Objective The current study aimed to evaluate eyecare needs along with ocular findings in patients treated in intensive care units because of Covid‐19 infection. Materials and Methods A total of 93 patients, 58 men and 35 women, who were under follow‐up and treatment in intensive care because of COVID‐19 infection from 1 January 2021 to 15 February 2021 were included in the study. Detailed eye examinations of the patients were performed with a portable handheld biomicroscope, direct and indirect ophthalmoscope. Cases requiring treatment for eye diseases were identified and treated. Results The mean patient age was 68.32 ± 9.97 years; 35 patients were followed up and treated with non‐invasive mechanical ventilation and 58 patients with invasive mechanical ventilation support. Mild, moderate, and severe chemosis was observed in 19 patients (20.4%), 10 patients (10.8%) and 4 patients (4.3%), respectively. Conjunctivitis (8.6%) was observed in eight patients. Corneal abrasion was present in seven patients (7.5%). Keratitis secondary to exposure keratopathy was observed in one patient. Eye care and medical treatment were initiated for these patients. We noted eight patients (8.6%) with retinal haemorrhage; however, to the best of our knowledge, these patients may show acute retinal involvement secondary to systemic diseases or have previous retinal findings other than Covid‐19 infection or treatments. Conclusion Findings of ocular involvement because of COVID‐19 infection were detected in the present study. Retinal haemorrhages were detected in addition to the common findings in viral infections. Especially in patients supported with mechanical ventilation, the detection and treatment of conditions that require eye care for exposure keratopathy are very important for recovering from the disease and the quality of vision.
Objective: The prognostic role of the initial lactate/albumin ratio (LAR) in critically ill patients with coronavirus disease-2019 (COVID-19) remains unknown. This study aimed to evaluate the prognostic value of the initial LAR in predicting 30-day mortality in critically ill patients with COVID-19 and compare the initial level of serum lactate and albumin for mortality prediction. Materials and Methods: A single-center and observational clinical study between April 2020 and December 2020 were retrospectively performed. Clinical and laboratory variables of patients evaluated in this study were collected within the first 24 hours following the intensive care unit (ICU) admission. Results: A total of 282 critically ill patients with COVID-19 were included in the study. The mean age of the patients was 66.34±12.08 years, wherein 179 (63.5%) were male. Patients who died within 30 days had higher lactate (p<0.001), lower serum albumin (p<0.001), and higher LAR levels (p<0.001). ROC analysis revealed that LAR (AUC: 0.824) was superior to the serum albumin (AUC: 0.644) and lactate levels (AUC: 0.795) for mortality prediction. Overall ICU mortality rates (75.6% vs. 13.1%, p<0.001) were significantly higher in patients with LAR of >0.60. Conclusion: LAR is a useful prognostic factor for risk stratification of critically ill patients with COVID-19.
Objective: The current study aimed to evaluate eye care needs along with ocular findings in patients treated in intensive care units due to Covid-19 infection. Materials and Methods: A total of 93 patients, 58 men and 35 women, who were under follow-up and treatment in intensive care due to COVID-19 infection between 01/01/2021 and 02/15/2021 were included in the study. Detailed eye examinations of the patients were performed with a portable handheld biomicroscope and direct and indirect ophthalmoscope. Cases requiring treatment for eye diseases were identified and treated. Results: The mean patient age was 68.32 ± 9.97 years; 35 patients were followed-up and treated with non-invasive mechanical ventilation and 58 patients with invasive mechanical ventilation support. Mild, moderate, and severe chemosis was observed in 19 patients (20.4%), 10 patients (10.8%), and 4 patients (4.3%), respectively. Conjunctivitis (8.6%) was observed in 8 patients. Corneal abrasion was present in 7 patients (7.5%). Keratitis secondary to exposure keratopathy was observed in one patient. Eye care and medical treatment was initiated for these patients. We noted 8 patients (8.6%) with retinal haemorrhage; however, to the best of our knowledge, these patients may show acute retinal involvement secondary to systemic diseases or have previous retinal findings other than Covid-19 infection or treatments. Conclusion: Findings of ocular involvement due to COVID-19 infection were detected in the present study. Retinal haemorrhages were detected in addition to the common findings in viral infections. Especially in patients supported with mechanical ventilation, the detection and treatment of conditions that require eye care for exposure keratopathy is very important for recovering from the disease and the quality of vision.
Moyamoya disease is a cerebrovascular disease named after its angiographic image diagnosis, the etiology of which is not known and which is characterized by the chronic progressive stenosis of the main internal cerebral arteries that make up the Willis polygon. Ischemic symptoms are at the forefront in this disease which is more frequently observed in children. The definitive treatment of this disease is surgery and cerebral ischemia is a complication that can develop frequently during surgery. That is why, care during the perioperative period is very important. Perioperative anesthetic goal is to ensure the balance between the delivery of oxygen to the brain and the consumption of oxygen. The objective of this presentation is to discuss the anesthesia application in a child case who underwent encephalo-dura-arterio-cynangiozis (EDAS) surgery because of a 15 month moyamoya disease.
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