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5. Predictive value of prognostic nutritional index on postoperative intensive care requirement and mortality in geriatric hip fracture patients.

Author

Arslan, Kadir, Celik, Semih, Arslan, Hale Cetin, Sahin, Ayca Sultan, Genc, Yasin, and Erturk, Cemil

Subjects
PREDICTIVE validity, NUTRITION, DEATH rate, INTENSIVE care units, PROGNOSTIC tests
Abstract

OBJECTIVE: The incidence of postoperative morbidity and mortality in hip fracture patients is high and is associated with nutritional deficiencies. This study investigated the predictive value of preoperative prognostic nutritional index (PNI) on postoperative intensive care unit (ICU) requirement and mortality in geriatric hip fracture patients. METHODS: Geriatric (≥65 years old) hip fracture patients who underwent surgery between January 2021 and September 2023 were evaluated retrospectively. Patients were classified according to the unit followed in the postoperative period (service group and ICU group) and 28-day mortality (mortality group and survivor group). The predictive value of PNI for ICU requirement and mortality and the factors affecting ICU requirement and mortality were investigated. RESULTS: The study included two hundred twenty-two patients, and 66.2% (n=147) were women. In the postoperative period, 47.7% (n=106) of the patients were followed in the ICU and 52.3% (n=116) in the inpatient service. The 28-day mortality of the patients was 6.8% (n=15). PNI was found to be significantly lower in patients followed in the ICU (group ICU) than in those followed in the service (group S) and in patients who died (group mortality) compared to those who lived (group survivor) (p<0.001 and p=0.029, respectively). In multivariate regression analysis, high American Society of Anesthesiologists (ASA) status and low PNI were determined to be independent risk factors for ICU requirement. Acute Physiology and Chronic Health Assessment II score was an independent predictor of mortality. In ROC curve analysis, the cut-off value of PNI in predicting mortality was 32.5, and the area under the curve was 0.660 (95% CI, 0.516--0.803). CONCLUSION: In geriatric hip fracture patients, preoperative PNI value can be used, like ASA status, in determining postoperative ICU requirements. Nutritional deficiencies are associated with adverse postoperative outcomes in this patient group, and low PNI values (<32.5) help predict in-hospital mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Author

