Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Ancillary Tests
    (2023) Zeyneloglu, Pinar; Bozbay, Suha
    Ancillary tests are the tests those help to confirm the clinical diagnosis of brain death. These tests are in 2 groups as electrophysiological and tests for the evaluation of cerebral blood circulation. They indicate the absence of cerebral blood circulation and brain electrical activity. They should not replace clinical evaluation.
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    A Comparison of Echocardiography and the Pressure Recording Analytical Method (PRAM) for Predicting Fluid Responsiveness after Passive Leg Raising
    (2021) Ozdemirkan, Aycan; Aitakhanoya, Manat; Gedik, Ender; Zeyneloglu, Pinar; Pirat, Arash; 0000-0002-7175-207X; ABI-2971-2020
    Objective: This study aims to assess the agreement between the cardiac index (CI) measured by pressure recording analytical method (PRAM) and transthoracic echocardiography (TTE) before and after the passive leg raise (PLR) maneuver. Methods: This is a prospective observational study in critically ill patients who were monitored with MostcareUp/PRAM (Vygon, Vytech, Padova, Italy). Cardiac index (CI) values and percent changes in CI values in response to PLR were recorded by TTE and PRAM. Results: Data of a total of 25 patients were collected. The median CI values that were calculated by TTE before and after PLR were 2.5 (1.2-4.7) L/min/m(2) and 2.9 (1.4-5.6) L/min/m(2), respectively. The median CI values that were calculated by PRAM before and after PLR were 2.5 (1.5-4.8) L/min/m(2) and 2.6 (1.7-5.7) L/min/m(2), respectively. There was significant correlations between the measured CI values both by TTE and PRAM before and after PLR (r=0.635, p=0.001 and r=0.610, p=0.001, respectively). The median percent changes in CI with TTE and PRAM were -0.13 (-0.7-0.4) and -0.11 (-0.5-0.5), respectively. Sixteen patients were determined as FR by TTE (64%) and 13 patients were determined as FR by PRAM (52%). The Kappa test showed moderate agreement between TTE and PRAM for predicting fluid responsiveness (k=0.595; p=0.002). The mean biases between the CI values measured by TTE and PRAM before and after PLR were 0.04 +/- 0.77 L/min/m(2) and 0.22 +/- 0.88 L/min/m(2), respectively. Conclusion: This study showed a significant correlation for CI values measured by both methods. For predicting fluid responsiveness there was agreement between the two methods after PLR.
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    Post-operative Respiratory Distress Due to Laryngeal Granuloma and Subglottic Stenosis in a Patient Undergoing Open Heart Surgery
    (2021) Yazar, Cagla; Aitakhanova, Manat; Gulleroglu, Aykan; Firat, Aynur Camkiran; Zeyneloglu, Pinar; 0000-0002-3887-0314; 0000-0002-6091-9065; AAJ-4188-2021
    The cause of impairment in respiratory functions after open heart surgery is multifactorial. A 67-year-old female patient admitted to the intensive care unit (ICU) was intubated after mitral valve replacement and tricuspid annuloplasty. She was extubated on the first post-operative (post-op) day. On post-op day 5, the patient was re-admitted to the ICU due to respiratory distress and tachypnea. Non-invasive mechanical ventilation (NIMV) support and dobutamine 5 mcg/kg/min were started. Prior to diagnosis of septic shock, tazocin 3x4.5 grams was administered. The patient was intubated on the post-op day 6 because of the increase in respiratory distress. She was extubated on the post-op day 7, and NIMV commenced. On the 8th post-op day, she was consulted to the ear, nose and throat (ENT) department because of sore throat. Widespread mucosal aphthous lesions were observed in the uvula, soft and hard palate, mandible inner mucosa and alveolar process. Galactomannan was detected positive in bronchoalveolar lavage and treatment with fluconozole started. On post-op day 15, the patient was discharged. That same night, she was admitted to the ICU again due to sudden respiratory distress and was placed on NIMV support, but the patient whose respiratory distress increased and was unconscious was intubated. The next day, direct laryngoscopy was performed by the ENT department under operating room conditions, and a 3x4 cm polypoid lesion was removed from the vocal cord level. However, after 2 days, the patient was re-examined by direct laryngoscopy, necrotic crusts were removed under the cricoid cartilage posteriorly in the subglottic region. The patient recovered from post-op respiratory distress, was extubated on the 18th post-op day and his support with NIMV continued. The patient was discharged on the 33rd post-op day. Laryngeal granuloma and subglottic strictures should be considered in patients with post-op respiratory distress, no matter how short the intubation period is.
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    Abdominal Compartment Syndrome
    (2015) Zeyneloglu, Pinar
    Intraabdominal hypertension and Abdominal compartment syndrome are causes of morbidity and mortality in critical care patients. Timely diagnosis and treatment may improve organ functions. Intra- abdominal pressure monitoring is vital during evaluation of the patients and in the management algorithms. The incidence, definition and risk factors, clinical presentation, diagnosis and management of intraabdominal hypertension and Abdominal compartment syndrome were reviewed here.
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    In Memoriam - Arash Pirat (1971-2017)
    (2018) Arslan, Gulnaz; Torgay, Adnan; Zeyneloglu, Pinar; 0000-0002-6829-3300; AAJ-5221-2021