Endotheliopathy plays an essential role in the pathophysiology of COVID-19. The endothelial activation and stress index (EASIX) indicates endothelial dysfunction. We aimed to investigate the relationship between a high EASIX score and mortality in patients with COVID-19. We retrospectively reviewed COVID-19 patients admitted to the ICU (intensive care unit) of the Ankara Bilkent City Hospital. We recorded hematological and biochemical parameters at the ICU admission and further calculated EASIX with the following equation: EASIX = Lactate dehydrogenase (U/L) × creatinine (mg/dL)/platelet count (10⁹/L). Statistical comparisons were made between the surviving and non-surviving groups in terms of EASIX. The median EASIX score was 1.2 (0.7–2.0) in the survivor group and a median of 2.5 (1.6–4.2) in the non-survivor group (p < 0.001). The mean log2-EASIX was 0.2 ± 0.9 in the survivor group and 1.3 ± 1.2 in the non-survivor group (p < 0.001). Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, and IL-6 were statistically significantly higher in the non-survivor group compared to the survivor group. The receiver operating characteristic (ROC) curve analysis showed that the cut-off value of the EASIX score was 2.05 (The area under the curve [AUC] = 0.764, p = 0.001, 95% CI: 0.662–0.847). Our study showed an association between high EASIX scores and poor prognosis in COVID-19 patients. Lactate dehydrogenase, creatinine, Troponin I, D-dimer, procalcitonin, ferritin, IL-6, EASIX, and log2-EASIX were statistically significantly higher in the non-survivor group compared to the survivor group. Being old and having chronic kidney disease increases the risk of death. Eventually, EASIX can be used to predict mortality in COVID-19 patients.

Aim: Cardiac arrest during cardiopulmonary bypass (CPBP) is achieved using cardioplegia solutions for myocardial protection. There are limited data about the systemic biochemical effects of cardioplegia solutions. This study aimed to compare the biochemical effects of del Nido cardioplegia, blood cardioplegia, and St. Thomas cardioplegia solutions.Material and Methods: This retrospective study included patients that underwent isolated Aortic valve replacement between 1 August 2017 and 31 July 2018. The medical records of patients reviewed after ethical approval of the protocol. Patients were divided into 3 groups according to the cardioplegia solution used during surgery, as follows: the del Nido cardioplegia group (dNC group); the blood cardioplegia group (BC group); the St. Thomas cardioplegia group (STC group). Perioperative clinical outcomes and laboratory findings were compared between groups. Results: The study included 26 patients that underwent minimally invasive aortic valve replacement. Fewer patients in the dNC group required inotropic agents than in the other 2 groups, but the difference was not significant (P = 0.844). There wasn’t a significant difference between the groups in the change in the troponin t level from the preoperative to postoperative period (P = 0.148). The difference in the arterial glucose and insulin levels was similar in all 3 groups (P = 0.372 and P = 0.258, respectively). Thyroid, liver, and renal function were also similar in all 3 groups. Conclusion: dNC solution is a safe alternative to BC and STC solutions during isolated minimally invasive aortic valve replacement surgery, in terms of myocardial protection and biochemical parameters.

Background/Objective: Patients who have undergone Billroth II gastrectomy may develop gastroparesis, hypomotility, and reflux esophagitis. These patients are at risk of aspiration of gastric contents into the lungs when subsequently sedated for Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. The aim of this study was to compare conscious sedation and deep sedation in terms of pulmonary complications in this selected cohort. Methods: Patients who had previously undergone Billroth II surgery and underwent ERCP procedure with sedation for gallstones or biliary tract strictures in a tertiary hospital between January 2020 and September 2023 were studied. Patient records were retrospectively obtained from the hospital information system. All the patients were divided into two groups as conscious sedation (Group CS) and deep sedation (Group DS). The groups were compared statistically in terms of pulmonary complications. Results: A total of 63 ERCP procedures were performed on 28 patients who had undergone Billroth II gastrectomy. There were 37 procedures involving conscious sedation (Group CS) and 26 involving deep sedation (Group DS). No statistically significant difference was found regarding pulmonary aspiration (p = 0.297) and other respiratory complications such as laryngospasm or desaturation between the two groups. In Group DS, it was observed that vomiting incidence was higher (p = 0.012), and airway maneuver requirements were increased (p = 0.007). Conclusions: In patients who have undergone Billroth II gastrectomy, both conscious sedation and deep sedation techniques can be used effectively during ERCP procedures. The complication rates and patient outcomes of the two techniques are comparable. The occurrence of respiratory complications leading to adverse post-procedural outcomes requires careful monitoring and meticulous follow-up for these patients.

Aim: We aimed to observe the effects of analgesics used intraoperatively on the postoperative pain and recovery in patients underwent LC . Material and Methods: ASA I-III group, aged 20-85 patients, who underwent LC surgery were included in the study. We denominated as groups the distribution of analgesics used in eight groups: control group(Group C) for patients without intraoperative analgesia; tramadol (Group T); metamizole (Group M); diclofenac (Group D); paracetamol (Group P); tramadol+metamizol (Group TM); tramadol+diclofenac (Group TD); tramadol+paracetamol (Group TP). Analgesics that can provide visual analog scale (VAS) ≤ 4 was considered effective. Additional analgesics were administered to the patients whom VAS was above 4 in recovery room. Recoveries of patients was determined with Aldrete Score. Results: 31 patients control group, in 35 patients tramadol, in 36 patients, metamizole, in 32 patients diclofenac and in 31 patients paracetamol, in 56 patients tramadol+metamizol, in 31 patients tramadol+diclofenac and in 32 patients tramadol+paracetamol were used. In all groups used analgesics, VAS≤ 4 could not be provided in first hour. In the patients used one analgesic alone and two analgesics together, lowest need for additional analgesics was in GP and GTP group within the first one hour. Aldrete scores were lowest in whom did not receive analgesics intraoperatively. Conclusion: We consider that the management of pain in laparoscopic cholecystectomy should be done early postoperative period. All analgesics should be administered on the basis of the knowledge of their pharmacokinetic profiles.

Aim: Brachial plexus block under ultrasonography guidance is a successful and frequently used anesthesia method for hand, wrist and forearm surgery. Brachial plexus block can be performed with axillary or midhumeral approach technique. In this study, we aimed to compare the intraoperative and postoperative anesthetic and analgesic properties of axillary or midhumeral approach in ultrasonography-guided brachial plexus block.Material and Methods: This randomized, controlled, double-blind, single-center study included 90 ASA I-III risk patients, aged 18-70 years, who underwent hand, wrist and forearm surgery. In Group I, axillary; in Group II, midhumeral approach techniques were performed for brachial plexus block. Cold test was used to evaluate sensory block, and three-point scale was used to evaluate motor block. Postoperative pain was assessed by visual analog scale.Results: There was no statistical difference between age, height, weight, BMI and gender characteristics of the patients included in the study. There was no statistically significant difference between the groups in terms of block onset and regression times on both sensory and motor examination (p> 0.05). The main result was that axillary approach shortens the complete block onset time on both sensory and motor examination (p <0.05). Another important result was that axillary approach provides higher surgeon and patient satisfaction levels significantly comparing to mid-humeral approach (p <0.05). Conclusion: Both approaches can be applied successfully in brachial plexus block and can be used effectively in elective surgeries. In patients who underwent axillary approach technique for brachial plexus block, full block onset time is earlier than in patients undergoing midhumeral approach technique. Therefore, axillary approach technique may be preferred in cases requiring urgent surgical intervention.