Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
4 results
Search Results
Item Vasoactive Inotropic Score for Predicting Pediatric Tracheostomy(2022) Silahli, Musa; Tekin, Mehmet; Celik, MehmetBackground: Although tracheostomy is not performed as frequently as in adults, it is also used in children. There is no clear consensus on timing and risk factors, especially in early infancy and in cases who underwent cardiac surgeries. In the early infancy period, pediatric cardiac surgery patients have to receive an inotropic agent after the cardiac surgery due to poor general condition or hemodynamic instability. As a result of prolonged intubation, tracheostomy is required to be performed in some of these patients. Objectives: The present study aimed to investigate the relationship between vasoactive inotropic scores (VIS) and tracheostomy in pediatric cardiac surgery patients. Methods: A total of 47 patients, 21 with tracheostomy and 26 without tracheostomy, who underwent cardiac surgery were included in this retrospective study. The VIS and inotrope score (IS) values were calculated and recorded hourly for 48 h postoperatively. Scores were calculated by multiplying the inotropes infusion rate of the patients with certain coefficients. It was attempted to determine objective formalized models and cut-off values that may benefit the relationship between VIS values and tracheostomy. Results: The median weight was 3,630 g (range, 2,040-13,400), and the median age was 69 days (range, 1-1,081) on the surgery day. The majority (93.6%) of the patients were aged < 1 year. Preoperative C-reactive protein measurements were significantly higher by 50% in patients who underwent tracheostomy (P=0.005). The albumin levels in the tracheostomy group (TG) were low, although not significantly (P=0.057). The VIS values of TG had 50% higher values than the non-tracheostomy group (NTG) (P<0.001). In addition, formula 1 predicted with 57% accuracy that a tracheostomy could be performed (VIS =18.170-0.170* HOUR; P < 0.001), and formula 2 predicted with 72% accuracy that a tracheostomy could not be performed (VIS =17.170-0.170* HOUR; P < 0.001). Hospital stay (P<0.001), mechanical ventilation duration (P<0.001), and the number of ongoing intubation on the 7th day post-surgery were significantly higher in TG. Conclusion: After pediatric cardiac surgery, VIS values can predict tracheostomy status and help intensive care professionals make decisions.Item Effects of personality traits on severity of sepsis(2021) Pehlivanlar Kucuk, Mehtap; Kucuk, Ahmet Oguzhan; Komurcu, Ozgur; Dikmen, Yalim; Kadioglu, Mustafa; Uzan, Cagdas Alp; Ergin Ozcan, Perihan; Orhun, Gunseli; Unal Akdemir, Neslihan; Eroglu, Ahmet; Ilyas, Yasir; Zeyneloglu, Pinar; Sahinturk, Helin; Dai Ozcengiz, Dilek; Firat, Ahmet; Aydin, Davut; Ozlu, Tevfik; Pehlivanlar, Aysegul; Kirakli, Cenk; Acar Cinleti, Burcu; Gok, Funda; Yosunkaya, Alper; Aktas, Murat; Ozturk, Cagatay Erman; Ulger, Fatma; 0000-0003-0159-4771; 34581156; AAJ-1419-2021Introduction: The aim of this study was to reveal the effect of the individual's lifestyle and personality traits on the disease process in patients with sepsis and to have clinical predictions about these patients. Materials and Methods: The study was planned as a multi-center, prospective, observational study after obtaining the approval of the local ethics committee. Patients were hospitalized in different intensive care units. Besides demographics and personal characteristics of patients, laboratory data, length of hospital and ICU stay, and mortality was recorded. Two hundred and fifty-nine patients were followed up in 11 different intensive care units. Mortality rates, morbidities, blood analyses, and personality traits were evaluated as primary outcomes. Results: Of the 259 patients followed up, mortality rates were significantly higher in men than in women (p=0.008). No significant difference was found between the patients' daily activity, tea and coffee consumption, reading habits, smoking habits, blood groups, atopy histories and mortality rates. Examining the personal traits, it was seen