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Öğe Compliance With the Surviving Sepsis Campaign Bundle: A Multicenter Study From Turkey(Springernature, 2021) Bahar, Ilhan; Oksuz, Hafize; Senoglu, Nimet; Demirkiran, Hilmi; Aydogan, Mustafa; Tomak, Yakup; Comez, MehmetObjectives Sepsis bundle compliance is not clear. We evaluated rates of compliance with sepsis bundle protocols among health care providers in Turkey. Methods Our study was carried out retrospectively. Forty-five intensive care units (ICU) participated in this study between March 2, 2018 and October 1, 2018. Results One hundred thirty-eight ICUs were contacted and 45 ICUs agreed to participate. The time taken for the diagnosis of sepsis was less than six hours in 384 (59.8%) patients, while if was more than six hours in 258 (40.2%) patients. The median linterquartile range (1QR)1 times for initial antibiotic administration, culturing, vasopressor initiation, and second lactate measurement were 120.0 (60-300) minutes, 24 (12-240) minutes, 40 (20-60) minutes, and 24 (18-24) hours, respectively. The rale of compliance with tissue and organ perfusion follow-up in the first six hours was 0%. The rates of three- and six-hour sepsis bundle protocol compliance were both 0%. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. The ICU mortality rates for sepsis and septic shock were 22% and 78%, respectively. Conclusions The rate of compliance with sepsis bundle protocols was evaluated in Turkey for the first time and determined to be 0%.Öğe THE EFFECT OF LOW-FLOW VERSUS HIGHFLOW ANESTHESIA ON POSTOPERATIVE COGNITIVE FUNCTIONS IN GERIATRIC PATIENTS UNDERGOING TUR-P SURGERY(Turkish Geriatrics Soc, 2024) Unal, Ekin Anil; Comez, Mehmet Selim; Demirkiran, Hilmi; Koyuncu, Onur; Hakimoglu, Sedat; Urfali, SenemIntroduction: This paper investigates the effect of low -flow anesthesia applications on postoperative cognitive function in geriatric age group (>= 65 years old) patients who underwent elective transurethral resection of the prostate surgery. Materials and Method: A total of 98 patients aged 65 and over who underwent elective transurethral resection of the prostate surgery under general anesthesia between December 2021 and November 2022 in Hatay Mustafa Kemal University Research Hospital's Department of Anesthesiology and Reanimation were included in the study. The patients were subjected to a mini mental test the day before the operation and postoperatively at six hours, one day, three days, and seven days. Visual analogue scale scores were evaluated at 3, 6, 12, 24, 48, and 72 hours. The data obtained were compared between the patient groups who underwent low -flow (1 L/min, n: 49) and high flow (4 L/min, n: 49) anesthesia. P< 0.05 was considered statistically significant. Results: A comparison between the postoperative 6thhour, 1st day, 2nd day, 3rd day, and 7th day mini mental testing scores of the low -flow anesthesia and high flow anesthesia groups did not exhibit any notable variations (p: 0.668, 0.785, 0.745, 0.705, respectively). The visual analogue scale scores of the cases at 3, 6, 12, 24, 48, and 72 hours did not differ statistically according to the type of flow applied (p: 0.316, 0.925, 0.651, 0.548, 0.624, 0.466, respectively). Conclusion: It is thought that low -flow anesthesia can be applied safely, but it does not have a significant effect on cognitive functions compared to high flow anesthesia.Öğe Prevalence and clinical features of chronic critical illness in the elderly population in Turkey(Geriatrics Society, 2020) Demirkiran, Hilmi; Uzunoglu, Emine; Erdivanli, Başar; Karadamar, Ulaş; Koç, Suna; Tomak, Yakup; Özmen, MustafaObjectives: The definition of chronic critical illness in the elderly has not yet been determined. The aim of the study is to determine the prevalence and clinical features of chronic critical illness in the elderly population in Turkey. Materials and Methods: Data from 16 intensive care units of public and private hospitals in Turkey were evaluated. Patients staying in the intensive care units for at least eight days between 2015 and 2017 and having at least one of the additional criteria were accepted as chronic critical illness and they were divided into two groups by age, those 65 and older and those under 65. Results: The chronic critical illness patient rate in the intensive care units was 10.7%. Of chronic critical illness patients in the intensive care units, 60.9% were 65 years of age and older, and the mortality rate of patients 65 years and older was 70%. The frequencies of ischemic stroke and sepsis, the number of patients with comorbidities, and the mortality rate were higher in patients over 65 years of age, while the frequency of traumatic brain injury, presence of a major wound, tracheostomy, length of hospital stay and cost of care were higher in patients under 65 years of age. Conclusion: We determined that prolonged mechanical ventilation, traumatic brain injury, tracheostomy and major wound presence in intensive care units patients 65 years and older increased hospital stay and costs. More work is needed to define chronic critical illness more clearly in elderly. © 2020, Geriatrics Society. All rights reserved.Öğe PREVALENCE AND CLINICAL FEATURES OF CHRONIC CRITICAL ILLNESS IN THE ELDERLY POPULATION IN TURKEY(Gunes Kitabevi Ltd Sti, 2020) Demirkiran, Hilmi; Uzunoglu, Emine; Erdivanli, Basar; Karadamar, Ulas; KOc, Suna; Tomak, Yakup; Ozmen, MustafaObjectives: The definition of chronic critical illness in the elderly has not yet been determined. The aim of the study is to determine the prevalence and clinical features of chronic critical illness in the elderly population in Turkey. Materials and Methods: Data from 16 intensive care units of public and private hospitals in Turkey were evaluated. Patients staying in the intensive care units for at least eight days between 2015 and 2017 and having at least one of the additional criteria were accepted as chronic critical illness and they were divided into two groups by age, those 65 and older and those under 65. Results: The chronic critical illness patient rate in the intensive care units was 10.7%. Of chronic critical illness patients in the intensive care units, 60.9% were 65 years of age and older, and the mortality rate of patients 65 years and older was 70%. The frequencies of ischemic stroke and sepsis, the number of patients with comorbidities, and the mortality rate were higher in patients over 65 years of age, while the frequency of traumatic brain injury, presence of a major wound, tracheostomy, length of hospital stay and cost of care were higher in patients under 65 years of age. Conclusion: We determined that prolonged mechanical ventilation, traumatic brain injury, tracheostomy and major wound presence in intensive care units patients 65 years and older increased hospital stay and costs. More work is needed to define chronic critical illness more clearly in elderly.