Kloss, P, Lindholz, M, Milnik, A, Azoulay, E, Cecconi, M, Citerio, G, De Corte, T, Duska, F, Galarza, L, Greco, M, Girbes, A, Kesecioglu, J, Mellinghoff, J, Ostermann, M, Pellegrini, M, Teboul, J, De Waele, J, Wong, A, Schaller, S, Aires, B, Gira, A, Eller, P, Hamid, T, Haque, I, De Buyser, W, Cudia, A, De Backer, D, Foulon, P, Collin, V, Van Hecke, J, De Waele, E, Van Malderen, C, Mesland, J, Biston, P, Piagnerelli, M, Haentjens, L, De Schryver, N, Van Leemput, J, Vanhove, P, Bulpa, P, Ilieva, V, Katz, D, Binnie, A, Geagea, A, Tirapegui, F, Lago, G, Graf, J, Perez-Araos, R, Vargas, P, Martinez, F, Labarca, E, Franco, D, Parra-Tanoux, D, Yepes, D, Hammouda, A, Elmandouh, O, Azzam, A, Hussein, A, Galal, I, Awad, A, Azab, M, Abdalla, M, Assal, H, Alfishawy, M, Ghozy, S, Tharwat, S, Eldaly, A, Ellervee, A, Reinhard, V, Chrisment, A, Poyat, C, Badie, J, Berdaguer Ferrari, F, Weiss, B, Schellenberg, C, Grunow, J, Lorenz, M, Spieth, P, Bota, M, Fichtner, F, Fuest, K, Lahmer, T, Herrmann, J, Meybohm, P, Markou, N, Vasileiadou, G, Chrysanthopoulou, E, Papamichalis, P, Soultati, I, Jog, S, Kalvit, K, Nainan Myatra, S, Krupa, I, Tharwat, A, Nichol, A, Mccarthy, A, Mahmoodpoor, A, Tonetti, T, Isoni, P, Spadaro, S, Volta, C, Mirabella, L, Noto, A, Florio, G, Guzzardella, A, Paleari, C, Baccanelli, F, Savi, M, Antonelli, M, De Pascale, G, Vaccarini, B, Montrucchio, G, Sales, G, Donadello, K, Gottin, L, Nizzero, M, Polati, E, De Rosa, S, Sulemanji, D, Abusalama, A, Elhadi, M, Jesus, M, Gonzalez, D, Robles, V, Canedo, N, Chavez, A, Dendane, T, Grady, B, de Jong, B, van der Heiden, E, Thoral, P, van den Bogaard, B, Spronk, P, Achterberg, S, Groeneveld, M, So, R, de Wijs, C, Scholten, H, Beishuizen, A, Cornet, A, Reidinga, A, Kranen, H, Mensink, R, den Boer, S, de Groot, M, Beck, O, Bethlehem, C, van Bussel, B, Frenzel, T, de Jong, C, Wilting, R, Mehagnoul-Schipper, J, Alasia, D, Kumar, A, Qayyum, A, Rana, M, Jayyab, M, Sierra, R, Hernandez, A, Taborda, L, Anselmo, M, Ramires, T, Silva, C, Roriz, C, Morais, R, Póvoa, P, Patricio, P, Pinto, A, Santos, M, Costa, V, Cunha, P, Gonçalves, C, Nunes, S, Camões, J, Adrião, D, Oliveira, A, Omrani, A, Maslamani, M, Elbuzidi, A, Qudah, B, Akkari, A, Alkhatteb, M, Baiou, A, Husain, A, Alwraidat, M, Saif, I, Bakdach, D, Ahmed, A, Aleef, M, Bintaher, A, Petrisor, C, Popov, E, Popova, K, Dementienko, M, Teplykh, B, Pyregov, A, Davydova, L, Vladislav, B, Neporada, E, Zverev, I, Meshchaninova, S, Sokolov, D, Gavrilova, E, Shlyk, I, Poliakov, I, Vlasova, M, Aljuhani, O, Alkhalaf, A, Humaid, F, Arabi, Y, Kuhail, A, Elrabi, O, Ghannam, M, Kansal, A, Ho, V, Ng, J, García, R, Fraga, X, del Pilar García-Bonillo, M, Padilla-Serrano, A, Cuadrado, M, Ferrando, C, Catalan-Monzon, I, Frutos-Vivar, F, Jimenez, J, Rodríguez-Solis, C, Franquesa-Gonzalez, E, Acosta, G, Cabrera, L, Parra, J, Gonzalez, F, del Carmen Conesa, M, Varela, I, Pravia, O, Delgado, M, de Cabo, C, Ioan, A, Perez-Calvo, C, Santos, A, Abad-Motos, A, Ripolles-Melchor, J, Martin, B, Teruel, S, Lucas, J, Ortiz, A, de Pablo Sánchez, R, Barrueco-Francioni, J, Espina, L, Bonell-Goytisolo, J, Salaverria, I, Mir, A, Rodriguez-Ruiz, E, Valverde, V, Cubero, P, Linde, F, Leganes, N, Romeu, J, Concha, P, Berezo-Garcia, J, Fraile, V, Cuenca-Rubio, C, Pérez-Torres, D, Serrano, A, Valero, C, Suner, A, Larrañaga, L, Legaristi, N, Ferrigno, G, Khlafalla, S, Bihariesingh-Sanchit, R, Zoerner, F, Grip, J, Kilsand, K, Mårtensson, J, Österlind, J, von Seth, M, Berkius, J, Ceruti, S, Glotta, A, Izdes, S, Turan, I, Cosar, A, Halacli, B, Dereli, N, Yilmaz, M, Akbas, T, Elay, G, Eyüpoğlu, S, Bílír, Y, Saraçoğlu, K, Kaya, E, Sahin, A, Ekren, P, Mengi, T, Suner, K, Tomak, Y, Eroglu, A, Alsabbah, A, Hanlon, K, Gervin, K, Mcmahon, S, Hagan, S, Higenbottam, C, Mullhi, R, Poulton, L, Torlinski, T, Gareth, A, Truman, N, Vijayakumar, G, Hall, C, Jubb, A, Cagova, L, Jones, N, Graham, S, Robin, N, Cowton, A, Donnelly, A, Singatullina, N, Kent, M, Boulanger, C, Campbell, Z, Potter, E, Duric, N, Szakmany, T, Kviatkovske, O, Marczin, N, Ellis, C, Saha, R, Sri-Chandana, C, Allan, J, Mumelj, L, Venkatesh, H, Gotz, V, Cochrane, A, Ficial, B, Kamble, S, Lumlertgul, N, Oddy, C, Jain, S, Crapelli, G, Vlachou, A, Golden, D, Garrioch, S, Henning, J, Loveleena, G, Davey, M, Grauslyte, L, Salciute-Simene, E, Cook, M, Barling, D, Broadhurst, P, Purvis, S, Spivey, M, Shuker, B, Grecu, I, Harding, D, Dean, J, Nielsen, N, Al-Bayati, S, Al-Sadawi, M, Charron, M, Stubenrauch, P, Santanilla, J, Wentowski, C, Rosenberger, D, Eksarko, P, Jawa, R, Kloss, Philipp, Lindholz, Maximilian, Milnik, Annette, Azoulay, Elie, Cecconi, Maurizio, Citerio, Giuseppe, De Corte, Thomas, Duska, Frantisek, Galarza, Laura, Greco, Massimiliano, Girbes, Armand R. J., Kesecioglu, Jozef, Mellinghoff, Johannes, Ostermann, Marlies, Pellegrini, Mariangela, Teboul, Jean-Louis, De Waele, Jan, Wong, Adrian, Schaller, Stefan J., Aires, Buenos, Gira, Alicia, Eller, Philipp, Hamid, Tarikul, Haque, Injamam Ull, De Buyser, Wim, Cudia, Antonella, De Backer, Daniel, Foulon, Pierre, Collin, Vincent, Van Hecke, Jolien, De Waele, Elisabeth, Van Malderen, Claire, Mesland, Jean-Baptiste, Biston, Patrick, Piagnerelli, Michael, Haentjens, Lionel, De Schryver, Nicolas, Van Leemput, Jan, Vanhove, Philippe, Bulpa, Pierre, Ilieva, Viktoria, Katz, David, Binnie, Alexandra, Geagea, Anna, Tirapegui, Fernando, Lago, Gustavo, Graf, Jerónimo, Perez-Araos, Rodrigo, Vargas, Patricio, Martinez, Felipe, Labarca, Eduardo, Franco, Daniel Molano, Parra-Tanoux, Daniela, Yepes, David, Hammouda, Ahmed, Elmandouh, Omar, Azzam, Ahmed, Hussein, Aliae Mohamed, Galal, Islam, Awad, Ahmed K., Azab, Mohammed