This study aimed to evaluate the effects of low-pressure (10 mmHg) and standard-pressure (14 mmHg) pneumoperitoneum on upper airway dimensions during lapar

This study aimed to compare the time-dependent changes in optic nerve sheath diameter (ONSD) associated with low-pressure (8 mmHg) and high-pressu

Objective: This study aimed to evaluate the readability levels of anesthesia informed consent forms used in Türkiye, applying the Ateşman and Bezirci-Yılmaz formulas, and to compare forms across university, public, and private hospitals.Methods: A total of 100 Turkish anesthesia consent forms, each obtained from a different healthcare institution, were analysed across all seven geographical regions of Türkiye. Forms were classified by institution type: university (n=25), public (n=45), and private (n=30). The Ateşman readability formula and the Bezirci-Yılmaz readability index were used. The Kruskal-Wallis H test, post-hoc Mann-Whitney U tests with Bonferroni correction, and Spearman correlation analysis were applied.Results: The overall mean Ateşman score was 35.60±15.63 (median: 36.24). Of the forms, 75.0% were classified as “Difficult,” 16.0% as “Very Difficult,” 5.0% as “Moderate,” and 4.0% as “Easy.” Overall, 91.0% of forms were at “Difficult” or harder levels. No statistically significant differences were found among the three groups for Ateşman scores (H=1.170; p=0.557) or Bezirci-Yılmaz index (H=0.531; p=0.767). Post-hoc pairwise comparisons with Bonferroni correction also revealed no significant differences (all adjusted p>0.05). A moderate negative correlation was found between mean sentence length and Ateşman score (rs=−0.549; p<0.001).Conclusion: A total of 91% of Turkish anesthesia consent forms are written at a readability level above that recommended for patient materials, and this problem is systemic regardless of institution type. As this study assessed textual readability rather than measured comprehension, these findings indicate a potential barrier to understanding rather than demonstrated comprehension failure. Redesigning forms with shorter sentences and plain language is recommended.

Objective:High-flow nasal cannula (HFNC) is widely used in acute hypoxemic respiratory failure; however, its impact on outcomes in patients with COVID-19 who ultimately require invasive mechanical ventilation (IMV) remains uncertain. This study evaluated the association between pre-intubation HFNC use and in-hospital mortality, successful extubation, and IMV duration.Methods:This retrospective single-center cohort included 457 adult patients with COVID-19 who underwent IMV between March 2020 and December 2022. Among them, 219 patients (47.9%) received HFNC prior to intubation, while 238 patients (52.1%) were intubated without prior HFNC exposure. Baseline demographic and clinical characteristics were balanced using inverse probability of treatment weighting (IPTW). The primary outcome was time to in-hospital mortality; secondary outcomes were successful extubation and IMV duration. Cox proportional hazards regression was prespecified as the primary analytic method and was complemented by double-robust models, propensity score matching (PSM), trimming scenarios, and E-value analysis.Results:Overall in-hospital mortality was 47.5% (217/457). Although crude mortality was higher in the HFNC group (56.2% vs. 39.5%; p=0.001), IPTW-weighted Cox analysis demonstrated a significant reduction in mortality associated with pre-intubation HFNC use (hazard ratio [HR]=0.65; 95% confidence interval [CI]: 0.49–0.86; p=0.002). Findings were consistent across sensitivity analyses and PSM. Kaplan–Meier curves diverged after approximately 150 hours in favor of HFNC. Male sex independently predicted mortality (HR=1.53; 95% CI: 1.16–2.02). Successful extubation rates were similar between groups, whereas IMV duration was longer in the HFNC group.Conclusion:Pre-intubation HFNC use was independently associated with reduced in-hospital mortality in patients with COVID-19 requiring IMV. Prospective multicenter randomized trials are warranted.

Objective: Awake tracheal intubation (ATI) is recommended for an anticipated difficult airway, yet its use remains limited. This study evaluated anesthesiologists’ ATI practices and scenario-based decision-making and identified factors associated with its use.Material and Methods: This cross-sectional, convenience-sampled online survey was conducted in Türkiye (13 March–13 April 2026). Anesthesiology residents and specialists completed an anonymous questionnaire covering demographics, three brief clinical scenarios (anticipated difficult airway, emergency, low cooperation), perceived barriers (a study-specific barrier score), and attitudes and practices. The primary outcome was self-reported performance of ATI at least once within the previous year; secondary outcomes were scenario-based decision-making, overall frequency, associated factors, and perceived barriers. Multivariable logistic regression explored associated factors (N = 302).Results: Among 302 respondents, 30.8% reported performing ATI at least once within the previous year, and only 3.0% did so frequently or very frequently. In the anticipated difficult airway scenario 70.2% selected ATI. In the emergency scenario 51.7% preferred ATI. In the low-cooperation scenario 10.6% expressed a definite preference. Response formats differed across scenarios, so these proportions are not directly comparable. Respondents reporting ATI practice had lower barrier scores. In multivariable analysis, greater clinical experience was associated with higher odds of ATI practice, whereas state-hospital employment and a higher barrier score were associated with lower odds.Conclusion: Self-reported ATI practice was limited and showed scenario-specific response patterns. Greater clinical experience, lower perceived barriers, and institutional setting were associated with reported practice and may inform future training and institutional strategies; the cross-sectional, convenience-sampled design precludes causal inference.

Aims: To determine whether the Charlson Comorbidity Index (CCI) independently predicts 30-day mortality after percutaneous endoscopic gastrostomy (PEG) in intensive care unit (ICU) patients, to compare it with acute illness severity measured at admission and on the day of the procedure, and to relate the interval between ICU admission and PEG to early outcome.Methods: This single-centre retrospective cohort included adult ICU patients undergoing PEG between June 2023 and June 2026. The primary endpoint was death within 30 days. Comorbidities, Acute Physiology and Chronic Health Evaluation (APACHE-II) and Sequential Organ Failure Assessment (SOFA) scores at admission, SOFA on the day of PEG, organ support and laboratory data were taken from records. Logistic regression, Kaplan-Meier analysis, Cox models and receiver operating characteristic analysis were used.Results: Of 334 patients, 143 (42.8%) died within 30 days. PEG was performed a median of 5 days (interquartile range 3-12) after ICU admission and death a median of 10 days later. The CCI was associated with mortality univariably but not after adjustment (adjusted odds ratio 0.960, p=0.571). The PEG-day SOFA score predicted mortality univariably (odds ratio 1.243, p