Scopus

Permanent URI for this collectionhttps://hdl.handle.net/11452/20668

Browse

Now showing 1 - 5 of 5

Bedside percutaneous tracheostomy experience with 72 critically ill patients
(Lippincott Williams & Wilkins, 2000) Kahveci, Ferda Şöhret; Gören, Suna; Kutlay, Oya; Özcan, Berin; Korfalı, Gülsen; Tıp Fakültesi; Anestezi ve Reanimasyon Ana Bilim Dalı; 0000-0002-1190-6831; 0000-0003-4820-2288; AAI-3551-2021; AAG-9356-2021; 6602405968; 7006563257; 6602199747; 6603825848; 6701462594
Tracheostomy is necessary in intensive care unit (ICU) patients requiring prolonged mechanical ventilation. As an alternative to the standard surgical method, percutaneous techniques are available. Seventy-two patients were electively selected for percutaneous tracheostomy (PCT) in a nine-bed combined medical-surgical intensive care unit. PCT was performed at bedside with the Porter Percutaneous Tracheostomy Kit that uses the Griggs technique. The procedure time and early complications were recorded. The procedure was successful in all patients. The average duration of placement was 7.4 min. There were no tracheostomy-related deaths. Major bleeding occurred in three patients and required surgical intervention. In one patient, minor bleeding occurred at the stoma site that resolved with applied pressure. Wound infections were treated with local antiseptics in two patients. These findings suggest that PCT is a simple, quick and safe procedure.
The decline in serum choline concentration in humans during and after surgery is associated with the elevation of cortisol, adrenocorticotropic hormone, prolactin and beta-endorphin concentrations
(Elsevier Ireland, 2002-05-10) İlçol, Yeşim Özarda; Özyurt, Gürayten; Kılıçturgay, Sadık; Uncu, Gülgün; Ulus, İsmail Hakkı; Tıp Fakültesi; Anestezi ve Reanimasyon Ana Bilim Dalı; Tıbbi Farmakoloji Ana Bilim Dalı; AAL-8873-2021; D-5340-2015; 15825404200; 6603035486; 15825327700; 6603716169; 7004271086
Serum choline concentrations decrease during and after surgery. We undertook this study to determine whether the decrease of choline is associated with an increase in stress hormones. In 16 patients undergoing abdominal surgery with general anesthesia, circulating choline cortisol, prolactin, adrenocorticotropic hormone (ACTH) and beta-endorphin levels were measured before, during and after surgery. Choline levels decreased by 41% (P < 0.01) during surgery, remained 15-38% decreased for 48 h, and returned to preoperative values 72 h after surgery. The decrease in serum choline was associated and inversely correlated with the increase in serum cortisol (P < 0.001; r = -0.642), prolactin (P < 0.001; r = -0.756), beta-endorphin (P < 0.001; r = -0.726) and ACTH (P < 0.01; r = -0.458). In conclusion, we found that abdominal surgery induces a decline in serum choline associated with an increase in circulating cortisol, prolactin, ACTH and beta-endorphin.
Effects of ketamine and thiopental on ischemia reoxygenation-induced LDH leakage and amino acid release from rat striatal slices
(Lippincott Williams & Wilkins, 2005-01) Başağan Moğol, Elif; Büyükuysal, Rifat Levent; Korfalı, Gülsen; Tıp Fakültesi; Farmakoloji ve Klinik Farmakoloji Ana Bilim Dalı; AAH-1657-2021; 23982134100; 6602686612; 6701462594
Increased release of glutamate is thought to contribute to ischemia-induced neuronal damage. Since general anesthetics such as thiopental and ketamine are thought to provide some degree of cerebral protection, this study was intended to 1) compare the effectiveness of ketamine and thiopental on ischemia-induced tissue damage; and, if so, 2) determine whether attenuation of the increased amino acid release is the sole mechanism for the protective effects demonstrated. Striatal slices prepared from Wistar Albino rats were incubated in an ischemic medium for 1 hour followed by 5 hours in a reoxygenation (REO) medium. Ketamine and thiopental were added medium during ischemia and/or REO periods, and the medium was collected at the end of each incubation period for measurement of amino acid release and lactate dehydrogenase (LDH) leakage. Ischemia significantly increased amino acid release without altering LDH leakage. Ischemia-induced increments in glutamate and aspartic acid releases returned to control levels during REO, but LDH leakage increased (P < 0.001) during this period. Although ketamine (100 muM) and thiopental (100 mu\M) failed to decrease ischermia-induced excitatory amino acid release, they protected the slices against REO-induced LDH leakage. Ketamine, but not thiopental, was effective even if added after ischemia (P < 0.05). These results indicate that ketamine and thiopental protect the slices against REO-induced LDH leakage. However, mechanisms other than attenuation of the enhanced glutamate release might be responsible for their protective effects.