A., Abdalla, Maged, Assal, Hebatallah, Alfishawy, Mostafa, Ghozy, Sherief, Tharwat, Samar, Eldaly, Abdullah, Ellervee, Anneli, Reinhard, Veronika, Chrisment, Anne, Poyat, Chrystelle, Badie, Julio, Berdaguer Ferrari, Fernando, Weiss, Björn, Schellenberg, Clara, Grunow, Julius J, Lorenz, Marco, Schaller, Stefan J, Spieth, Peter, Bota, Marc, Fichtner, Falk, Fuest, Kristina, Lahmer, Tobias, Herrmann, Johannes, Meybohm, Patrick, Markou, Nikolaos, Vasileiadou, Georgia, Chrysanthopoulou, Evangelia, Papamichalis, Panagiotis, Soultati, Ioanna, Jog, Sameer, Kalvit, Kushal, Nainan Myatra, Sheila, Krupa, Ivan, Tharwat, Aisa, Nichol, Alistair, McCarthy, Aine, Mahmoodpoor, Ata, Tonetti, Tommaso, Isoni, Paolo, Spadaro, Savino, Volta, Carlo Alberto, Mirabella, Lucia, Noto, Alberto, Florio, Gaetano, Guzzardella, Amedeo, Paleari, Chiara, Baccanelli, Federica, Savi, Marzia, Antonelli, Massimo, De Pascale, Gennaro, Vaccarini, Barbara, Montrucchio, Giorgia, Sales, Gabriele, Donadello, Katia, Gottin, Leonardo, Nizzero, Marta, Polati, Enrico, De Rosa, Silvia, Sulemanji, Demet, Abusalama, Abdurraouf, Elhadi, Muhammed, Jesus, Montelongo Felipe De, Gonzalez, Daniel Rodriguez, Robles, Victor Hugo Madrigal, Canedo, Nancy, Chavez, Alejandro Esquivel, Dendane, Tarek, Grady, Bart, de Jong, Ben, van der Heiden, Eveline, Thoral, Patrick, van den Bogaard, Bas, Spronk, Peter E., Achterberg, Sefanja, Groeneveld, Melanie, So, Ralph K. L., de Wijs, Calvin, Scholten, Harm, Beishuizen, Albertus, Cornet, Alexander D., Reidinga, Auke C., Kranen, Hetty, Mensink, Roos, den Boer, Sylvia, de Groot, Marcel, Beck, Oliver, Bethlehem, Carina, van Bussel, Bas, Frenzel, Tim, de Jong, Celestine, Wilting, Rob, Mehagnoul-Schipper, Jannet, Alasia, Datonye, Kumar, Ashok, Qayyum, Ahad, Rana, Muhammad, Jayyab, Mustafa Abu, Sierra, Rosario Quispe, Hernandez, Aaron Mark, Taborda, Lúcia, Anselmo, Mónica, Ramires, Tiago, Silva, Catarina, Roriz, Carolina, Morais, Rui, Póvoa, Pedro, Patricio, Patricia, Pinto, André, Santos, Maria Lurdes, Costa, Vasco, Cunha, Pedro, Gonçalves, Celina, Nunes, Sandra, Camões, João, Adrião, Diana, Oliveira, Ana, Omrani, Ali, Maslamani, Muna Al, elbuzidi, Abdurrahmaan Suei, qudah, Bara Mahmoud Al, Akkari, Abdel Rauof, Alkhatteb, Mohamed, Baiou, Anas, Husain, Ahmed, Alwraidat, Mohamed, Saif, Ibrahim Abdulsalam, Bakdach, Dana, Ahmed, Amna, Aleef, Mohamed, Bintaher, Awadh, Petrisor, Cristina, Popov, Evgeniy, Popova, Ksenia, Dementienko, Mariia, Teplykh, Boris, Pyregov, Alexey, Davydova, Liubov, Vladislav, Belskii, Neporada, Elena, Zverev, Ivan, Meshchaninova, Svetlana, Sokolov, Dmitry, Gavrilova, Elena, Shlyk, Irina, Poliakov, Igor, Vlasova, Marina, Aljuhani, Ohoud, Alkhalaf, Amina, Humaid, Felwa Bin, Arabi, Yaseen, Kuhail, Ahmed, Elrabi, Omar, Ghannam, Madihah E., Kansal, Amit, Ho, Vui Kian, Ng, Jensen, García, Raquel Rodrígez, Fraga, Xiana Taboada, del Pilar García-Bonillo, Ma, Padilla-Serrano, Antonio, Cuadrado, Marta Martin, Ferrando, Carlos, Catalan-Monzon, Ignacio, Frutos-Vivar, Fernando, Jimenez, Jorge, Rodríguez-Solis, Carmen, Franquesa-Gonzalez, Enric, Acosta, Guillermo Pérez, Cabrera, Luciano Santana, Parra, Juan Pablo Aviles, Gonzalez, Francisco Muñoyerro, del Carmen Conesa, Maria Lorente, Varela, Ignacio Yago Martinez, Pravia, Orville Victoriano Baez, Delgado, Maria Cruz Martin, de Cabo, Carlos Munoz, Ioan, Ana-Maria, Perez-Calvo, Cesar, Santos, Arnoldo, Abad-Motos, Ane, Ripolles-Melchor, Javier, Martin, Belén Civantos, Teruel, Santiago Yus, Lucas, Juan Higuera, Ortiz, Aaron Blandino, de Pablo Sánchez, Raúl, Barrueco-Francioni, Jesús Emilio, Espina, Lorena Forcelledo, Bonell-Goytisolo, José M., Salaverria, Iñigo, Mir, Antonia Socias, Rodriguez-Ruiz, Emilio, Valverde, Virginia Hidalgo, Cubero, Patricia Jimeno, Linde, Francisca Arbol, Leganes, Nieves Cruza, Romeu, Juan Maria, Concha, Pablo, Berezo-Garcia, José Angel, Fraile, Virginia, Cuenca-Rubio, Cristina, Pérez-Torres, David, Serrano, Ainhoa, Valero, Clara Martínez, Suner, Andrea Ortiz, Larrañaga, Leire, Legaristi, Noemi, Ferrigno, Gerardo, Khlafalla, Safa, Bihariesingh-Sanchit, Rosita, Zoerner, Frank, Grip, Jonathan, Kilsand, Kristina, Mårtensson, Johan, Österlind, Jonas, von Seth, Magnus, Berkius, Johan, Ceruti, Samuele, Glotta, Andrea, Izdes, Seval, Turan, Işıl Özkoçak, Cosar, Ahmet, Halacli, Burcin, Dereli, Necla, Yilmaz, Mehmet, Akbas, Türkay, Elay, Gülseren, Eyüpoğlu, Selin, Bílír, Yelíz, Saraçoğlu, Kemal Tolga, Kaya, Ebru, Sahin, Ayca Sultan, Ekren, Pervin Korkmaz, Mengi, Tuğçe, Suner, Kezban Ozmen, Tomak, Yakup, Eroglu, Ahmet, Alsabbah, Asad, Hanlon, Katie, Gervin, Kevin, McMahon, Sean, Hagan, Samantha, Higenbottam, Caroline V, Mullhi, Randeep, Poulton, Lottie, Torlinski, Tomasz, Gareth, Allen, Truman, Nick, Vijayakumar, Gopal, Hall, Chris, Jubb, Alasdair, Cagova, Lenka, Jones, Nicola, Graham, Sam, Robin, Nicole, Cowton, Amanda, Donnelly, Adrian, Singatullina, Natalia, Kent, Melanie, Boulanger, Carole, Campbell, Zoë, Potter, Elizabeth, Duric, Natalie, Szakmany, Tamas, Kviatkovske, Orinta, Marczin, Nandor, Ellis, Caroline, Saha, Rajnish, Sri-Chandana, Chunda, Allan, John, Mumelj, Lana, Venkatesh, Harish, Gotz, Vera Nina, Cochrane, Anthony, Ficial, Barbara, Kamble, Shruthi, Lumlertgul, Nuttha, Oddy, Christopher, Jain, Susan, Crapelli, Giulia Beatrice, Vlachou, Aikaterini, Golden, David, Garrioch, Sweyn, Henning, Jeremy, Loveleena, Gupta, Davey, Miriam, Grauslyte, Lina, Salciute-Simene, Erika, Cook, Martin, Barling, Danny, Broadhurst, Phil, Purvis, Sarah, Spivey, Michael, Shuker, Benjamin, Grecu, Irina, Harding, Daniel, Dean, James T., Nielsen, Nathan D., Al-Bayati, Sama, Al-Sadawi, Mohammed, Charron, Mariane, Stubenrauch, Peter, Santanilla, Jairo, Wentowski, Catherine, Rosenberger, Dorothea, Eksarko, Polikseni, Jawa, Randeep, Kloss, P, Lindholz, M, Milnik, A, Azoulay, E, Cecconi, M, Citerio, G, De