Clinical and electroencephalographic findings in patients with sepsis-associated encephalopathy and the evaluation of their effects on survival

Objective: Acute brain dysfunction is common in sepsis patients and is associated with increased mortality. This study aimed to investigate the clinical and electroencephalographic (EEG) findings of patients with acute neurological dysfunction due to sepsis and to evaluate their relationship with prognosis.Methods: Sixty-one patients with sepsis were included in this prospective observational study. All patients underwent a daily neurological examination. EEG monitoring was performed in patients with delirium, coma, clinical seizures, and focal neurological findings. The patients were divided into two groups as survivors and non-survivors.Results: Sixty-one patients included in the study had a median age of 60 years (range=21 to 81), Acute Physiology and Chronic Health Evaluation 2 score of 24 (range=14 to 39), and Sepsis-related Organ Failure Assessment score of 10 (range=3 to 24). During the EEG examination, coma was detected in 23 patients (38%), delirium/confusion in 20 patients (33%), clinical seizures in 16 patients (26%) and focal neurological findings in two patients (3%). The overall mortality rate was 42% (n=26). The EEG examination showed slowing of background activity in all patients. Also, among three patients who had seizure activity, two showed findings of an electrophysiological seizure. The EEG examination revealed a relationship between low-amplitude non-reactive background activity and mortality.Conclusion: EEG monitoring may be indicated in the follow-up of encephalopathy in sepsis, the determination of the severity of the disease, the presence of an accompanying seizure or status, and prognosis.Keywords: Sepsis, brain dysfunction, electroencephalography, prognosi

Tracheal stenosis and reconstructive surgery: Our experience on anesthesia and airway management

Tracheal stenosis is an important clinical problem. Several treatment modalities are being used such as tracheal dilatation, laser surgery, surgical resection, and reconstruction. Surgery of the trachea is a special endeavor where the airway is shared by the surgeon and the anesthesiologist. In this article, we discussed the various methods of anesthesia and airway management in three cases who developed tracheal stenosis secondary to prolonged intubation in intensive care and were performed tracheal dilation, laser surgery, resection, and end-to-end anastomosis

Ability of mini-fluid challenge to predict fluid responsiveness in obese patients undergoing surgery in the prone position

BACKGROUND: Pulse pressure variation (PPV) and stroke volume variation (SVV) can predict fluid responsiveness effectively. However, high Body Mass Index (BMI) can restrict their use due to changes in respiratory system compliance (CS), intra-abdominal pressure, and stroke volume (SV) in the prone position. Therefore. we aimed to investigate the effectiveness of mini-fluid challenge (MFC) in predicting fluid responsiveness in obese (BMI >= 30 kg/m(2)) patients in the prone position