusion: Process and outcome surveillance of DA-HAI significantly reduced DA-HAI.

Published
2012

15. A Case of Acute Fatty Liver of Pregnancy

Author

Fatma Ülger, Handan Çelik, Ahmet Dilek, Migraci Tosun, Süleyman Altunsoy, Erdal Malatyalıoğlu, and Haydar Şahinoğlu

Subjects
Acute fatty liver, Pregnancy, Gynecology and obstetrics, RG1-991
Abstract

We described a case of acute fatty liver developed early postpartum period. Acute fatty liver of pregnancy (AFLP) is a rare medical condition and is important due to its implications on maternal and fetal morbidity and mortality. AFLP is managed with supportive care and close surveillance is needed in these patients. We report the case of a previously healthy 29 year old woman within the postpartum first day who presented to the emergency department with postpartum severe vaginal bleeding. An evaluation revealed hepatic and renal failure. The patient required aggressive supportive care, transfusion of multiple blood products in intensive care unit. This case was unusual because AFLP was reported in postpartum period and the patient presented due to postpartum severe vaginal bleeding after vaginal delivery and was subsequently diagnosed as AFLP

Published
2009

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