Araştırma Çıktıları
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Item Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study(BMC, 2020-01-01) Gucyetmez, Bulent; Atalan, Hakan Korkut; Sertdemir, Ibrahim; Cakir, Ulkem; Telci, Lutfi; Grp, Covid 19 StudyItem Base-excess chloride(PUBLIC LIBRARY SCIENCE, 2021-01-01) Gucyetmez, Bulent; Tuzuner, Filiz; Atalan, Hakan Korkut; Sezerman, Ugur; Gucyetmez, Kaan; Telci, LutfiTo practically determine the effect of chloride (Cl) on the acid-base status, four approaches are currently used: accepted ranges of serum Cl valuesItem Serum Vitamin D Level at ICU Admission and Mortality(AVES, 2017-01-01) Atalan, Hakan Korkut; Gucyetmez, BulentObjective: Vitamin D is a fat-soluble vitamin that plays a major role in the regulation of bone and calcium metabolism and has effects on the immune and cardiovascular systems. Vitamin D deficiency is commonly seen in the general population as well as in critically ill patients and is reported to be associated with increased mortality and morbidity. Our aim was to determine the relationship between vitamin D level at ICU admission and mortality. Methods: A total of 491 patients admitted to the ICU between January 2014 and January 2015 were evaluated retrospectively. The patients who were under 18 years old, had elective surgery, or whose serum vitamin D levels and outcomes were unknown were excluded. The patient's age, gender, APACHE II score, number of organ dysfunction, serum vitamin D level at ICU admission and outcomes were recorded. Results: Vitamin D level was low (<25 ng dL(-1)) in 166 (77.1\%) of the patients. In non-survivor patients, APACHE II score and the number of organ dysfunction were significantly higher than the survivor patients (p<0.001 and p<0.001). There was a negative correlation between vitamin D level and APACHE II score (r(2)=0.04, p=0.006). In multivariate analyses, the likelihood of mortality was increased 9.8-fold (range 4.2-17.6) and 8.9-fold (range 3.9-14.1) with an APACHE II score >= 24 and the number of organ dysfunction >= 2, respectively (p<0.001 and p<0.001). Conclusion: Vitamin D deficiency is commonly seen in intensive care patients. Although it is not an independently decisive factor for mortality, it might be related with poor clinical status at ICU admission. The APACHE II score and number of organ dysfunction are still important parameters for increased mortality.Item Elective Tracheotomy Practices in Turkey(PUBLIC LIBRARY SCIENCE, 2016-01-01) Gucyetmez, Bulent; Atalan, Hakan Korkut; Cakar, Nahit; Grp, Turkish Tracheotomy SurveyObjectives Elective tracheotomy (ET) procedures in intensive care units (ICU) might be different in accordance with countries and ICUs' features. The aim of the present study was to search the epidemiology of ET procedures in Turkey. Methods A questionnaire which consists of 43 questions was sent by e-mail to 238 ICUs which were officially recognized by The Turkish Ministry of Health. All answers were obtained between August 1, 2015 and August 31, 2015. Results Two hundred and three ICUs (85.3\%) participated in this study. 177 (87.2\%) and 169 (83.4\%) of ICU's were level III and mixed ICUs respectively. Anesthesiologists were the director of 189 (93.0\%) ICUs. Estimated total count of admitted, mechanically ventilated and tracheotomized patients in 2014 were 126282, 80569 (63.8\%) and 8989 (7.1\%) respectively. Most common indication for ET was prolonged mechanical ventilation (76.9\%). The first choice for ET procedure was percutaneous in 162 (79.8\%) ICUs. Griggs guide wire dilatational forceps (GWDF) technique was used as the first choice for elective percutaneous tracheotomy (EPT) by 143 (70.4\%) ICUs. Most common early EPT complication was bleeding (68.0\%) and late EPT complication was stenosis (35.0\%). While facilitation of weaning was most important advantage (26.1\%), bleeding and tracheal complications were most important disadvantages for EPT (29.1\%). Conclusions Most common indications for ET are prolonged MV and coma in Turkish ICUs. EPT is the preferred procedure for ET and GWDF is the most common technique. Bronchoscopy and USG are rarely used as a guide.