Evaluation of Family Satisfaction Level at Erciyes University Medical Faculty Intensive Care Units with a Validated Survey

Objective: This study aims to investigate the validity and reliability of the FS-ICU 24 survey in the Turkish language, to evaluate the satisfaction of ICU patients' relatives, and to determine the factors affecting satisfaction

The impact of seasonal changes on spinal anesthesia-related complications: A prospective observational longitudinal study

Aim: In this tudy, it was aimed to investigate the complications that may develop during and after the anesthesia in patients undergoing spinal anesthesia, and the seasonal relationships of the monitored parameters in this study.Material and Methods: A total of 190 patients with ASA I-II group, aged between 18-65 years, who were scheduled for lower extremity operation, were included in the study after obtaining the ethics committee approval and the consent of the patients. The patients were divided into four groups: Group Su, Group Au, Group Wi, and Group Sp. Patient heart rate, blood pressure, peripheral oxygen saturation values were recorded. A subarachnoid puncture was performed with a 25G Quincke spinal needle and the number of attempts required for successful puncture was recorded. For spinal anesthesia, standard dose of 3 ml (15 mg) of 0.5% levobupivacaine was administered to all groups. All patients were visited on 6-12-24-48-72nd postoperative hours and on the 7th postoperative day, and the discharged patients were asked about complications via telephone.Results: The number of atropine injections due to complications of intraoperative bradycardia was significantly higher in Group Su than in the other groups (p = 0.010). Although there was no statistical difference between groups in terms of headache complications (p = 0.394), it was quantitatively higher in Group Su. The low back pain incidence was significantly higher in Group Su (37.7%, p = 0.01). Discussion: In this study, we concluded that intraoperative and postoperative complications were more common in the summer period in patients who underwent spinal anesthesia

Evaluation of Non-intensive Care Unit-Acquired Sepsis and Septic Shock Patients in Intensive Care Unit Outcomes

Objective: Sepsis is a clinical condition that requires urgent treatment. Most patients with sepsis require intensive care. There is a high mortality rate. The primary aim of the present study was to examine risk factors for mortality in patients with sepsis or septic shock in a medical intensive care unit (ICU). The secondary objective was to analyze the demographic and clinical characteristics of these patients

The frequency of ESBL producing bacterial infections and related antimicrobial susceptibility in ICU patients: A five-year longitudinal study ESBL producing bacterial infections in ICU

Aim: This study aimed to evaluate the incidence of nosocomial infections caused by extended-spectrum beta-lactamase (ESBL) producing bacteria and related antimicrobial susceptibility in critically ill patients over a 5-year period. Material and Methods: The retrospective study was carried out in critically ill patients infected with ESBL-producing pathogens during intensive care unit (ICU) stay. Participants' medical data between 2014 and 2018 were included. ESBL-positive isolates from clinical specimens were evaluated by species and antibiotic susceptibility. Results: Ninety of 2456 critically ill patients had ESBL-positive bacterial infections. The mean age of the study sample was 58.7 +/- 19.1 years and 53.3% were males. ESBL-producing E. coli was noted in 60 (66.7%) patients, K. pneumoniae in 27 (30.0%) patients and K. oxytoca in 3 (3.3%) patients. Colistin (100%), meropenem (94.9%), imipenem (94.0%), and amikacin (90.0%) were active against >= 90% of ESBL-producing pathogens, while ertapenem (89.4%), fosfomycin (87.5%), tigecycline (80.0%) were active against >= 80% of pathogens in ICU. Susceptibility of ESBL producers was remarkably low against levofloxacin (30.8%) and ciprofloxacin (36.7%). The mortality rate of the sample was 25.5%. Discussion: Our findings revealed that ESBL-producing E. coli was highly responsible for ESBL-positive bacterial infections in ICU. The continued efficacy of colistin, carbapenems and amikacin against ESBL-producing E. coli and K. pneumoniae was exhibited

The Clinical and Laboratory Efficacy of HA 330 Treatment Combined with Continuous Renal Replacement Therapy in Septic Shock Patients: A Case Series

