Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Influence of Different Sugammadex Doses on Neural Tube Development in Early-Stage Chick Embryos(2023) Ayhan, Asude; Efe, Ekin; Fidan, Pinar A.; Efe, Oguzhan E.; Ates, Eylem Gul; Sahinturk, Fikret; Ayhan, Selim; 0000-0002-6166-2601; 0000-0001-6955-9839; 0000-0002-3243-7843; 0000-0003-3047-0305; 0000-0002-0471-3177; 37565787; HGE-9282-2022; AAJ-2057-2021; AAJ-4728-2021; W-7908-2019; ABG-5365-2020; AAI-7972-2021Background: Sugammadex is a modified gamma-cyclodextrin that has been developed with the goal of reversing the steroidal neuromuscular blocking agents. The aim of the present study is to investigate the effects of different sugammadex doses on embryologic and neural tube development in an early-stage chick embryo model. Methods: A total of 100 specific pathogen-free, fertilized domestic chicken eggs were randomly divided into five groups (n = 20, each), and placed in an automatic cycle incubator. The eggs in the "control (C)" group were incubated without administration of any drug till the end of the experiment. Subblastodermic administration of 0.9% NaCl as vehicle control (VC) and different doses of sugammadex solutions prepared with the latter [2 mg/mL (LD), 4 mg/mL (MD), 16 mg/mL (HD)] were performed at 30 hr of incubation. All embryos were removed from the eggs at 72 hr when they were expected to reach Hamburger-Hamilton (HH) stages 19-20, then they were fixed, and evaluated histo-morphologically. Results: Embryonic development was not observed in 11 eggs (1 in C, 1 in VC; 3 in LD, 3 in MD, and 3 in HD). All the developed embryos were compatible with the HH stages 19-20. A neural tube closure defect was detected in one embryo in the HD group. No statistically significant difference was found between the groups in terms of embryonic and neural tube developments. Conclusions: No significant association was found between the drug and adverse outcomes; however, a trend with dosing was seen. Further studies are required before conclude on safety and extrapolate these results to human beings.Item Anesthetic and Perioperative Management of Nontransplant Surgery in Patients After Liver Transplant(2017) Ersoy, Zeynep; Ayhan, Asude; Ozdemirkan, Aycan; Polat, Gulsah Gulsi; Zeyneloglu, Pinar; Arslan, Gulnaz; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0003-2312-9942; 0000-0002-3462-7632; 0000-0003-3299-6706; 0000-0001-8285-0372; 28260430; AAF-3066-2021; AAH-7003-2019; C-3736-2018; AAJ-8097-2021; AAJ-2066-2021Objectives: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. Materials and Methods: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Baskent University Hospital. Results: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33). The median time between transplant and nontransplant surgery was 1231 days. The most frequent types of nontransplant surgery were abdominal (22%), orthopedic (16%), and urologic (13%). Seventy patients had an American Society of Anesthesiologists status of 2 (49%); the status was 3 in 71 patients (49%) and 4 in 3 patients (2%). Of the 144 procedures, 23 were emergent (16%) and 48% were abdominal. General anesthesia was used in 69%, regional anesthesia in 19%, and sedoanalgesia in 11%. Twenty-five patients required intraoperative blood-product transfusion (17%). Intraoperative hemodynamic instability developed in 17% of patients, and hypoxemia developed in 2%. Eleven patients remained intubated at the end of surgery (8%). Of the 144 procedures, 19 (13%) required transfer to the intensive care unit, 108 (75%) transferred to the ward, and the remaining 17 (12%) were discharged on the same day. Eight patients developed respiratory failure (6%), 7 had renal dysfunction (5%), 4 had coagulation abnormalities (3%), and 10 had infectious complications (7%) in the early postoperative period. The median hospital stay was 4 days, and 5 patients (4%) developed rejection during hospitalization. Five patients died of respiratory or infectious complications (4%). Conclusions: Most liver-graft recipients who undergo nontransplant surgery are given general anesthesia, transferred to the ward after the procedure, and discharged without major complications. We suggest that orthotopic liver transplant recipients may undergo nontransplant surgery without any post operative graft dysfunction.Item Incidence and Patient Outcomes in Renal Replacement Therapy After Orthotopic Liver Transplant(2017) Ayhan, Asude; Ersoy, Zeynep; Ulas, Aydin; Zeyneloglu, Pinar; Pirat, Arash; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0003-3299-6706; 0000-0002-3462-7632; 0000-0003-2312-9942; 0000-0002-8130-9901; 28260481; AAF-3066-2021; AAJ-2066-2021; AAJ-8097-2021; AAJ-2057-2021; C-3736-2018Objectives: Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes. Materials and Methods: We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included. Results: A total of 177 (79 adult, 98 pediatric) orthotopic liver transplants were performed during the study period. Of these, 35 patients (19%) required renal replacement therapy during the early posttrans plantation period. After excluding 5 patients with previous chronic renal failure, 30 patients (17%; 20 adult [25%], 10 pediatric [10%]) with acute kidney injury required renal replacement therapy. The mean patient age was 31.1 +/- 20.0 years, with a mean Model for End-stage Liver Disease score of 16.7 +/- 12.3. Of the patients with acute kidney injury who underwent renal replacement therapy, in-hospital mortality was 23.3% (7 of 30 patients), and 40% remained on dialysis. No significant difference was seen in mortality between early versus delayed initiation of renal replacement therapy in patients with stage 3 acute kidney injury (P = .17). Conclusions: Of liver transplant recipients who present with acute kidney injury, 19% require renal replacement therapy, and in-hospital mortality is 20% in the early postoperative period.Item Anesthetic Management of Renal and Liver Transplantation Recipients During Cesarean Section(2018) Firat, Aynur Camkiran; Ayhan, Asude; Araz, Coskun; Haberal, Mehmet; Kayhan, Zeynep; 0000-0003-3299-6706; 0000-0002-4927-6660; 0000-0002-3462-7632; 0000-0003-0579-1115; AAJ-2066-2021; AAJ-4576-2021; AAJ-8097-2021; AAJ-4623-2021Item Early Postoperative Acute Kidney Injury Among Heart Transplant Recipients: Incidence, Risk Factors and Impact on Clinical Consequences(2018) Aliyev, Ali; Ayhan, Asude; Zeyneloglu, Pinar; Pirat, Arash; Sezgin, Atilla; Kayhan, Zeynep; 000-0003-3299-6706; 0000-0003-0579-1115; AAE-8052-2019; AAJ-2066-2021; AAJ-4623-2021