Usporedba učinkovitosti fleksibilne laringealne maske i endotrahealne intubacije kod adenotonzilektomije

This study compared the effectiveness of flexible laryngeal mask (F-LMA) insertion and endotracheal intubation in pediatric patients undergoing adenotonsillectomy surgery. A total of 60 patients aged 2-12 years were included in the study. Patients were divided into the F-LMA group (n=30) and endotracheal tube (ETT) group (n=30). The groups were compared according to intubation time, heart rate, SpO2, EtCO2, airway pressure, surgical field of view, and recovery time. Both the insertion time and recovery time were shorter in the F-LMA group than in the ETT group (16.93±4.84 s vs. 23.93±8.74 s; and 10±2 min vs. 14.5±3 min; p<0.001 both). The airway pressure measurements at 5-min intervals were significantly lower in the F-LMA group than in the ETT group (p<0.001). F-LMA may be a useful alternative to ETT for adenotonsillectomy surgery because it is safe, provides shorter induction and recovery times, reduces intraoperative airway pressure, and provides an adequate operative field of view.U ovom istraživanju usporedili smo učinkovitost postavljanja fleksibilne laringealne maske (F-LMA) i endotrahealne intubacije (ETT) u pedijatrijskih bolesnika podvrgnutih adenotonzilektomiji. U studiju je bilo uključeno ukupno 60 bolesnika u dobi od 2-12 godina. Bolesnici su podijeljeni u dvije skupine, F-LMA i ETT, od po 30 bolesnika. Ove dvije skupine uspoređene su prema sljedećim parametrima: trajanje intubacije, srčani ritam, SpO2, EtCO2, tlak dišnih putova, kirurško vidno polje i vrijeme oporavka. Vrijeme postavljanja kao i vrijeme oporavka bili su kraći u skupini F-LMA nego u skupini ETT (16,93±4,84 s prema 23,93±8,74 s, p=0,001; 10±2 min prema 14,5±3 min, p<0,001). Tlak dišnih putova mjeren u 5-minutnim razmacima bio je značajno niži u skupini F-LMA u usporedbi sa skupinom ETT (p<0,001). F-LMA mogla bi biti korisna alternativa za ETT kod adenotonzilektomije, jer je sigurna, omogućava kraće vrijeme indukcije i oporavka, snižava intraoperacijski tlak u dišnim putovima te osigurava odgovarajuće operativno vidno polje

Where are We on Organ Donation?

Objective: It was aimed to present the acceptance rate of organ donation of cases that were diagnosed with brain death and evaluated in terms of their demographic and clinical properties retrospectively in Adıyaman University Training and Research Hospital. Material and Method: In the intensive care unit of our hospital, cases that were diagnosed with brain death between the dates of January 2008 and December 2014 were retrospectively analyzed. Cases were evaluated in terms of age, sex, cause of brain death, blood groups, donation status, reasons for acceptance or rejection of donation, cardiac arrest, vasopressin treatment, laboratory test results, arterial blood gas values before and after the apnea test, intensive care unit follow-up durations, apnea test, seasonal and annual distribution. Also, potential donors and recipients were analyzed in accordance with their demographic characteristics. Results: The diagnosis of brain death was made in totally 57 cases; of those, 34 (59.6%) were men and 23 (40.4%) were women. The most common causes for brain death were traumatic subarachnoid hemorrhage (SAH) and intracerebral hematoma. Most of the cases had A Rh+ blood type (n=18, 31.5%) and the rate of brain death was 4.7 times higher in Rh (+) patients in comparison to Rh (-) patients. The rate of incidence of cardiac arrest was 12.3% (n=7), and it was more common in traumatic SAH patients. The rate of receiving vasopressor therapy was 21.1% (n=12), and the mean duration of therapy was 1.3±0.8 days. It was more commonly used in traumatic SAH patients (n=10). The follow-up period was 2.7±3.2 (minimum: 1, maximum: 17) days. Five patients were considered to be organ donors. The most common reason for acceptance of donation was the effect of organ transplantation coordinator during family interviews (n=3, 60%). In total, 4 livers, 5 kidneys and 1 heart transplantation operations were performed to 10 patients. Conclusion: Due to problems in organ donation, patients that might be potential organ donors must be transferred to intensive care unit and taken under critical patient care since then, and brain death should be considered in patients with Glasgow coma scale <7. The raising the awareness and training of the staff in intensive care units about the recognition of brain death and donor care are also important. Also, the interview with the families must be performed by an experienced coordinator to increase the rate of acceptance of donation and raise the awareness of the community regarding the organ donation

Pseudocholinesterase Enzyme Deficiency in Adıyaman City Area.

Pseudocholinesterase (PChE) is an enzyme responsible for the hydrolysis of succinylcholine. In case of its deficiency, the effect of succinylcholine that is approximately 5-10 min is prolonged up to few hours. The use of succinylcholine has been declined recently. However, it is still actively used in some special conditions and in developing countries. In this study, incidence of PChE enzyme deficiency around Adiyaman city was investigated and presented with the literature review