Minimally invasive awake craniotomy using steiner-lindquist stereotactic laser guidance
(George Thieme Verlag, 2009-08) Bekar, Ahmet; Bilgin, Hülya; Korfalı, Gülşen; Korfalı, Ender; Kocaeli, Hasan; Taşkapılıoğlu, Özlem; Tıp Fakültesi; Nöroşirürji Ana Bilim Dalı; 0000-0001-6639-5533; A-7338-2016; 6603677218; 6701663354; 35484339700; 35484622300; 6603500567; 35485721600
Introduction: Awake craniotomy permits the continuous assessment of intraoperative neurological functions. In addition, stereotactic laser guidance aids in performing minimally invasive procedures related to the radical resection of lesions located in eloquent and non-eloquent brain regions. Methods: Between May 2000 and October 2006, 117 consecutive patients with various intracranial tumoral lesions underwent 141 resection procedures. The eloquent areas were determined with the aid of anatomic landmarks and/or functional MRI (fMRI) examinations. The resection of the lesions was performed under continuous neurological examination. In all cases, postoperative MRI was performed within 24-72 h. Results: Seventy-seven males and 40 females were included in this study. The mean age of the patients was 52.0 +/- 12.6 years. Most of the lesions were located within the parietal lobe. Of the lesions, 33 (23.4%) were located within the cortex, whereas 108 (76.5%) were subcortical. The most common pathologies were metastasis (70 cases) and glioblastome multiforme (27 cases). In 20 (14.2%) of the patients, fMRI was performed preoperatively. Of 21 patients with multiple lesions, 18 underwent 2 craniotomies and 3 underwent 3 craniotomies. The mean operation time was 72 +/- 0.3 min, and the mean hospital stay was 3.26 +/- 1.82 d. The average lesion size was 11.92 +/- 15.26 cm(3). In 7 cases (4.9%), the surgery caused either new neurological deficits or a worsening of the existing deficits; these deficits were permanent in 2 (1.4%) cases. One patient (0.7%) died due to the development of postoperative intracerebral hemorrhage. Conclusions: Awake craniotomy with the aid of stereotactic laser guidance is a safe procedure that assists in performing minimally invasive resection of lesions in eloquent and non-eloquent brain regions. Although direct intraoperative stimulation was not performed, detection of the functioning areas of the brain with fMRI decreased additional postoperative neurological deficits. Overall, this method decreased the operation time and hospital stay.
Risk factors and complications of intracranial pressure monitoring with a fiberoptic device
(Elsevier, 2009-02) Bekar, Ahmet; Doğan, Şeref; Abaş, Faruk; Caner, Burcu; Korfalı, Gülşen; Kocaeli, Hasan; Yılmazlar, Selçuk; Korfalı, Ender; Caner, Burcu; Tıp Fakültesi; Anestezi ve Reanimasyon Ana Bilim Dalı; 0000-0003-3633-7919; AAI-6531-2021; AAH-5070-2021; 7102693077; 6603677218; 8546184300; 25027089000; 6701462594; 6603500567; 6603059483; 7004641343
We prospectively investigated the complications associated with intraparenchymal intracranial pressure (ICP) monitoring using the Camino intracranial pressure device. A fiberoptic ICP monitoring transducer was implanted in 631 patients. About half of the patients (n = 303) also received an external ventricular drainage set (EVDS). The durations (mean +/- SD) of ICP monitoring in patients without and with an EVDS were 6.5 +/- 4.4 and 7.3 +/- 5.1 days, respectively. Infection occurred in 6 patients with only an ICP transducer (6/328, 1.8%) and 24 patients with an EVDS also (24/303, 7.9%). The duration of monitoring had no effect on infection, whereas the use of an EVDS for more than 9 days increased infection risk by 5.11 times. Other complications included transducer disconnection (2.37%), epidural hematoma (0.47%), contusion (0.47%), defective probe (0.31%), broken transducer (0.31%), dislocation of the fixation screw (0.15%), and intraparenchymal hematoma (0.15%). In conclusion, intraparenchymal ICP monitoring systems can be safely used in patients who either have, or are at risk of developing, increased ICP.

Browse

Browsing by Department "Anestezi ve Reanimasyon Ana Bilim Dalı"