IntroductionA pressure ulcer (PU) is localized tissue damage in the dermis and subdermis caused by compression, friction, shearing, and other factors (1). It is commonly encountered in all hospitalized patients, especially those in intensive care units (ICUs) (2). The incidence of PU was found to increase from 4% to 49% in Denmark and vary from 38% to 24% in Germany (3) and from 14% to 42% in the United States (4,5). Studies from Turkey showed that the incidence of PU varied between 15% and 29% (6-8).Mobilization, sensorial perceptions, and consciousness in patients in ICUs are impaired due to the administration of sedative and anesthetic agents (9-11). It has been shown that vasopressin administered to maintain sufficient cardiac output in ICUs leads to constriction in the capillary circulation, which prevents oxygen and blood supply to the skin. This creates a risk of PU (12). Changes in metabolism resulting from such conditions as major surgery, burns, major trauma, and sepsis in ICUs increase the risk of PU development (9-13). In addition, the risk of PU is increased due to impairment of hemodynamic status, cardiovascular diseases, circulatory failure, impaired oxygenation, diabetes mellitus, anemia, infection, edema, catabolic disorders, and pressure (4,10,11,14). In a systematic review, it was reported that PU is not caused by a single factor, but rather develops due Background/aim: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. Materials and methods:The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition. Results:The incidence of pressure ulcer was 15.5%. Duration of mechanical ventilation was longer and the body mass index was higher in patients developing pressure ulcers than in those without pressure ulcers. Additionally, 90.11% of patients with pressure ulcers had edema and 82.35% of patients with pressure ulcers received vasopressin. The patients with pressure ulcers had higher PH levels, lower PaO2 levels, higher PCO2 levels, lower SaO2 levels, and higher urine output. Conclusion:It can be recommended that nurses and other health professionals should be aware of factors playing a role in pressure ulcer development and should be able to conduct appropriate interventions to prevent pressure ulcers.

Purpose: This study aims to compare the perceptions of nurses and families on the needs of the relatives of the patients in Intensive Care Unit (ICU). Methods This cross-sectional study was conducted in the ICU of a university hospital. The study comprised 213 critical care patients’ relatives and 54 nurses working in the same ICU. Data were collected using the Turkish version of Critical Care Family Needs Inventory (CCFNI) and a questionnaire on the characteristics of the participants. The difference between the perceptions of families and nurses was analyzed using Student t-test. Results: CCFNI’s assurance/proximity subscale mean scores ranked first among bothpatients and nurses. The item “To be assured the best care possible is being given to the patient” was the top priority for both groups. Mean assurance/proximity and information dimensions of relatives were significantly higher compared to nurses (p < 0.001). No significant difference was found between the perception of patient relatives and nurses related to support and comfort dimensions (p < 0.05). Conclusion The needs of the relatives of patients are underestimated by nurses. This inhibited the performance of ICU nurses in line with the holistic care approach. Educational objectives that include the needs of ICU patients’ relatives should be incorporated into the undergraduate and in-service training of nurses. Policies should be established to create space and time for effective relative-nurse communication.

This study aimed to determine and compare the effects of two different gastric residual volume (GRV) thresholds, 200 mL and 400 mL, on target calories and gastrointestinal intolerance in intensive care patients receiving enteral nutrition. Materials and Methods: Prospective data of 56 patients over 18 years of age who were expected to stay in the intensive care unit for more than three days were included in the study. Patients were randomized into two groups as GRV threshold 200 mL (group 1) and GRV 400 mL (group 2). Enteral Measurement of GRV was done every six hours. The feeding was initiated at a rate of 20 mL/h and was increased by 10 mL/h to reach the goal rate. Results: There was no significant difference between two groups regarding gender, age, APACHE II score, body mass index, length of stay in intensive care unit, admission reason, and co-morbidities. There was also no significant difference in the incidence of GRV, vomiting, diarrhea and intolerance. Time to target calories was 24 hours in group 1 and 26 hours in group 2, and no significant difference was found between the two groups. Conclusion: In this study, there was no significant difference between 200 mL and 400 mL GRV regarding time to target calories and incidence of gastrointestinal complications in critical intensive care unit patients.

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Nowadays, orthotopic liver transplantation (OLT) is the most definitive treatment in patients with end stage liver failure. In the early postoperative period after OCT, hemodynamic stabilization, maintenance of oxygenation with mechanical ventilation and weaning, preservation of renal functions and providing hemostasis should be our main targets. Early diagnosis and treatment of complications with an experienced intensive care team is important for graft function and survival. In this review, perioperative intensive care management of OLT patients was discussed according to current literature.