Corte, T, Duska, F, Galarza, L, Greco, M, Girbes, A, Kesecioglu, J, Mellinghoff, J, Ostermann, M, Pellegrini, M, Teboul, J, De Waele, J, Wong, A, Schaller, S, Aires, B, Gira, A, Eller, P, Hamid, T, Haque, I, De Buyser, W, Cudia, A, De Backer, D, Foulon, P, Collin, V, Van Hecke, J, De Waele, E, Van Malderen, C, Mesland, J, Biston, P, Piagnerelli, M, Haentjens, L, De Schryver, N, Van Leemput, J, Vanhove, P, Bulpa, P, Ilieva, V, Katz, D, Binnie, A, Geagea, A, Tirapegui, F, Lago, G, Graf, J, Perez-Araos, R, Vargas, P, Martinez, F, Labarca, E, Franco, D, Parra-Tanoux, D, Yepes, D, Hammouda, A, Elmandouh, O, Azzam, A, Hussein, A, Galal, I, Awad, A, Azab, M, Abdalla, M, Assal, H, Alfishawy, M, Ghozy, S, Tharwat, S, Eldaly, A, Ellervee, A, Reinhard, V, Chrisment, A, Poyat, C, Badie, J, Berdaguer Ferrari, F, Weiss, B, Schellenberg, C, Grunow, J, Lorenz, M, Spieth, P, Bota, M, Fichtner, F, Fuest, K, Lahmer, T, Herrmann, J, Meybohm, P, Markou, N, Vasileiadou, G, Chrysanthopoulou, E, Papamichalis, P, Soultati, I, Jog, S, Kalvit, K, Nainan Myatra, S, Krupa, I, Tharwat, A, Nichol, A, Mccarthy, A, Mahmoodpoor, A, Tonetti, T, Isoni, P, Spadaro, S, Volta, C, Mirabella, L, Noto, A, Florio, G, Guzzardella, A, Paleari, C, Baccanelli, F, Savi, M, Antonelli, M, De Pascale, G, Vaccarini, B, Montrucchio, G, Sales, G, Donadello, K, Gottin, L, Nizzero, M, Polati, E, De Rosa, S, Sulemanji, D, Abusalama, A, Elhadi, M, Jesus, M, Gonzalez, D, Robles, V, Canedo, N, Chavez, A, Dendane, T, Grady, B, de Jong, B, van der Heiden, E, Thoral, P, van den Bogaard, B, Spronk, P, Achterberg, S, Groeneveld, M, So, R, de Wijs, C, Scholten, H, Beishuizen, A, Cornet, A, Reidinga, A, Kranen, H, Mensink, R, den Boer, S, de Groot, M, Beck, O, Bethlehem, C, van Bussel, B, Frenzel, T, de Jong, C, Wilting, R, Mehagnoul-Schipper, J, Alasia, D, Kumar, A, Qayyum, A, Rana, M, Jayyab, M, Sierra, R, Hernandez, A, Taborda, L, Anselmo, M, Ramires, T, Silva, C, Roriz, C, Morais, R, Póvoa, P, Patricio, P, Pinto, A, Santos, M, Costa, V, Cunha, P, Gonçalves, C, Nunes, S, Camões, J, Adrião, D, Oliveira, A, Omrani, A, Maslamani, M, Elbuzidi, A, Qudah, B, Akkari, A, Alkhatteb, M, Baiou, A, Husain, A, Alwraidat, M, Saif, I, Bakdach, D, Ahmed, A, Aleef, M, Bintaher, A, Petrisor, C, Popov, E, Popova, K, Dementienko, M, Teplykh, B, Pyregov, A, Davydova, L, Vladislav, B, Neporada, E, Zverev, I, Meshchaninova, S, Sokolov, D, Gavrilova, E, Shlyk, I, Poliakov, I, Vlasova, M, Aljuhani, O, Alkhalaf, A, Humaid, F, Arabi, Y, Kuhail, A, Elrabi, O, Ghannam, M, Kansal, A, Ho, V, Ng, J, García, R, Fraga, X, del Pilar García-Bonillo, M, Padilla-Serrano, A, Cuadrado, M, Ferrando, C, Catalan-Monzon, I, Frutos-Vivar, F, Jimenez, J, Rodríguez-Solis, C, Franquesa-Gonzalez, E, Acosta, G, Cabrera, L, Parra, J, Gonzalez, F, del Carmen Conesa, M, Varela, I, Pravia, O, Delgado, M, de Cabo, C, Ioan, A, Perez-Calvo, C, Santos, A, Abad-Motos, A, Ripolles-Melchor, J, Martin, B, Teruel, S, Lucas, J, Ortiz, A, de Pablo Sánchez, R, Barrueco-Francioni, J, Espina, L, Bonell-Goytisolo, J, Salaverria, I, Mir, A, Rodriguez-Ruiz, E, Valverde, V, Cubero, P, Linde, F, Leganes, N, Romeu, J, Concha, P, Berezo-Garcia, J, Fraile, V, Cuenca-Rubio, C, Pérez-Torres, D, Serrano, A, Valero, C, Suner, A, Larrañaga, L, Legaristi, N, Ferrigno, G, Khlafalla, S, Bihariesingh-Sanchit, R, Zoerner, F, Grip, J, Kilsand, K, Mårtensson, J, Österlind, J, von Seth, M, Berkius, J, Ceruti, S, Glotta, A, Izdes, S, Turan, I, Cosar, A, Halacli, B, Dereli, N, Yilmaz, M, Akbas, T, Elay, G, Eyüpoğlu, S, Bílír, Y, Saraçoğlu, K, Kaya, E, Sahin, A, Ekren, P, Mengi, T, Suner, K, Tomak, Y, Eroglu, A, Alsabbah, A, Hanlon, K, Gervin, K, Mcmahon, S, Hagan, S, Higenbottam, C, Mullhi, R, Poulton, L, Torlinski, T, Gareth, A, Truman, N, Vijayakumar, G, Hall, C, Jubb, A, Cagova, L, Jones, N, Graham, S, Robin, N, Cowton, A, Donnelly, A, Singatullina, N, Kent, M, Boulanger, C, Campbell, Z, Potter, E, Duric, N, Szakmany, T, Kviatkovske, O, Marczin, N, Ellis, C, Saha, R, Sri-Chandana, C, Allan, J, Mumelj, L, Venkatesh, H, Gotz, V, Cochrane, A, Ficial, B, Kamble, S, Lumlertgul, N, Oddy, C, Jain, S, Crapelli, G, Vlachou, A, Golden, D, Garrioch, S, Henning, J, Loveleena, G, Davey, M, Grauslyte, L, Salciute-Simene, E, Cook, M, Barling, D, Broadhurst, P, Purvis, S, Spivey, M, Shuker, B, Grecu, I, Harding, D, Dean, J, Nielsen, N, Al-Bayati, S, Al-Sadawi, M, Charron, M, Stubenrauch, P, Santanilla, J, Wentowski, C, Rosenberger, D, Eksarko, P, Jawa, R, Kloss, Philipp, Lindholz, Maximilian, Milnik, Annette, Azoulay, Elie, Cecconi, Maurizio, Citerio, Giuseppe, De Corte, Thomas, Duska, Frantisek, Galarza, Laura, Greco, Massimiliano, Girbes, Armand R. J., Kesecioglu, Jozef, Mellinghoff, Johannes, Ostermann, Marlies, Pellegrini, Mariangela, Teboul, Jean-Louis, De Waele, Jan, Wong, Adrian, Schaller, Stefan J., Aires, Buenos, Gira, Alicia, Eller, Philipp, Hamid, Tarikul, Haque, Injamam Ull, De Buyser, Wim, Cudia, Antonella, De Backer, Daniel, Foulon, Pierre, Collin, Vincent, Van Hecke, Jolien, De Waele, Elisabeth, Van Malderen, Claire, Mesland, Jean-Baptiste, Biston, Patrick, Piagnerelli, Michael, Haentjens, Lionel, De Schryver, Nicolas, Van Leemput, Jan, Vanhove, Philippe, Bulpa, Pierre, Ilieva, Viktoria, Katz, David, Binnie, Alexandra, Geagea, Anna, Tirapegui, Fernando, Lago, Gustavo, Graf, Jerónimo, Perez-Araos, Rodrigo, Vargas, Patricio, Martinez, Felipe, Labarca, Eduardo, Franco, Daniel Molano, Parra-Tanoux, Daniela, Yepes, David, Hammouda, Ahmed, Elmandouh, Omar, Azzam, Ahmed, Hussein, Aliae Mohamed, Galal, Islam, Awad, Ahmed K., Azab, Mohammed