OBJECTIVES: The primary aim was to define factors related to the return of spontaneous circulation (ROSC) after in-hospital cardiac arrest (IHCA), and the secondary aim was to determine factors related to 28-day mortality in patients admitted to intensive care unit (ICU) after ROSC. METHODS: In this retrospective study, we included the patients who suffered from IHCA in a tertiary hospital between July 2016 and April 2019. Pre- and post-resuscitation characteristics of the patients and event characteristics were defined to reveal the independent factors associated with ROSC and 28-day survival. RESULTS: A total of 254 patients (median age 73 years, 58.3% males) underwent cardiopulmonary resuscitation (CPR). The ROSC rate was 45.7%. Of all, 51 patients (median age, 63 years, 54.9% males) were admitted to in-hospital ICUs. The 28-day survival rate was 31.4%. The independent risk factors were chronic kidney disease (odds ratio [OR], 3.18, 95% confidence interval [CI], 1.37–7.19, P = 0.007), chronic obstructive pulmonary disease (OR, 2.84, 95% CI, 1.23–6.61, P = 0.015), asystole as an initial rhythm (OR, 2.94, 95% CI, 1.27–6.79, P = 0.012), multi-trauma-related complications (OR, 21.11, 95% CI, 4.71–94.69, P < 0.001), and septic shock (OR, 4.10; 95% CI, 1.16–14.54, P = 0.029) for ROSC; and a cerebral performance category score >2 (OR, 20.86, 95% CI, 2.74–158.65, P = 0.003), Acute Physiology and Chronic Health Evaluation II score >14 (OR, 7.58, 95% CI, 1.06–54.23, P = 0.044) for 28-day mortality. CONCLUSIONS: Independent risk factors related to ROSC and 28-day mortality were defined in the study. However, further studies are needed to devise new strategies for increased hospital discharge with preserved neurologic functions.

Retrospective Analysis of Totally Implantable Venous Access Ports which was Performed using the Patient’s Height as a Guide, and the Effect of Catheter Tip Position on Complications - Turkish Journal of Anaesthesiology and Reanimation

Perioperative pain management in children is challenging due to limited communication and the risk of long-term psychological effects. Regional anesthesia, particularly the caudal block (CB), is frequently used in pediatric surgery for lower abdominal and urogenital procedures. However, the influence of injection speed during CB on intracranial and hemodynamic responses remains unclear. This prospective observational cohort study included 64 pediatric patients (American Society of Anesthesiologists I–II, aged 1–7 years) undergoing elective lower abdominal or urogenital surgery under general anesthesia. All patients received a CB with 0.8 mL/kg of 0.125% bupivacaine. Injection speed was not assigned by the study protocol but reflected routine clinical practice, and patients were categorized according to the injection speed used (0.25 mL/s or 0.5 mL/s). The primary outcome was the change in optic nerve sheath diameter (ONSD) over time and between injection-speed groups. Secondary outcomes included heart rate and mean arterial pressure, recorded at baseline and at predefined time points after the block. Baseline ONSD values were similar between groups. ONSD increased transiently after caudal injection in both groups, with a significantly greater increase in the fast-injection group immediately after the block. These differences were short-lived, and ONSD values returned toward baseline within 10 to 20 minutes, with no persistent intergroup differences. Heart rate and mean arterial pressure showed mild, transient reductions in both groups, which were slightly more pronounced in the fast-injection group but remained within physiological limits. Different caudal injection speeds were associated with distinct transient changes in ONSD and hemodynamic parameters. Slower injection was associated with more gradual physiological responses during the early postinjection period.