PubMed İndeksli Açık & Kapalı Erişimli Yayınlar
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Item EVALUATION AND MANAGEMENT OF DIFFICULT AIRWAY IN OBESITY: A SINGLE CENTER RETROSPECTIVE STUDY(2016) Ayhan, Asude; Kaplan, Serife; Kayhan, Zeynep; Arslan, Gulnaz; 27276769The primary aim of this single center retrospective study was to evaluate difficult mask ventilation (DMV) and difficult laryngoscopy (DL) in a unique group of obese patients. A total of 427 adult patients with body mass index (BMI) >= 25 and surgically treated for endometrial cancer from 2011 to 2014 were assessed. Additional increase in BMI, comorbidities, bedside screening tests for risk factors, and the tools used to manage the patients were noted and their effects on DMV and/or DL investigated. Every escalation in the number of risk factors increased the probability of DMV 2.2-fold, DL 1.8-fold and DMV+DL 3.0-fold. Among bedside tests, limited neck movement (LNM), short neck (SN) and absence of teeth were significant for DMV (p<0.05), LNM, SN and obstructive sleep apnea for DL (p<0.05), and LNM and SN for DMV+DL (p<0.05). However, a 10-point increase of BMI was not an independent risk factor when patients with BMI >25% were considered. In conclusion, LNM and SN are independent risk factors for developing DMV and/or DL in obese endometrial cancer patients, while BMI increase over 30 was not additionally affecting difficult airway.Item Effect of Graft Weight to Recipient Body Weight Ratio on Hemodynamic and Metabolic Parameters in Pediatric Liver Transplant: A Retrospective Analysis(2017) Haberal, Mehmet; Ersoy, Zeynep; Kaplan, Serife; Ozdemirkan, Aycan; Torgay, Adnan; Arslan, Gulnaz; Pirat, Arash; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-3462-7632; 28260433; AAF-3066-2021; AAJ-5221-2021; AAJ-8097-2021; AAH-7003-2019Objectives: To analyze how graft-weight-to-body-weight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. Materials and Methods: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio <= 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters. Results: Patients in the large-graft-for-size group (>4%) received more colloid solution (57.7 +/- 20.1 mL/kg vs 45.1 +/- 21.9 mL/kg; P = .08) and higher doses of furosemide (0.7 +/- 0.6 mg/kg vs 0.4 +/- 0.7 mg/kg; P = .018). They had lower mean pH (7.1 +/- 0.1 vs 7.2 +/- 0.1; P = .004) and PO2 (115.4 +/- 44.6 mm Hg vs 147.6 +/- 49.3 mm Hg; P = .004) values, higher blood glucose values (352.8 +/- 96.9 mg/dL vs 262.8 +/- 88.2 mg/dL; P < .001), and lower mean body temperature (34.8 +/- 0.7 degrees C vs 35.2 +/- 0.6 degrees C; P = .016) during the neohepatic phase. They received more blood transfusions during both the anhepatic (30.3 +/- 24.3 mL/kg vs 18.8 +/- 21.8 mL/kg; P = .013) and neohepatic (17.7 +/- 20.4 mL/kg vs 10.3 +/- 15.5 mL/kg; P = .031) phases and more fresh frozen plasma (13.6 +/- 17.6 mL/kg vs 6.2 +/- 10.2 mL/kg; P = .012) during the neohepatic phase. They also were more likely to be hypotensive (P < .05) and to receive norepinephrine infusion more often (44% vs 22%; P < .05) intra-operatively. More patients in this group were mechanically ventilated in the intensive care unit (56% vs 31%; P = .035). There were no significant differences between the groups in postoperative acute renal dysfunction, graft rejection or loss, infections, length of intensive care stay, and mortality (P > .05). Conclusions: High graft weight-to-body-weight ratio is associated with adverse metabolic and hemodynamic changes during the intraoperative and early postoperative periods. These results emphasize the importance of using an appropriately sized graft in liver transplant.