A., Abdalla, Maged, Assal, Hebatallah, Alfishawy, Mostafa, Ghozy, Sherief, Tharwat, Samar, Eldaly, Abdullah, Ellervee, Anneli, Reinhard, Veronika, Chrisment, Anne, Poyat, Chrystelle, Badie, Julio, Berdaguer Ferrari, Fernando, Weiss, Björn, Schellenberg, Clara, Grunow, Julius J, Lorenz, Marco, Schaller, Stefan J, Spieth, Peter, Bota, Marc, Fichtner, Falk, Fuest, Kristina, Lahmer, Tobias, Herrmann, Johannes, Meybohm, Patrick, Markou, Nikolaos, Vasileiadou, Georgia, Chrysanthopoulou, Evangelia, Papamichalis, Panagiotis, Soultati, Ioanna, Jog, Sameer, Kalvit, Kushal, Nainan Myatra, Sheila, Krupa, Ivan, Tharwat, Aisa, Nichol, Alistair, McCarthy, Aine, Mahmoodpoor, Ata, Tonetti, Tommaso, Isoni, Paolo, Spadaro, Savino, Volta, Carlo Alberto, Mirabella, Lucia, Noto, Alberto, Florio, Gaetano, Guzzardella, Amedeo, Paleari, Chiara, Baccanelli, Federica, Savi, Marzia, Antonelli, Massimo, De Pascale, Gennaro, Vaccarini, Barbara, Montrucchio, Giorgia, Sales, Gabriele, Donadello, Katia, Gottin, Leonardo, Nizzero, Marta, Polati, Enrico, De Rosa, Silvia, Sulemanji, Demet, Abusalama, Abdurraouf, Elhadi, Muhammed, Jesus, Montelongo Felipe De, Gonzalez, Daniel Rodriguez, Robles, Victor Hugo Madrigal, Canedo, Nancy, Chavez, Alejandro Esquivel, Dendane, Tarek, Grady, Bart, de Jong, Ben, van der Heiden, Eveline, Thoral, Patrick, van den Bogaard, Bas, Spronk, Peter E., Achterberg, Sefanja, Groeneveld, Melanie, So, Ralph K. L., de Wijs, Calvin, Scholten, Harm, Beishuizen, Albertus, Cornet, Alexander D., Reidinga, Auke C., Kranen, Hetty, Mensink, Roos, den Boer, Sylvia, de Groot, Marcel, Beck, Oliver, Bethlehem, Carina, van Bussel, Bas, Frenzel, Tim, de Jong, Celestine, Wilting, Rob, Mehagnoul-Schipper, Jannet, Alasia, Datonye, Kumar, Ashok, Qayyum, Ahad, Rana, Muhammad, Jayyab, Mustafa Abu, Sierra, Rosario Quispe, Hernandez, Aaron Mark, Taborda, Lúcia, Anselmo, Mónica, Ramires, Tiago, Silva, Catarina, Roriz, Carolina, Morais, Rui, Póvoa, Pedro, Patricio, Patricia, Pinto, André, Santos, Maria Lurdes, Costa, Vasco, Cunha, Pedro, Gonçalves, Celina, Nunes, Sandra, Camões, João, Adrião, Diana, Oliveira, Ana, Omrani, Ali, Maslamani, Muna Al, elbuzidi, Abdurrahmaan Suei, qudah, Bara Mahmoud Al, Akkari, Abdel Rauof, Alkhatteb, Mohamed, Baiou, Anas, Husain, Ahmed, Alwraidat, Mohamed, Saif, Ibrahim Abdulsalam, Bakdach, Dana, Ahmed, Amna, Aleef, Mohamed, Bintaher, Awadh, Petrisor, Cristina, Popov, Evgeniy, Popova, Ksenia, Dementienko, Mariia, Teplykh, Boris, Pyregov, Alexey, Davydova, Liubov, Vladislav, Belskii, Neporada, Elena, Zverev, Ivan, Meshchaninova, Svetlana, Sokolov, Dmitry, Gavrilova, Elena, Shlyk, Irina, Poliakov, Igor, Vlasova, Marina, Aljuhani, Ohoud, Alkhalaf, Amina, Humaid, Felwa Bin, Arabi, Yaseen, Kuhail, Ahmed, Elrabi, Omar, Ghannam, Madihah E., Kansal, Amit, Ho, Vui Kian, Ng, Jensen, García, Raquel Rodrígez, Fraga, Xiana Taboada, del Pilar García-Bonillo, Ma, Padilla-Serrano, Antonio, Cuadrado, Marta Martin, Ferrando, Carlos, Catalan-Monzon, Ignacio, Frutos-Vivar, Fernando, Jimenez, Jorge, Rodríguez-Solis, Carmen, Franquesa-Gonzalez, Enric, Acosta, Guillermo Pérez, Cabrera, Luciano Santana, Parra, Juan Pablo Aviles, Gonzalez, Francisco Muñoyerro, del Carmen Conesa, Maria Lorente, Varela, Ignacio Yago Martinez, Pravia, Orville Victoriano Baez, Delgado, Maria Cruz Martin, de Cabo, Carlos Munoz, Ioan, Ana-Maria, Perez-Calvo, Cesar, Santos, Arnoldo, Abad-Motos, Ane, Ripolles-Melchor, Javier, Martin, Belén Civantos, Teruel, Santiago Yus, Lucas, Juan Higuera, Ortiz, Aaron Blandino, de Pablo Sánchez, Raúl, Barrueco-Francioni, Jesús Emilio, Espina, Lorena Forcelledo, Bonell-Goytisolo, José M., Salaverria, Iñigo, Mir, Antonia Socias, Rodriguez-Ruiz, Emilio, Valverde, Virginia Hidalgo, Cubero, Patricia Jimeno, Linde, Francisca Arbol, Leganes, Nieves Cruza, Romeu, Juan Maria, Concha, Pablo, Berezo-Garcia, José Angel, Fraile, Virginia, Cuenca-Rubio, Cristina, Pérez-Torres, David, Serrano, Ainhoa, Valero, Clara Martínez, Suner, Andrea Ortiz, Larrañaga, Leire, Legaristi, Noemi, Ferrigno, Gerardo, Khlafalla, Safa, Bihariesingh-Sanchit, Rosita, Zoerner, Frank, Grip, Jonathan, Kilsand, Kristina, Mårtensson, Johan, Österlind, Jonas, von Seth, Magnus, Berkius, Johan, Ceruti, Samuele, Glotta, Andrea, Izdes, Seval, Turan, Işıl Özkoçak, Cosar, Ahmet, Halacli, Burcin, Dereli, Necla, Yilmaz, Mehmet, Akbas, Türkay, Elay, Gülseren, Eyüpoğlu, Selin, Bílír, Yelíz, Saraçoğlu, Kemal Tolga, Kaya, Ebru, Sahin, Ayca Sultan, Ekren, Pervin Korkmaz, Mengi, Tuğçe, Suner, Kezban Ozmen, Tomak, Yakup, Eroglu, Ahmet, Alsabbah, Asad, Hanlon, Katie, Gervin, Kevin, McMahon, Sean, Hagan, Samantha, Higenbottam, Caroline V, Mullhi, Randeep, Poulton, Lottie, Torlinski, Tomasz, Gareth, Allen, Truman, Nick, Vijayakumar, Gopal, Hall, Chris, Jubb, Alasdair, Cagova, Lenka, Jones, Nicola, Graham, Sam, Robin, Nicole, Cowton, Amanda, Donnelly, Adrian, Singatullina, Natalia, Kent, Melanie, Boulanger, Carole, Campbell, Zoë, Potter, Elizabeth, Duric, Natalie, Szakmany, Tamas, Kviatkovske, Orinta, Marczin, Nandor, Ellis, Caroline, Saha, Rajnish, Sri-Chandana, Chunda, Allan, John, Mumelj, Lana, Venkatesh, Harish, Gotz, Vera Nina, Cochrane, Anthony, Ficial, Barbara, Kamble, Shruthi, Lumlertgul, Nuttha, Oddy, Christopher, Jain, Susan, Crapelli, Giulia Beatrice, Vlachou, Aikaterini, Golden, David, Garrioch, Sweyn, Henning, Jeremy, Loveleena, Gupta, Davey, Miriam, Grauslyte, Lina, Salciute-Simene, Erika, Cook, Martin, Barling, Danny, Broadhurst, Phil, Purvis, Sarah, Spivey, Michael, Shuker, Benjamin, Grecu, Irina, Harding, Daniel, Dean, James T., Nielsen, Nathan D., Al-Bayati, Sama, Al-Sadawi, Mohammed, Charron, Mariane, Stubenrauch, Peter, Santanilla, Jairo, Wentowski, Catherine, Rosenberger, Dorothea, Eksarko, Polikseni, and Jawa, Randeep

