High flow nasal cannula (HFNC) was mostly used in intensive care units with few studies in other departments. We hypothesized that HFNC applied at wards is beneficial for acute respiratory failure in hematological malignancy patients. The study is a single center, randomized controlled study. Inclusion criteria were hypoxemic respiratory failure and hematological malignancy. Patients were randomized to either venturi mask/nasal cannula oxygen treatment or HFNC. One hundred patients were included into the study. Median age was 58.5 (18-86) years and APACHE II score was 17 (5-29). HFNC group was 51 patients and oxygen treatment group 49 patients. P/F ratios were similar between the groups throughout the study period. Endotracheal intubation was required in 10 (20.0%) patients in oxygen group and 17 (33.0%) patients in HFNC group (p=0.14). A total of 17 (35.0%) patients in oxygen group and 17 (33.0%) patients in HFNC group received non-invasive mechanical ventilation (p=0.97). Median VAS comfort scores at 2nd and 24th hours were not different between groups. Twenty-eight-day mortality rate was 36.7% (18 deaths) in standard group and 45.0% (23 deaths) in HFNC group (p=0.39). HFNC applied in wards is not superior to standard oxygen treatment for acute respiratory failure in hematological malignancy patients.

There are limited data on the long-term outcomes of COVID-19 from different parts of the world. To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Retrospective, observational cohort. Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO₂/FiO₂ ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.

Critically ill patients are at risk of developing gastrointestinal (GI) bleeding due to stress causing mucosal damage. Aim of the study was to determine the effect of oral/ enteral nutrition with or without concomitant pantoprazole on upper GI bleeding in low risk critically ill patients. This was a prospective, randomized, open-label, multicenter study conducted with intensive care unit (ICU) patients receiving oral/enteral nutritional support. Patients were randomly assigned into two groups including intervention group (received oral/EN plus pantoprazole) and control group (received only oral/EN). A total of 300 patients (intervention group: 152, control group: 148) participated in the study. Overall, 226 (75 %) patients were fed by oral and 74 (25%) patients fed by enteral tube. Median duration of nutritional support 4 (range: 2-33) days. Overt upper GI bleeding was noted only in one patient (0.65%) who was in the intervention group. The overall length of ICU stay of 4 (2-105) days, while ICU stay was significantly longer in the intervention group than in the control group (p=0.006). Our findings seems to indicate that in patients who are at low risk for GI bleeding and under oral/enteral nutritional support, the use of PPIs may not reduce the risk of bleeding, however these results are imprecise because of low event (GI bleeding) rate and limited power.

We describe a patient with hypersensitivity vasculitis due to ofloxacin therapy; the vasculitis was associated with elevated transaminase and IgA levels. Cyclophosphamide and intravenous pulse prednisolone resulted in clinical improvement.