Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
3 results
Search Results
Item Accuracy of Continuous Noninvasive Arterial Pressure Monitoring in Living-Liver Donors During Transplantation(2015) Araz, Coskun; Zeyneloglu, Pinar; Pirat, Arash; Veziroglu, Nukhet; Firat, Aynur Camkiran; Arslan, Gulnaz; 0000-0003-2312-9942; 0000-0002-4927-6660; 0000-0003-1470-7501; 25894178; C-3736-2018; AAJ-4576-2021Objectives: Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant. Materials and Methods: There were 40 patients analyzed while undergoing hepatic lobectomy for liver transplant. Invasive pressure monitoring was established at the radial artery and continuous noninvasive arterial pressure monitoring using a finger sensor was recorded simultaneously from the contralateral arm. Systolic, diastolic, and mean arterial pressures from the 2 methods were compared. Correlation between the 2 methods was calculated. Results: A total of 5433 simultaneous measurements were obtained. For systolic arterial blood pressure, 55% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.479, continuous noninvasive arterial pressure bias was -0.3 mm Hg, and limits of agreement were 32.0 mm Hg. For diastolic arterial blood pressure, 50% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.630, continuous noninvasive arterial pressure bias was -0.4 mm Hg, and limits of agreement were 21.1 mm Hg. For mean arterial blood pressure, 60% continuous noninvasive arterial pressure measurements were within 10% direct arterial measurement; the correlation was 0.692, continuous noninvasive arterial pressure bias was +0.4 mm Hg, and limits of agreement were 20.8 mm Hg. Conclusions: The 2 monitoring techniques did not show acceptable agreement. Our results suggest that continuous noninvasive arterial pressure monitoring is not equivalent to invasive arterial pressure monitoring in donors during living-donor liver transplant.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 Posttransplant Pneumonia Among Solid Organ Transplant Recipients Followed in Intensive Care Unit(2022) Yesiler, Fatma Irem; Yazar, Cagla; Sahinturk, Helin; Zeyneloglu, Pinar; Haberal, Mehmet; 0000-0002-3887-0314; 0000-0003-0159-4771; 0000-0002-3462-7632; 34269656; AAJ-1419-2021; AAJ-8097-2021Objectives: Pneumonia is a significant cause of morbidity and mortality in solid-organ transplant recipients. We studied the demographic characteristics, respiratory management, and outcomes of solid-organ transplant recipients with pneumonia in an intensive care unit. Materials and Methods: There have been 2857 kidney, 687 liver, and 142 heart transplants performed between October 16, 1985, and February 28, 2021, at our center. We retrospectively analyzed records for 51 of 193 recipients with pneumonia during the posttransplant period between January 1, 2016, and December 31, 2018. Results: Fifty-one of 193 recipients were followed in the intensive care unit. Mean age was 45.4 +/- 16.6 years among 42 male (82.4%) and 9 female (17.6%) recipients. Twenty-six patients (51%) underwent kidney transplant, 14 (27.5%) liver transplant, 7 (13.7%) heart transplant, and 4 (7.8%) combined kidney and liver transplant. Most pneumonia episodes occurred 6 months after transplant (70.6%) with acute hypoxemic respiratory failure. Mean Acute Physiology and Chronic Health Evaluation System II score was 18.9 +/- 7.7, and the Sequential Organ Failure Assessment score was 8.5 +/- 3.9 at intensive care unit admission. Whereas 66.7% of pneumonia cases were nosocomial acquired, 33.3% were community acquired. The intensive care unit and 28-day mortality rates were 39.2% and 64.7%, respectively. Conclusions: Solid-organ transplant recipients with pneumonia have been associated with poor prognosis. Our cohort followed in the intensive care unit comprised mostly patients with nosocomial pneumonia with acute hypoxemic respiratory failure, hospitalized 6 months after transplant with high Acute Physiology and Chronic Health Evaluation System II scores predictive of mortality. In this high-risk patient group, careful follow-up, early discovery of warning signs, and rapid treatment initiation could improve the outcomes in the intensive care unit.