that 90 people had A-type personality structure and 51 (56.7%) of them died with higher mortality rate compared to type B (p=0.038). There was no difference between personalities, in concomitant ARDS occurrence, need for sedation and renal replacement therapies. Conclusion: Among individuals diagnosed with sepsis/septic shock, mortality increased significantly in patients with A-type personality trait compared to other personality traits. These results showed that personal traits may be useful in predicting the severity of disease and mortality in patients with sepsis/septic shock.Item Effects of diaphragm thickness on rehabilitation outcomes in post-ICU patients with spinal cord and brain injury(2020) Guzel, Sukran; Umay, Ebru; Gundogdu, Ibrahim; Bahtiyarca, Zeynep Tuba; Cankurtaran, Damla; 0000-0001-9852-0917; 32601716; AAG-3148-2021Background Intensive care unit (ICU) complications affect outcomes but it remains unknown if the diaphragm thickness affects rehabilitation outcomes after ICU. We conducted a pilot study to evaluate the effect of diaphragm thickness on rehabilitation outcomes of post-ICU patients with spinal cord injury (SCI) and traumatic brain injury (TBI) and to evaluate factors that may be associated with diaphragm atrophy. Materials and methods Fifty-one patients (26 SCI, 25 TBI) who admitted to the rehabilitation clinic from the ICU included in this study. All demographic data were recorded. All participants underwent diaphragmatic ultrasonography evaluation before and after 12 weeks of neurologic rehabilitation program. The diaphragm thickness and outcome parameters were compared in all patient groups and in each patient subgroups. Evaluation parameters of patients before and after treatment were compared in patient subgroups. Results Diaphragm atrophy was found in 14 patients (64%) in TBI group and 12 patients (46%) in SCI group. The diaphragm thickness negatively correlated with the ICU length of stay and positively correlated with the before/after rehabilitation functional scores and the change in functional independence measure scores (p < 0.05). According to the regression analysis; the change in functional independence measure scores was found to be affected by the diaphragm thickness (p < 0.05). Conclusions The diaphragm thickness may be an effective factor on the rehabilitation process.Item Intensive Care Psychological Assessment Tool (IPAT): Turkish validity and reliability study(2019) Duman, Berker; Kotan, Zeynep; Kotan, Vahap Ozan; Mutlu, Nevzat Mehmet; Doganay Erdogan, Beyza; Sayar Akaslan, Damla; Tatli, Safiye Zeynep; Kumbasar, Hakan; 31408296Background/aim: It is of crucial importantance to be able to detect acute psychological distress in patients. 'the Intensive Care Psychological Assessment Tool (IPAT) was developed for this purpose in intensive care units. This study aims to evaluate the validity and reliability of the Turkish version of IPAT. Materials and methods: In total, 98 patients were included. To assess concurrent validity, the Intensive Care Experiences Scale (ICES) and the Hospital Anxiety Depression Scale were performed. Cronbach's alpha coefficient was used to estimate internal consistency. Interitem and item-total score correlations were also performed. Sensitivity and specificity were derived for concurrent anxiety and depression. Results: The internal reliability was good. Cronbach's a = 0.85. Items were well-correlated, with an average interitem correlation of 0.38. The concurrent validity of IPAT was good. Correlation between IPAT scores, anxiety, depression, ICES, and the diagnosis of delirium were as follows, respectively: r = 0.61, P < 0.01, r 0.54, P < 0.01, r = -0.66, P < 0.01, r = 0.37, P < 0.01. With a cutoff score of > 6, IPAT showed 85% sensitivity and 61% specificity to detect concurrent anxiety, and 74% sensitivity and 82% specificity to detect concurrent depression [AUC = 0.77 (95% CI, 0.68-0.87) and 0.84 (95% CI, 0.76-0.92), respectively). Conclusion: The Turkish version of IPAT was found to be a valid and reliable tool to assess acute psychological distress among patients in intensive care units.