Abstract

Background: Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods: This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results: Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions: Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04

Published
2023

12. Lactate is associated with mortality in very old intensive care patients suffering from COVID-19: results from an international observational study of 2860 patients

Author

Bruno, Raphael Romano, Wernly, Bernhard, Flaatten, Hans, Artigas, Antonio, Bollen Pinto, Bernardo, Binnebössel, Stephan, Baldia, Philipp Heinrich, Kelm, Malte, Beil, Michael, Sigal, Sivri, van Heerden, Peter Vernon, Elhadi, Muhammed, Zafeiridis, Tilemachos, Arche Banzo, Maria José, Moreno, Rui, Boumendil, Ariane, De Lange, Dylan W., Eller, Philipp, Joannidis, Michael, Mesotten, Dieter, Reper, Pascal, Oeyen, Sandra, Swinnen, Walter, Serck, Nicolas, Dewaele, Elisabeth, Chapeta, Edwin, Brix, Helene, Brushoej, Jens, Kumar, Pritpal, Nedergaard, Helene Korvenius, Johnsen, Tim Koch, Bundesen, Camilla, Hansen, Maria Aagaard, Uhrenholt, Stine, Bundgaard, Helle, Fjølner, Jesper, Innes, Richard, Gooch, James, Cagova, Lenka, Potter, Elizabeth, Reay, Michael, Davey, Miriam, Abusayed, Mohammed Abdelshafy, Humphreys, Sally, Collins, Amy, Aujayeb, Avinash, Leaver, Susannah, Khaliq, Waqas, Habib, Ayman Abdelmawgoad, Azab, Mohammed A., Wassim, Kyrillos, Elgazzar, Yumna A., Salah, Rehab, Abosheaishaa, Hazem Maarouf, Hussein Mohamed, Aliae A. R., Azzam, Ahmed Y., Tharwat, Samar, Ali, Yasmin Khairy Nasreldin Mohamed, Elmandouh, Omar, Galal, Islam, Abu-Elfatth, Ahmed, Motawea, Karam, Elbahnasawy, Mohammad, Shehata, Mostafa, Elbahnasawy, Mohamed, Tayeb, Mostafa, Osman, Nermin, Abdel-Elsalam, Wafaa, Hussein, Aliae Mohamed, Aldhalia, Amer, Galbois, Arnaud, Guidet, Bertrand, Charron, Cyril, Berlemont, Caroline Hauw, Besch, Guillaume, Rigaud, Jean-Philippe, Maizel, Julien, Djibré, Michel, Burtin, Philippe, Garcon, Pierre, Nseir, Saad, Valette, Xavier, Alexandru, Nica, Marin, Nathalie, Vaissiere, Marie, Plantefeve, Gaëtan, Mentec, Hervé, Vanderlinden, Thierry, Jurcisin, Igor, Megarbane, Buno, Chousterman, Benjamin Glenn, Dépret, François, Garnier, Marc, Besset, Sebastien, Oziel, Johanna, Ferre, Alexis, Dauger, Stéphane, Dumas, Guillaume, Goncalves, Bruno, Vettoretti, Lucie, Thevenin, Didier, Schaller, Stefan, Kurt, Muhammed, Faltlhauser, Andreas, Meyer, Christian, Milovanovic, Milena, Lutz, Matthias, Shala, Gonxhe, Haake, Hendrik, Randerath, Winfried, Kunstein, Anselm, Meybohm, Patrick, Barth, Eberhard, Poerner, Tudor, Simon, Philipp, Lorenz, Marco, Dindane, Zouhir, Kuhn, Karl Friedrich, Welte, Martin, Voigt, Ingo, Kabitz, Hans-Joachim, Wollborn, Jakob, Goebel, Ulrich, Stoll, Sandra Emily, Kindgen-Milles, Detlef, Dubler, Simon, Jung, Christian, Fuest, Kristina, Schuster, Michael, Steiner, Stephan, Papadogoulas, Antonios, Mulita, Francesk, Rovina, Nikoletta, Aidoni, Zoi, Chrisanthopoulou, Evangelia, Kondili, Eumorfia, Andrianopoulos, Ioannis, Gurjar, Mohan, Mahmoodpoor, Ata, Hussein, Rand, Al-Juaifari, Maytham Aqeel, Karantenachy, Abdullah Khudhur Ahmed, Sviri, Sigal, Elsaka, Ahmed, Marsh, Brian, Comellini, Vittoria, Al-Ali, Farah, Almani, Sari, Khamees, Almu' Atasim, Al-Shami, Khayry, El Din, Ibrahim Salah, Abubaker, Taha, Ahmed, Hazem, Rabha, Ahmed, Emhamed, Marwa, Abdeewi, Saedah, Abusalama, Abdurraouf, Alhadi, Abdulmueti, Huwaysh, Mohammed, Alghati, Esraa Abdalqader, Ghannam, Abdelilah, Namendys-Sylva, Silvio A., Groenendijk, Martijn, Evers, Mirjam, Van Lelyveld-Haas, Lenneke, Meynaar, Iwan, Cornet, Alexander Daniel, Zegers, Marieke, Dieperink, Willem, De Lange, Dylan, Dormans, Tom, Hahn, Michael, Sjøbøe, Britt, Strietzel, Hans Frank, Olasveengen, Theresa, Romundstad, Luis, Andersen, Finn H., Massoud, John George Grace, Khan, Aamir Ghafoor, Al-Qasrawi, Shahd, Amro, Sarah, Kluzik, Anna, Zatorski, Pawel, Drygalski, Tomasz, Szczeklik, Wojciech, Klimkiewicz, Jakub, Solek-Pastuszka, Joanna, Onichimowski, Dariusz, Czuczwar, Miroslaw, Gawda, Ryszard, Stefaniak, Jan, Stefanska-Wronka, Karina, Zabul, Ewa, Oliveira, Ana Isabel Pinho, Assis, Rui, De Lurdes Campos Santos, Maria, Santos, Henrique, Cardoso, Filipe Sousa, Gordinho, André, Grintescu, Ioana Marina, Tomescu, Dana, Badawy, Mohamed Raafat, José Arche Banzo, M., Zalba-Etayo, Begoña, Cubero, Patricia Jimeno, Priego, Jesús, Gomà, Gemma, Tomasa-Irriguible, Teresa Maria, Sancho, Susana, Ferreira, Aida Fernández, Vázquez, Eric Mayor, Mira, Ángela Prado, Ibarz, Mercedes, Iglesias, David, Arias-Rivera, Susana, Frutos-Vivar, Fernando, Lopez-Cuenca, Sonia, Aldecoa, Cesar, Perez-Torres, David, Canas-Perez, Isabel, Tamayo-Lomas, Luis, Diaz-Rodriguez, Cristina, De Gopegui, Pablo Ruiz, Saleh, Mahmoud, Hilles, Momin Majed Yousuf, Abualqumboz, Enas M. Y., Ben-Hamouda, Nawfel, Roberti, Andrea, Fleury, Yvan, Abidi, Nour, Schefold, Joerg C., Chau, Ivan, Dullenkopf, Alexander, Chaaban, Mohammad Karam, Shebani, Mohammed Mouaz, Hmaideh, Ahmad, Shaher, Aymen, Sahin, Ayca Sultan, Saracoglu, Kemal Tolga, Al-Sadawi, Mohammed, Pugh, Richard, Smuts, Sara, and Al-Saban, Rafat Ameen Mohammed

