Tıp Fakültesi / Faculty of Medicine

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

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search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccessSubject: search.filters.subject.Intensive care

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    Acute Respiratory Failure in Cardiac Transplant Recipients
    (2015) Komurcu, Ozgur; Ozdemirkan, Aycan; Firat, Aynur Camkiran; Zeyneloglu, Pinar; Sezgin, Atilla; Pirat, Arash; 0000-0003-2312-9942; 0000-0003-1470-7501; 26640904; C-3736-2018; AAH-7003-2019
    Objectives: This study sought to evaluate the incidence, risk factors, and outcomes of acute respiratory failure in cardiac transplant recipients. Materials and Methods: Cardiac transplant recipients >15 years of age and readmitted to the intensive care unit after cardiac transplant between 2005 and 2015 were included. Results: Thirty-nine patients were included in the final analyses. Patients with acute respiratory failure and without acute respiratory failure were compared. The most frequent causes of readmission were routine intensive care unit follow-up after endomyocardial biopsy, heart failure, sepsis, and pneumonia. Patients who were readmitted to the intensive care unit were further divided into 2 groups based on presence of acute respiratory failure. Patients' ages and body weights did not differ between groups. The groups were not different in terms of comorbidities. The admission sequential organ failure assessment scores were higher in patients with acute respiratory failure. Patients with acute respiratory failure were more likely to use bronchodilators and n-acetylcysteine before readmission. Mean peak inspiratory pressures were higher in patients in acute respiratory failure. Patients with acute respiratory failure developed sepsis more frequently and they were more likely to have hypotension. Patients with acute respiratory failure had higher values of serum creatinine before admission to intensive care unit and in the first day of intensive care unit. Patients with acute respiratory failure had more frequent bilateral opacities on chest radiographs and positive blood and urine cultures. Duration of intensive care unit and hospital stays were not statistically different between groups. Mortality in patients with acute respiratory failure was 76.5% compared with 0% in patients without acute respiratory failure. Conclusions: A significant number of cardiac transplant recipients were readmitted to the intensive care unit. Patients presenting with acute respiratory failure on readmission more frequently developed sepsis and hypotension, suggesting a poorer prognosis.
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    Severe Hypernatremia Associated Catheter Malposition in An Intensive Care Patient
    (2016) Silahli, Musa; Gokdemir, Mahmut; Duman, Enes; Gokmen, Zeynel; 0000-0003-0944-7178; 0000-0002-2746-0547; 0000-0002-5676-2747; 27555161; AAB-5059-2022; AAX-9343-2021; AAJ-8069-2021; N-4174-2014
    We present a catheter related severe hypernatremia in a 2-month-old baby who was admitted to the pediatric intensive care. Imbalance of plasma sodium is commonly seen in pediatric intensive care patients. The water and sodium balance is a complex process. Especially, brain and kidneys are the most important organs that affect the water and sodium balance. Other mechanisms of the cellular structure include osmoreceptors, Na-K ATPase systems, and vasopressin. Hypernatremia is usually an iatrogenic condition in hospitalized patients due to mismanagement of water electrolyte imbalance. Central venous catheterization is frequently used in pediatric intensive care patients. Complications of central venous catheter placement still continue despite the usage of ultrasound guidance. Malposition of central venous catheter in the brain veins should be kept in mind as a rare cause of iatrogenic hypernatremia. (C) 2016 Elsevier Inc. All rights reserved.
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    Fifteen Years Of Central Catheter Applications And Outcomes In Intensive Care Patients: A Single-Center Pediatric Experience
    (2022) Silahli, Musa; Kesim, Cagri; https://orcid.org/0000-0003-0944-7178; https://orcid.org/0000-0002-8964-291X; 35100890; AAD-5996-2021
    Background: To investigate the clinical outcome of central line placement in the pediatric age group and to evaluate the risk factors for central line-associated bloodstream infection (CLABSI). Methods: We retrospectively examined the outcomes and CLABSI risk factors of pediatric patients aged 0-17 years admitted to intensive care units who had central catheters placed between January 2005 and December 2020. Results: Of the 2718 catheter admissions, 1502 catheter admissions were eligible for the regression and other outcome analyses. Fifty-seven percent of the study group were umbilical artery and vein catheters and 43% were other central catheter admissions, including ultrasound-guided catheter admissions. Logistic regression analysis showed us that right internal jugular vein (RIJV) (OR = 1.5, 95% CI = 1.15-2.02, p = 0.030) was the insertion site and ultrasound-guided interventional radiology catheter placement was the technique (OR = 1.7, 95% CI = 1.07-2.90, p = 0.024), duration of catheter stay (OR = 1.07, 95%CI = 1.06-1.08, p < 0.001), catheter placement in patients older than 2 years (OR = 2.42, 95% CI = 1.69-3.45, p < 0.001), were risk factors for CLABSI. Conclusion: Although CLABSI has variable risk factors, the most important risk factor seems to be the length of catheter stay.