Wos İndeksli Yayınlar Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/11727/4807

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Author: search.filters.author.Pirat, Arashsearch.filters.applied.f.language: search.filters.language.tur

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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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    A Rat Model of Acute Respiratory Distress Silymarin's Antiinflamatory and Antioxidant Effect
    (2016) Adiguzel, Senay Canikli; Pirat, Arash; Turkoglu, Suna; Bayraktar, Nilufer; Ozen, Ozlem; Kaya, Muge
    Objective: In this study, it was aimed to evaluate the anti-inflammatory and antioxidative effects of Silymarin in rats in whom artificial acute pulmonary damage was provided with caecal ligation-perforation method. Material and Method: Forty-six rats were randomized to sham (n=14), control (n=16), silymarin (n=16) groups. Each group had early and late subgroups. Silimarin was administered in the silimarin group and saline was administerd in control and sham groups. Artificial acute pulmonary damage associated with sepsis was provided with caecal ligation-perforation method in control and silimarin groups. Rats in the early subgroup Were terminated at the end of the 12th hour and threats in the late group were followed-up. Serum and bronchoalveolar lavage fluid (BAL) tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, and IL-6; lung tissue malondialdehyde (MDA) and glutathione (GSH) levels; lung histopathologic examination; and lung wet-to-dry (w/d) weight ratio measurements were used to compare and evaluate the severity of lung injury between the groups. Results: Mortality rates for silymarin and control groups were 62.5% and 12.5%, respectively (log-rank p=0.0506). Compared with the silymarin group, the control group exhibited significantly more severe lung injury, as indicated by higher mean values for serum and BAL TNF-alpha, IL-1beta and IL-6 (p<0.05 for all measurements), total lung histopathologic injury score (p=0.001), w/d (p=0.019) and lung-tissue MDA (p=0.011) levels. Lung tissue GSH levels were significantly higher in silymarin group than control group (p=0.001). Conclusion: Silymarin reduces the severity of sepsis induced-acute lung injury and may also improve survival in a cecal ligation and perforation rat model. These beneficial effects of this agent are probably due to its inhibitory effects on inflammatory process and oxidative injury.
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    The Effect of Extensively Drug-resistant Infections on Mortality in Surgical Intensive Care Patients
    (2018) Sahinturk, Helin; Ozdemirkan, Aycan; Kilic, Fatma; Ozalp, Onur; Arslan, Hande; Zeyneoglu, Pinar; Pirat, Arash
    Objective: The aim of the study was to assess the outcomes of intensive care unit acquired extensively drug-resistant (XDR) bacterial infections in a surgical patient cohort. Materials and Methods: The data of patients with XDR bacteria isolated at Baskent University Hospital, Anesthesia and Surgical Intensive Care Unit between January 2016 and December 2016 were reviewed retrospectively. Adult patients over 18 years of age who had undergone surgery within the first 24 hours and who developed intensive care unit infection 48 hours after admission to intensive care unit were included in the study. Results: All of the 341 patients who admitted to the surgical intensive care unit during the study period were underwent surgery within the first 24 hours. XDR bacterial infections were isolated in 30 out (9%) of these 341 patients. The mean APACHE II score was calculated as 18.5 +/- 5.3, and expected mean mortality rate of 35 +/- 17.1. The mean length of intensive care unit stay was 27.0 +/- 27.4 days, while the mean hospital stay was 49.0 +/- 34.3 days. The hospital mortality rate was found to be 57% (n=7). Conclusion: As a conclusion of our study, we found that XDR bacterial infections were common (9%) among intensive care surgical patients and their mortality rate was higher than their expected mortality rate according to their APACHE II scores calculated during intensive care unit admission (57% vs. 35%, respectively).