Subjects
Research, Intensive / Critical Care Medicine, Emergency Medicine, Anesthesiology, ddc
Published
2020

13. EFFECTIVENESS OF USING PRE-HOSPITAL ASPIRIN AND ANTI-INFLAMMATORY DRUGS ON MORTALITY AND MORBIDITY IN ACUTE RESPIRATORY DISTRESS SYNDROME PATIENTS

Author

Sahin, Ayca Sultan, Derbent, Abdurrahim, Salihoglu, Ece, and Ege Üniversitesi

Subjects
Acute respiratory distress syndrome, anti-inflammatory drug, aspirin
Abstract

Salihoglu, Ece/0000-0002-7170-7877, WOS: 000508954100002, Objective: in this study, we aimed to investigate the efficacy of pre-hospital use of aspirin and anti-inflammatory agents in patients with Acute Respiratory Distress Syndrome (ARDS) and mortality in critically ill patients, by retrospectively screening ARDS patients treated in intensive care unit (ICU). Material and Method: Demographic data, duration time of ICU, intensive care unit Apache-II score, presence of comorbidity and mortality, procalcitonin and C-Reactive Protein (CRP) levels. neutrophil/lymphocyte (N/L) rates, Berlin Criteria, the use of aspirin and anti-inflammatory drugs, and the presence of infection findings from, the files of ARDS patients followed from January 2016 to January 2017. Results: Forty of the 43 ARDS patients were included in the study. Eighteen patients (90%) had worsening in the first week, 14 (70%) had chest X-ray pathology, 15 had (75%) pulmonary edema and 12 had (60%) needed oxygen. Statistically significant difference was found in these Berlin Criteria (p= 0.05). Conclusion: Pre-hospital aspirin and anti-inflammatory drugs seemed to decrease morbidity in terms of Berlin. Criteria but there were no significant differences between mortality in ARDS patients in intensive care unit. However, further research is needed to confirm the results.

Published
2019

16. Massive Subcutaneous Emphysema During Laparoscopic Gynecologic Surgery.

Author

SAHIN, Ayca Sultan and ALTUNAY, Mahmut Boray

Subjects
SUBCUTANEOUS emphysema, LAPAROSCOPES, GYNECOLOGIC surgery, BODY mass index, CARBON dioxide, OVARIAN cysts
Abstract

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY 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.)

Published
2020
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19. Effect of Dexamethasone on Postoperative Analgesia Following the Transversus Abdominis Plane Block in Gynecological Laparotomies.

Author

Küçüksaraç G, Arslan KR, and Sahin AS

Abstract

Purpose: Postoperative pain is an acute pain that begins with surgical trauma and decreases as the tissue heals. The transversus abdominis plane (TAP) block is one of the abdominal field blocks used in the treatment of acute postoperative pain after lower abdominal surgery. This study aims to investigate the effects of dexamethasone added to a local anesthetic solution on postoperative analgesia in ultrasonography-guided TAP block., Materials and Methods: Our study included female patients aged 18-80 with American Society of Anesthesiology (ASA) I-II status who had undergone gynecological laparotomy (total abdominal hysterectomy (TAH), total abdominal hysterectomy + bilateral salpingoophorectomy (TAH+BSO), myomectomy). The patients were examined in two groups, each consisting of 30 people. Patients in whom dexamethasone was added to the analgesic solution while applying the TAP block were classified as Group D and patients without dexamethasone were classified as Group B. The patients' Visual Analog Scale (VAS) scores at the 2nd, 4th, 8th, 12th, and 24th hours postoperatively; their painkiller needs in the first 24 hours postoperatively; their first mobilization time; and their total analgesic requirements in the first 24 hours postoperatively were examined., Results: When postoperative 2, 4, 8, and 12 hours VAS scores were compared, no significant difference was found between the groups (p>0.05). Postoperative 24th-hour VAS scores were significantly lower in Group D (p<0.001). No statistically significant difference was found when additional analgesic demands were compared between the groups at 2, 4, 8, and 12 hours postoperatively (p>0.05). Additional analgesic demand at the 24th postoperative hour was significantly lower in Group D (p=0.020). When the 24-hour additional IV analgesic demands of the patients were compared, the additional analgesic demand in Group B was found to be significantly higher than in Group D (p=0.038). When postoperative mobilization hours were compared between the groups, no statistically significant difference was found between the two groups (p=0.617). When the patient's first analgesic request times were compared, no significant difference was found between the groups (p=0.617)., Conclusion: It was determined that dexamethasone added to bupivacaine in USG-guided TAP block reduced the amount of additional analgesic consumed in the first 24 hours postoperatively and reduced VAS scores. We think that adding dexamethasone to local anesthetics in the TAP block will benefit multimodal analgesia., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Kanuni Sultan Süleyman Training and Research Hospital Ethics Committee issued approval 2022.01.332. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Küçüksaraç et al.)

