PubMed Açık Erişimli Yayınlar

Permanent URI for this collectionhttps://hdl.handle.net/11727/10763

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Author: search.filters.author.Gedik, Ender

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    Comparison Of Confirmed And Probable COVID-19 Patients In The Intensive Care Unit During The Normalization Period
    (2022) Yesiler, Fatma Irem; Capras, Mesher; Kandemir, Emre; Sahinturk, Helin; Gedik, Ender; Zeyneloglu, Pinar; https://orcid.org/0000-0002-0612-8481; https://orcid.org/0000-0003-0159-4771; 34812130; AAJ-4212-2021; AAJ-1419-2021
    The decrease in social distance together with the normalization period as of June 1, 2020, in our country caused an increase in the number of coronavirus disease 2019 (COVID-19) patients. Our aim was to compare the demographic features, clinical courses, and outcomes of confirmed and probable COVID-19 patients admitted to our intensive care unit (ICU) during the normalization period. Critically ill 128 COVID-19 patients between June 1, 2020, and December 2, 2020, were analyzed retrospectively. The mean age was 69.7 +/- 15.5 y (61.7% male). Sixty-one patients (47.7%) were confirmed. Dyspnea (75.0%) was the most common symptom and hypertension (71.1%) was the most common comorbidity. The mean Acute Physiology and Chronic Health Evaluation System (APACHE II) score; Glasgow Coma Score; Sequential Organ Failure Assessment scores on ICU admission were 17.4 +/- 8.2,12.3 +/- 3.9, and 5.9 +/- 3.4, respectively. One hundred and one patients (78.1%) received low-flow oxygen, 48 had high-flow oxygen therapy (37.5%), and 59 (46.1%) had invasive mechanical ventilation. Fifty-three patients (41.496) had vasopressor therapy and 30 (23.4%) patients had renal replacement therapy due to acute kidney injury (AKI). Confirmed patients were more tachypneic (p= 0.005) and more hypoxemic than probable patients (p < 0.001). Acute respiratory distress syndrome and AKI were more common in confirmed patients than probable (both p < 0.001). Confirmed patients had higher values of hemoglobin, C- reactive protein, fibrinogen, and D-dimer than probables (respectively, p = 0.028. 0.006, 0.000. and 0.019). The overall mortality was higher in confirmed patients (p = 0.209, 52.6% vs. 47.4%). Complications are more common among confirmed COVID-19 patients admitted to ICU. The mortality rate of confirmed COVID-19 patients admitted to the ICU was found to be higher than probable patients. Mortality of confirmed cases was higher than prediction of APACHE-II scoring system.
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    Effects of Minimal Flow Sevoflurane or Desflurane Anaesthesia on Hemodynamic Parameters, Body Temperature and Anaesthetic Consumption
    (2020) Taskın, Duygu; Gedik, Ender; Kayhan, Zeynep; 0000-0002-7175-207X; 0000-0003-0579-1115; 33103139; ABI-2971-2020; AAJ-4623-2021
    Objective: We aimed to compare minimal flow sevoflurane and desflurane anaesthesia in terms of hemodynamic parameters, body temperature, anaesthetic gas consumption and cost. Methods: 120 patients with ASA I-II (>18yo) who underwent elective surgery for longer than 60 min after general anaesthesia were randomized into two groups. The Drager Perseus (R) A500 workstation was used. Pre-oxygenation was performed for 3 min with 6 L min(-1) to 100% oxygen. Fractional inspirium oxygen concentration (FiO(2)) was reduced to 40%, fresh gas flow was 4 L min(-1) after intubation. Sevoflurane or desflurane was started at 1.5 minimal alveolar concentration (MAC). When the MAC value reached 0.9, fresh gas flow was reduced to 0.5 L min(-1), FiO(2) was increased to 68%. At the end of the surgery, the vaporizer was switched off, the fresh gas flow was increased (4 L min(-1), FiO(2) 100%). When the train-of-four (TOF) ratio was 100%, extubation was carried out. Results: There were no differences in patient characteristics and initial hemodynamic parameters of the groups. There were statistically significant differences between the times to reach 0.9 MAC, extubation and eye opening; anaesthetic, O-2 and air consumption in both groups. Conclusion: With minimal flow, the time to reach target MAC, time to extubation and eye opening were significantly faster for desflurane and anaesthetic, oxygen and air consumption in desflurane anaesthesia were less than sevoflurane. Thus, we can say that desflurane has faster anaesthetic induction and recovery time with lower anaesthetic consumption than sevoflurane.