Background: The Systemic Inflammation Index (SII), associated with increased systemic inflammation and adverse outcomes, has been demonstrated to be efficacious and a significant biomarker in different patient populations. This investigation aims to examine the correlation between the admission SII, a relatively new biomarker, and 28-day mortality outcomes in intensive care units (ICUs). Methods: This retrospective cohort analysis was undertaken in a tertiary-level ICU in Turkey from 3 April 2024 through 31 December 2024. Baseline demographic data, clinical characteristics, and laboratory parameters were recorded. Inflammatory parameters such as SII, NLR, and PLR were calculated at the time of ICU admission. SII = neutrophil count (10³/ill) × PLT count (10³/μL)/lymphocyte count, NLR = neutrophil count (10³/μL)/lymphocyte count (10³/μL), and PLR = PLT (10³/μL)/lymphocyte count (10³/μL). Results: In this study, a total of 702 patients who met the eligibility criteria were recruited. The study’s overall mortality rate for 28 days was 36.9% with 259 deaths. The median age of the cohort was 70 years (57–80), with 41.6% of the participants being female. The SII was markedly elevated in non-survivors compared to survivors (p = 0.010). The analysis revealed that the SII/1000 was an independent predictor of elevated mortality risk (OR 1.029, 95% CI 1.001–1.057, p = 0.042). Conclusions: The identification of the Systemic Inflammation Index on admission to the ICUs is of critical importance. The SII has been demonstrated to serve as a significant and independent predictor of mortality. There is a need for prospective and large-scale studies to generalize this finding to other populations or for more widespread use in clinical practice.

Background and Objectives: The study aimed to evaluate the predictive significance of Shock Indices and induction agents in predicting the risk of Peri-Intubation Cardiovascular Collapse (PIC) during intubation in the ICU. Materials and Methods: A total of 130 patients were analyzed in the study after dividing them into 2 groups based on the definition of PIC as Patients with PIC and Non-PIC Patients. PIC was defined as the detection of at least SBP < 65 mmHg measured at least once within 30 min after the intubation, SBP < 90 mmHg for 30 min, initiation of norepinephrine treatment, increasing the norepinephrine dose taken before the intubation, increasing SBP to >90 mmHg with >15 mL/kg crystalloid fluid infusion, or development of cardiac arrest. The relationship between Shock Index (SI), Diastolic Shock Index (DSI), Modified Shock Index (MSI), Age Shock Index (Age-SI), and induction agents (ketamine, propofol) and PIC was evaluated. Results: The PIC was detected in 62 patients (47.7%). Age-SI showed the highest predictive performance (AUC = 0.686, p < 0.001). Ketamine provided a protective effect (OR = 0.161, p = 0.003). Propofol (OR = 2.962, p = 0.048), age (OR = 1.065, p = 0.002), lactate (OR = 1.265, p = 0.047), and DSI (OR = 2.300, p = 0.037) were identified as independent risk factors. ICU mortality was significantly higher in the PIC group (74.2% vs. 20.6%, p < 0.001). Conclusions: Age, lactate, DSI, and Age-SI are valuable predictive parameters for PIC. Ketamine reduces the risk of PIC, while propofol increases it. These results support evidence-based risk assessment and induction agent selection in ICU intubation protocols.