© 2023 S. Karger AG. All rights reserved.Introduction: Blood purification therapy is a method used to enable cytokine removal and to improve disturbed immune homeostasis in patients with sepsis or septic shock. This study aimed to evaluate the impact of HA 330 treatment on biochemical and hemodynamic parameters and cytokine levels in adult patients with septic shock. Methods: Critically ill patients with septic shock who received continuous veno-venous hemodiafiltration and HA 330 treatment were included in this prospective observational study. Biochemical and hemodynamic parameters were followed throughout HA 330 treatment. Serum interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, high-mobility group box1 (HMGB-1) protein, IL-10 levels were analyzed by ELISA method, before and after each HA 330 session. Results: A total of 18 critically ill patients were included in this study. The median APACHE 2 score was 22.2 ± 7.49 and median SOFA score 9.6 ± 5.44 on intensive care unit admission. SOFA scores were significantly decreased on the 3rd day of HA 330 treatment, compared to 2nd day scores (p = 0.017). Median leukocyte value was significantly decreased (p = 0.027 and p = 0.024), while hemodynamic parameters remained unchanged throughout the HA 330 treatment. Median CRP and procalcitonin levels were significantly reduced at day 3 of HA 330 treatment compared to the baseline (p = 0.015 and p = 0.033, respectively). Serum IL-1 β, IL-6, IL-8, TNF-a, HMGB-1, and IL-10 levels decreased insignificantly by 11.5%, 26.4%, 11.4%, 37.9%, 0.02%, and 35.5%, respectively, at the end of the hemoperfusion treatment compared to the pre-treatment. Conclusion: The administration of HA 330-based hemoperfusion in septic shock patients revealed improvements in SOFA scores, leukocyte count, and CRP and procalcitonin levels. However, there was no statistically significant change in concentrations of inflammatory cytokines and hemodynamic parameters during HA 330 treatment

Cytokine Levels and Severity of Illness Scoring Systems to Predict Mortality in COVID-19 Infection

Various scoring systems and cytokines have been cited as predicting disease severity in COVID-19 infection. This study analyzed the link between mortality rate, levels of cytokines, and scoring systems such as the Glasgow Coma Scale (GCS), Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and Charlson Comorbidity Index in patients infected with COVID-19. Adult patients infected with COVID-19 were followed up in the intensive care unit (ICU) and analyzed prospectively. We measured serum cytokine levels (Interleukin-10 (IL-10), Interleukin-8 (IL-8), Interleukin-6 (IL-6), Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α) and High mobility group box 1 (HMGB-1)) and recorded GCS, APACHE II, SOFA, and Charlson comorbidity index scores on admission to the ICU. Receiver operating curve (ROC) analysis was performed to predict mortality from IL-1β, IL-6 IL-10, IL-8, TNF-α, and HMGB-1 values. Study participants were grouped as follows: Group A, survivors, and Group B, deceased, during the 28-day follow-up. The mean age was 65.69 (±13.56) in Group A (n = 36) and 70.85 (±10.06) in Group B (n = 27). The female/male ratio was 23/40. Age, sex, body mass index (BMI), comorbid illnesses, GCS, APACHE II, SOFA, and Charlson scores, duration of hospitalization or ICU admission, therapeutic choices, and lymphocyte, PMNL, NLR, platelet, D-dimer, fibrinogen, GGT, CRP, procalcitonin, and lactate levels were similar between the groups. The frequency of acute kidney injury (AKI) was higher in Group B (p = 0.005). Serum IL-10, IL-8, IL-6, IL-1β, TNF-α, HMGB-1, ferritin, and LDH values were higher, and PaO2/FiO2 was lower in Group B than in Group A. ROC analysis showed that there was an association between serum IL-1β (>1015.7), serum IL-6 (>116.7), serum IL-8 (>258.4), serum IL-10 (>247.5), serum TNF-α (>280.7), and serum HMGB-1 (>23.5) and mortality. AKI gave rise to a greater risk of mortality (odds ratio: 7.081, p = 0.014). Mortality was associated with serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1 but not with GCS, APACHE II, SOFA, or Charlson comorbidity index scores. AKI increased the risk of mortality by seven times. Our findings suggest that cytokine levels (serum IL-10, IL-8, IL-6, IL-1β, TNF-α, and HMGB-1) were predictors of mortality in COVID-19 infection. In addition, our results might give an opinion about the course of COVID-19 infection