Amaç: Koronavirüs hastalığı-2019 (COVİD-19) pandemisi tüm sağlık hizmetlerini olumsuz etkilemektedir. Bu çalışmada pandemi döneminde merkezimizde, yoğun bakım ünitelerinin önemli kalite göstergesi olan yoğun bakım mortalite oranının nasıl etkilendiğini araştırdık. Gereç ve Yöntem: Bu retrospektif tek merkezli çalışmada, dahili cerrahi non-COVİD-19 hastaların kabul edildiği 20 yataklı yoğun bakım ünitesinde mortalite oranları, pandemi öncesi ve sonrası 6 aylık zaman periyotlarında karşılaştırıldı. Bulgular: Pandemi döneminde yoğun bakım ünitemizde takip edilen hastalarda mortalite oranı artmıştır. Mortalite ile yoğun bakım ünitesine kabul endikasyonu (cerrahi nedenle kabul sonrası, medikal nedenle kabul sonrası, travma sonrası) ve yoğun bakım ünitesine kabul yeri (acil servis, farklı hastane) arasında anlamlı bir ilişki olduğu görülmüştür (p

Increased intracranial pressure is a possible cause of postoperative delirium in open heart surgery patients. Optic nerve sheath diameter is a non-invasive measurement method used to monitor intracranial pressure changes. The authors suggested in this study that optic nerve sheath diameter monitoring could identify patients at risk of postoperative delirium. This prospective observational study was conducted by evaluating data from 90 patients undergoing open heart surgery. Optic nerve sheath diameter in patients was recorded before and after anesthesia induction, before and after cardiopulmonary bypass, and after intensive care transfer. Postoperative delirium was evaluated with the Confusion Assessment Method for the Intensive Care Unit scale. The study was completed with 90 patients and postoperative delirium was observed in 20 of the patients (22.2%). Optic nerve sheath diameter (OR, 5.787; 95% CI, 1.489–22.496; P = 0.011), history of alcohol use (OR, 6.032; 95% CI, 1.052–34.604; P = 0.044), and EuroSCORE II (OR, 3.090; 95% CI, 1.453–6.571; P = 0.003) was associated with postoperative delirium. Optic nerve sheath diameter measured by ultrasonography is associated with postoperative delirium. The increase in optic nerve sheath diameter can be used predictively for postoperative delirium in open heart surgery. Samsun University Samsun Training and Research Hospital, following ethics committee approval (Samsun University clinical research ethics committee (KAEK) 2023 11/7) and Clinical Trials (NCT05942183 / 05.09.2024) registration.

Compartment syndrome of the extremities is a rare but potentially devastating condition. Anaesthetic and analgesic drugs used in the perioperative period may cause a delayed diagnosis by preventing the symptoms from appearing, and irreversible complications can occur. In this report, a case of compartment syndrome secondary to vascular access and its treatment in a morbidly obese patient who underwent abdominoplasty was presented.

The aim of this study was to determine the effects of intraoperative hyperglycemia on postoperative outcomes in orthotopic liver transplant recipients. After ethics committee approval was obtained, we retrospectively analyzed the records of patients who underwent orthotopic liver transplant from January 2000 to December 2013. A total 389 orthotopic liver transplants were performed in our center, but patients aged < 15 years (179 patients) were not included in the analyses. Patients were divided into 2 groups based on their maximum intraoperative blood glucose level: group 1 (patients with intraoperative blood glucose level < 200 mg/dL) and group 2 (patients with intraoperative blood glucose level > 200 mg/dL). Postoperative complications between the 2 groups were compared. There were 58 patients (37.6%; group 1, blood glucose < 200 mg/dL) who had controlled blood glucose and 96 patients (62.3%; group 2, blood glucose > 200 mg/dL) who had uncontrolled blood glucose. The mean age and weight for groups 1 and 2 were similar. There were no differences between the 2 groups regarding the duration of anhepatic phase (P = .20), operation time (P = .41), frequency of immediate intraoperative extubation (P = .14), and postoperative duration of mechanical ventilation (P = .06). There were no significant differences in frequency of patients who had postoperative infectious complications, acute kidney injury, or need for hemodialysis. Mortality rates after liver transplant were similar between the 2 groups (P = .81). Intraoperative hyperglycemia during orthotopic liver transplant was not associated with an increased risk of postoperative infection, acute renal failure, or mortality.

Background Dexmedetomidine is a potent and highly selective alpha-2 adrenoceptor agonist with sympatholytic, sedative, anxiolytic and analgesic properties. The aim of this study is to determine the effect of a dexmedetomidine infusion in liver transplant recipients in the early postoperative period on early and smooth extubation. Methods We performed a retrospective chart review of 21 patients undergoing liver transplantation between December 1, 2018 and February 31, 2020. Patients were divided into the dexmedetomidine and midazolam groups. The primary outcome was the extubation time. Secondary outcomes were mean arterial pressure and heart rate before and after extubation. The collected data included the patients’ age, gender, surgery time, Model for End-stage Liver Disease score, cold ischemia time, blood transfusion amount and extubation visual analogue scale (VAS) scores. Results Extubation time was significantly shorter in the dexmedetomidine group than in the midazolam group (median [minimum-maximum], 4 [0-6], 8 [4-13] hours, respectively, P = .000). Extubation VAS scores were statistically significantly lower in dexmedetomidine group (P = .000). Mean arterial pressure values before and after extubation were significantly higher in patients' midazolam group than the dexmedetomidine group (P = .003, P = .005, respectively). Conclusions Dexmedetomidine infusions provided early and smooth extubation with stable haemodynamics in our patients.