55 yaşında erkek hasta; sol kol ve bacakta kuvvet kaybı şikayetiyle acil servise getirilmiş. Glasgow Koma Skoru (GKS):12 (Göz:3 Motor:6 Sözel:3), bilinci açık, kısmi koopere, dizartrik, kas gücü sol üstte ve altta 1/5, Babinsky -/+. Bilgisayarlı Tomografi (BT) Anjio’da sağ internal karotid arter (İCA) oklüzyonu görüldü ve anjio ile sağ İCA’ya balon anjioplasti ve stent; sol İCA ve orta serebral arter (MCA) oklüzyonuna mekanik trombektomi uygulandı. Yoğun bakım ünitesinde (YBÜ) takip edilen hastanın işlem sonrası 12. saatte GKS:13’e (G:4, M:6, S:3) geriledi; kontrol beyin BT’de hemorajik transformasyon, sağ MCA alanında ödem ve orta hatta sola itilme izlendi. Dekompresyon cerrahisi uygulandı. Postoperatif dördüncü saatte ekstübe edildi, GKS:15, koopere, oryante idi. Mannitol %20 4X100 mL İV infüzyon tedavisi başlandı. YBÜ takibinin dördüncü gününde Enoksaparin sodyum 60 mg 1X0,6 mL Subkutan ve Klopidogrel 75 mg tablet 1X1 Peroral tedavisine eklendi. Postoperatif 4. günde kas gücü sol üstte 3/5, sol altta 4/5 olan hasta fizyoterapi programına dahil edildi. YBÜ’de takibinin 11. gününde bilinç açık, oryante, koopere, oda havasında spontan soluyan, fizyoterapi programı devam eden hasta nöroloji servisine devredildi. 55-year-old male patient was brought to the emergency room complaining of loss of strength in his left arm and leg. Glasgow Coma Score (GCS):12 (Eye:3 Motor:6 Verbal:3), conscious, partially cooperative, dysarthric, muscle strength 1/5 in the upper and lower left, Babinsky -/+. Computerized Tomography (CT) Angiography revealed right internal carotid artery (ICA) occlusion, and angiography performed balloon angioplasty and stent to the right ICA; mechanical thrombectomy was performed for left ICA and middle cerebral artery (MCA) occlusion. The GCS of the patient, who was followed up in the intensive care unit (ICU), decreased to 13 (E:4, M:6, V:3) at the 12th hour after the procedure; control brain CT showed hemorrhagic transformation, edema in the right MCA area, and a shift to the left in the midline. Decompression surgery was performed. He was extubated at the fourth postoperative hour, GCS:15, cooperative and oriented. Mannitol 20% 4X100 mL IV infusion treatment was started. On the fourth day of ICU follow-up, Enoxaparin sodium 60 mg 1X0.6 mL Subcutaneous and Clopidogrel 75 mg tablet 1X1 Peroral were added to the treatment. On the 4th postoperative day, the patient, whose muscle strength was 3/5 in the upper left and 4/5 in the lower left, was included in the physiotherapy program. On the 11th day of his follow-up in the ICU, the patient, who was conscious, oriented, cooperative, breathing spontaneously on room air, and whose physiotherapy program was continuing, was transferred to the neurology service.

Yoğun Bakımda Akciğer Tüberkülozu: Tanı, Tedavi ve İzolasyon İmren TAŞKIRAN Erişkin Yoğun Bakım Hasta Popülasyonunun Özellikleri ve Yoğun Bakımda Güncel Sorunlar Ömer EMGİN Yaşam Sonu Bakımı: Etik, Klinik ve Kişisel Perspektifler Yakup ÖZGÜNGÖR Yoğun Bakımda Enteral ve Parenteral Beslenme Engin HAFTACI Yoğun Bakımda Hasta ve Hasta Yakını İletişimi Murat GÜNEŞ Beyin Ölümü Tanısı-Güncel Konular Mehmet YAVUZ Yoğun Bakımda Tiroid Fonksiyon Bozuklukları Uğur AYDOĞAN Yoğun Bakımda Adrenal Yetmezlik Ebru AYDOĞAN Yoğun Bakımda Obstrüktif Uyku Apne Sendromu Engin KIRMIZIGÜL Donör Bakımı Ayşe ÇAPAR Yoğun Bakımda İnflamatuar Barsak Hastalıkları Adnan ATA Yoğun Bakımda Plevral Efüzyon ve Ultrasonografi Ömer KEKLİCEK Yoğun Bakım Hastalarında Venöz Tromboembolizm Turgay ATAY