Ischemia-reperfusion injury can cause renal damage, and phosphodiesterase inhibitors are reported to regulate antioxidant activity. We investigated the prevention of renal damage using tadalafil after renal ischemia reperfusion (I/R) injury in rats. A total of 21 adult male Wistar albino rats were randomly divided into three groups of seven, including Group 1-control, Group 2-I/R, and Group 3-tadalafil + I/R group (I/R-T group) received tadalafil intraperitoneally at 30 minutes before ischemia. Inducible nitric oxide synthase, endothelial nitric oxide synthase, malondialdehyde, and total antioxidant capacity levels were evaluated, and histopathological changes and apoptosis in the groups were examined. Tadalafil decreased malondialdehyde levels in the I/R group and increased the total antioxidant capacity level. Histopathological and immunohistochemical findings revealed that tadalafil decreased renal injury scores and the ratios of injured cells, as measured through apoptotic protease activating factor 1, inducible nitric oxide synthase, and endothelial nitric oxide synthase levels. We suggest that tadalafil has protective effects against I/R-related renal tissue injury.

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Introduction: Crush trauma may be life threating in extremities. Crush syndrome leads to a systemic disorder through muscle cytolysis and the spread of metabolic substance into the circulatory system. In the present study, we summarized the follow-up and treatment of 10 cases with intensive care unit (ICU) crush injury. Meterials and Methods: We have analyzed the clinical data of 10 patients with crush injury who were under treatment in the intensive care unit of our clinic. Age, sex, diagnosis, APACHE II score, sepsis, intensive care complications, treatment parameters in intensive care and arterial blood gases parameters, routine blood biochemistry, alanine aminotransferase, lactate dehydrogenase, creatine kinase, creatinine, existence of blood urea nitrogen, urinary protein and severity score of the patients have been recorded. Patients have been closely monitored for symptoms of crush injury, changes, crush area, urination and dangerous complications. Results: The mean age of 10 patients (10 male) was 41.3 ± 8.7 years. APACHE II score was 21,7. 8 out of 10 patients had traumatic shock, one showed acute renal failure and one presented with multiple organ dysfunction syndrome (MODS). In 3 patients presenting the criteria for crush syndrome, the symptoms of extremity distension and sensory function disorder were regulated with rapid surgical operation and hemodialysis, and urination increased, even in some patients, it reached the normal level. Serologic parameters were regulated in most of the patients after application. Amputation was applied to 5 (50%) patients in our group for serious infection and crush. 2 (20%) patients died, one because of MODS and one because of acute renal failure. Conclusion: Early and aggressive resuscitation, emergency treatment and close monitoring of serious complications are of great importance for saving the lives of the patients with crush syndrome under intensive care.

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Patients post-operatively followed in intensive care units in are known to have high morbidity and mortality rates. The aim of the present study was to compare the effects of enteral versus total parenteral nutrition for length of ICU stay in postoperative patients. Nutritional support for patients were divided into two groups; enteral nutrition (Group E) total parenteral administered (Group P). Demographic findings, APACHE II score and serum albumin levels were determined in the preoperative period in both groups of patients. In both groups were recorded type of operation and blood transfusion during the operation. Gas, fecal discharge time in the postoperative period, of patients in groups and, postoperative day 7th, serum albumin, and serum C-reactive protein (CRP), length of stay intensive care unit and mortality rates were determined. Abdominal cramps, the tension in the abdomen, nausea and diarrhea in patients in group E were accepted as complications of enteral nutrition. In this study were included group E 89, group P 82 patients. Between groups were similar demographic features, APACHE II score and serum albumin levels. Both groups was not significant difference operation type, operation time and blood transfusion. Postoperative gas discharge and fecal discharge were significantly difference earlier period in Group E (p <0.05). In terms of the serum albumin and CRP levels were not significant difference between groups postoperative day 7th. Gastrointestinal complications was detected in Group E 58.5% and in Group P 28.9%. Both groups showed two patients mortality in postoperative period. The median length of ICU stay was shorter Group E versus Group P in postoperative period (p <0.05). In the postoperative period the implementation of enteral nutrition was associated with the decreased length of ICU stay and recovered earlier gastrointestinal function. We thought that enteral nutrition support can be used safely and priority postoperative patients in ICU.