Published
2024
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20. A Retrospective Comparison of Clinical and Laboratory Aspects of Patients With COVID-19-Related Acute Respiratory Distress Syndrome (ARDS) and Non-COVID-19-Related ARDS.

Author

Yıldız N, Kaya E, and Sahin AS

Abstract

Aim/objective: This study investigated demographic characteristics, hemodynamic values, respiratory datas, laboratory values ​​such as biochemistry and blood gas, and treatment approaches of coronavirus disease 2019 (COVID-19)-related and non-COVID-19-related acute respiratory distress syndrome (ARDS) patients hospitalized in the intensive care unit (ICU)., Background: Determining the differences and similarities between COVID-19-related ARDS (CARDS) patients and non-COVID-19-related ARDS (NCARDS) patients will be useful to better understand these two diseases., Materials and Methods: A total of 32 NCARDS patients who were followed and treated in the ICU for various reasons between January 2015 and December 2020 and 32 CARDS patients who were followed and treated in the ICU for various reasons between March 2020 and December 2020 were examined retrospectively. Age, gender, comorbidities, Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation (APACHE) II Score, blood pressure, heart rate, saturation, laboratory results, arterial blood gas (ABG) values, length of stay in the ICU, intubation, the number of days till the patient was extubated, the treatments applied, admission to the service, and mortality were evaluated., Results: In the comparison between the two groups, the demographic data of the patients, the number of days intubated and extubated, APACHE II scores, and ICU length of stay were not statistically different. Values of positive end-expiratory pressure (PEEP), first hospitalization GCS, first hospitalization hemoglobin (Hgb), albumin at first admission, alanine aminotransferase (ALT) at first admission, and steroid use were found to be significantly different in patients with CARDS (p < 0.001). The median of PEEP values (p = 0.04), first admission GCS values (p = 0.04), first admission Hgb values (p = 0.005), albumin values at the first admission (p = 0.03), ALT values (p = 0.03), and the rate of steroid use (p = 0.001) of CARDS patients were significantly higher than those of NCARDS patients. The median of the first hospitalization heart rate values (p = 0.009), first hospitalization saturation values (p = 0.001), and first admission neutrophil values (p = 0.03) in NCARDS patients were significantly higher than that of CARDS patients. There was no significant difference between the two groups in terms of mortality, sedation use, inotropic support, C-reactive protein (CRP), and procalcitonin values., Conclusions: CARDS and NCARDS have clinical and laboratory similarities and differences. Therefore, there should be differences in our follow-up and treatment approach to these two disease groups., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. İstanbul S.B.Ü. Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi Etik Kurulu (Istanbul Ministry of Health University Kanuni Sultan Süleyman Training and Research Hospital Ethics Committee) issued approval KAEK/2021.01.26. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yıldız et al.)

Published
2024
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21. Evaluation of patients diagnosed with brain death in the intensive care unit: 10 years of tertiary center experience in Istanbul.

Author

Arslan K and Sahin AS

Abstract

Objective: Early and accurate diagnosis of brain death in intensive care units (ICU) is essential for organ transplantation. This study aimed to evaluate the cases diagnosed with brain death in the ICU of a tertiary center in Istanbul., Methods: The cases diagnosed as brain death in the ICU during the ten years between January 2013 and September 2022 were evaluated retrospectively. The demographic characteristics of the patients, the diagnosis of hospitalization in the ICU, the time from arrival to the ICU until the diagnosis of brain death, the somatic survival time after the diagnosis of brain death, the acceptance rate of organ donation by the families and the organs removed were evaluated., Results: A total of 44 patients were diagnosed with brain death. The mean age of the cases was 39.7±17.4 years, and 63% were male. The most common hospitalization diagnosis was intracranial hemorrhage (81.8%). Traffic accidents, hypertensive and aneurysm-related hemorrhages, gunshot wounds, and falls from height were the most common causes of intracranial hemorrhage. Patients were admitted to the ICU most frequently from the emergency department (54%). The mean time to brain death was 7.9±6.2 days, and the somatic survival time was 1.9±1.9 days in patients who did not receive organ transplantation. While the apnea test was positive in 91% of the cases, the apnea test could not be completed in 9% of the cases. While relatives of 7% (n=3) of the cases accepted organ donation, a patient was not allowed to be an organ donor for medical reasons. Organ transplantation was performed in two patients (5%)., Conclusion: As in the whole world, getting treatment as soon as possible for the patients waiting on the organ transplant list in Turkiye by increasing the number of organs to be obtained from cadavers. In cases with suspected brain death in the ICU, diagnosing brain death as soon as possible and conducting family interviews with trained organ transplant coordinators will increase the number of cadaver donors. However, we think policies should be developed to ensure that society is informed and encouraged about brain death and organ donation., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2024 by Istanbul Provincial Directorate of Health.)

Published
2024
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22. Baseline serum vitamin A and vitamin C levels and their association with disease severity in COVID-19 patients.

Author

Yilmaz G, Bulut H, Ozden Omaygenc D, Akca A, Can E, Tuten N, Bestel A, Erdem B, Atmaca UO, Kara Y, Kaya E, Unsel M, Sahin AS, and Salihoglu Z

Subjects
Humans, Vitamin D, Vitamin A, Vitamins, Ascorbic Acid, Patient Acuity, COVID-19 complications, Vitamin D Deficiency complications
Abstract

Aim: We aimed to investigate the association between the serum concentrations of Vitamin A and Vitamin C and the severity of the COVID-19.  Methods: Fifty-three consecutive PCR (+) COVID-19 patients admitted to a dedicated ward were enrolled in this study. Blood samples for serum Vitamin A and C measurements were drawn from all participants upon admission. All subjects underwent thoracic CT imaging prior to hospitalization. CT severity score (CT-SS) was then calculated for determining the extent of pulmonary involvement. A group of healthy volunteers, in whom COVID-19 was ruled out, were assigned to the control group (n=26). These groups were compared by demographic features and serum vitamin A and C levels. The relationship between serum concentrations of these vitamins and pre-defined outcome measures, CT-SS and length of hospitalization (LOH), was also assessed.  Results: In COVID-19 patients, serum Vitamin A (ng/ml, 494±96 vs. 698±93; p<0.001) and Vitamin C (ng/ml, 2961 [1991-31718] vs. 3953 [1385-8779]; p=0.007) levels were significantly lower with respect to healthy controls. According to the results of correlation analyses, there was a significant negative association between Vitamin A level and outcome measures (LOH, r=-0.293; p=0.009 and CT-SS, r=-0.289; p=0.010). The negative correlations between Vitamin C level and those measures were even more prominent (LOH, r=-0.478; p<0.001 and CT-SS, r=-0.734: p<0.001)., Conclusion: COVID-19 patients had lower baseline serum Vitamin A and Vitamin C levels as compared to healthy controls. In subjects with COVID-19, Vitamin A and Vitamin C levels were negatively correlated with CT-SS and LOH.

Published
2023
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