4 research outputs found
Anesthetic management of a patient with Weber Christian Disease (WCD) for cataract surgery: Acase report
Enteral Nutrition Target of Critical Patients in The Intensive Care Unit
Amaç: Beslenme desteği, yoğun bakım
ünitesindeki (YBÜ) hastaların tedavisinin önemli bir parçası olup enteral
beslenme ilk tercih edilen yoldur. Bu çalışmada, yoğun bakım ünitemize başvuran
hastalar için beslenme desteği başlama zamanı, beslenme hedefine ulaşma düzeyi,
bunun sürdürülebilirliği ve hedefe ulaşmada karşılaşılan nedenlerin
araştırılması planlandı.Çalışma planı: Çalışmaya Acil Yoğun Bakım Ünitesinde
01.01.2017 ve 31.12.2018 tarihleri arasında takip edilen 18-90 yaş arası
yetişkin hastalar dahil edildi ve çalışma retrospektif olarak planlandı.
Hastaların demografik özellikleri, beslenme desteği başlama zamanı, hedefe
ulaşma zamanı, enteral beslenme sırasında karşılaşılan beslenmeyi durdurma
nedenleri değerlendirildi.Bulgular: 152 hasta analiz edildi ve enteral
beslenen 49 hasta araştırıldı. Hastalarda enteral beslenme desteği nazogastrik
tüp (% 93) ve perkütan endoskopik gastrostomi (PEG) (% 7) ile sağlandı. Enteral
beslenmeye başlama süresi ortalama 10.3 (± 8.6) saat olarak bulundu. Hedefe
ulaşmak için ortalama süre, hastaların %96'sında 14,1 (± 5,9) saat olarak
gözlendi. 2 hastada, kusma ve aşırı gastrik rezidü volüm nedeniyle hedef doza
ulaşılamadı. Otuz (% 61) hastada beslenme sırasında problem yaşandı ve enteral
beslenme kesintiye uğradı.Sonuç: 48 saatten fazla yoğun bakımda yatan
kritik hastalar yetersiz beslenme için risk altında sayılmalıdır. Yoğun bakıma
yatan hastalarda, ağızdan alım yoksa 48 saat içinde enteral beslenmeye başlanılması
önerilir (erken enteral beslenme).
Anahtar Sözcükler: erken enteral beslenme,
beslenme hedefi, malnütrisyo
Co-existence of Multiple Sclerosis and anti-NMDA Receptor Encephalitis: A Case Report and Review of Literature
The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye
Background:Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear.Aims:To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19.Study Design:Multicenter prospective observational clinical study.Methods:This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated.Results:As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004).Conclusion:Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients