No abstract
Artan geriatrik ve çoklu morbidite içeren hasta popülasyonu ile ilişkili olarak ASA III-IV grubu hasta operasyonlarında artış görülmektedir. Bu çalışmada preoperatif değerlendirmede ASA III-IV skoru verilen ileri yaş hastalarda uygulanan anestezi tipinin postoperatif komplikasyonlar ve mortalite üzerine etkisinin incelenmesi amaçlandı.
Objective: Ensuring airway security carries the utmost importance in anesthesia. Specific predictive tests or findings for difficult airway are not defined for children under 3 years old. This study is aimed at finding out the value of anthropometric measurements in the prediction of difficult laryngoscopy and intubation in children by comparing them to direct laryngoscopic evaluation of Cormack-Lehane test and intubation evaluation of Intubation Difficulty Scale." Method: A total of 108 patients (aged 0-3 years), undergoing elective surgery were included in this study. Patients with known syndrome, facial anomaly, Anesthesiologists Physical Status Classification Class >2, and laryngeal mask airway were excluded from the study. Demographic data, head circumference, weight, height measurements, body mass index and percentile values were recorded by a pediatric surgeon in the preoperative period. During laryngoscopy and intubation evaluations were made using Cormack-Lehane Score and Intubation Difficulty Scale and recorded by a blinded resient. All recorded parameters were compared with Cormack-Lehane and Intubation Difficulty Scale scores. Results: When all parameters were compared with CL Grade I-II-III, IDS scores; a statistically significant difference was found between age and head circumference and CL Grade I, II (p<0.05, p<0.05). When all parameters were compared in terms of difficult and easy direct laryngoscopy, relations between difficult direct laryngoscopy and male gender and low weight percentile were observed (p<0.05). Difficult intubation was not found according to Intubation Difficulty Scale. Conclusion: Anthropometric measurements are not predictive for difficult direct laryngoscopy and difficult intubation in pediatric patients. The potentiality of difficult direct laryngoscopy could be higher in boys than girls and in children with low weight percentile.
Background SBTx has become a feasible therapeutic option for patients with irreversible intestinal failure. Increase in the number and in the European Scientific Journal April 2016 edition vol.12, No.12 ISSN: 1857 To compare the center's experience during a twelve year period, the results were divided into two groups (before (n:7) and after 2010 (n:18)). At the appropriate time, data were reported as mean± standard deviation, median, and range. Kaplan Meier method was used for the survival analysis of the graft and the patients. Results Median age of the patients was 39 (min 6 months, max: 56 yr). Six of them were in the pediatric age group. Compared to before 2010, graft survival rates increased from 28.1% to 53.8% in 3 months, from 28.6% to 35.9% in 6 months, and from 14.3% to 29.9% in one year after 2010. At the same period, patient survival rate increased from 57.1% to 72.2% in 3 months, from 28.6% to 38.9% in 6 months, and from 14.3% to 33.3% in one year. In the pediatric age group, patient and graft survival rates were 85.7% in 3 months, 71.4% in 6 months, and 71.4 % in 1 year. Conclusion SBTx is an effective treatment choice for selected patients with intestinal failure. Although patient and graft survival rates were improved after 2010 in our center, it was inferior. Patient and graft survival rates in pediatric SBTx are favourable and promising.
Objective: Due to high mortality rates, small bowel transplantation is a rarely applied intervention. In this study, we aimed to investigate the effects of perioperative hemodynamic data, electrolyte balance and blood gas parameters on early period mortality of the patients who underwent small bowel transplantation. Methods: The data of 23 patients, who had undergone small bowel transplantation in our clinic between 2004 and 2016, were examined retrospectively. All the patients' demographic data, causes of small bowel syndrome, perioperative hemodynamic data, electrolyte and blood gas values, blood replacement and early postoperative mortality rates within 48 hours were recorded. Statistical analysis was used to identify the parameters that effected early mortality. Results: The mean age of the 23 patients (13 female, and 10 male) was 34.54±15.2 years. Early period mortality was identified in four patients. When comparing demographic and clinic data with mortality, no statistically significant difference was found. There was a significant difference in pH, HCO3, BE values before and after reperfusion. No significant difference was found between electrolyte, blood gas values and early period mortality in the comparison of the same data. Conclusion: Many variables effect mortality in small bowel transplantation patients. We think that hemodynamic and metabolic changes should be monitored carefully in perioperative period to avoid early period mortality. ÖZ Amaç:Yüksek mortalite oranları nedeniyle ince bağırsak transplantasyonu oldukça nadir olarak uygulanan bir girişimdir. Bu çalışmada, ince barsak transplantasyonu uygulanan olguların peroperatif dönemdeki hemodinamik verilerini, elektrolit yönetimini, kan gazı değerlerinin erken dönem mortalite üzerine etkilerini araştırmayı amaçladık. Yöntem: 2004-2016 yılları arasında hastanemiz kliniğimizde ince barsak transplantasyonu operasyonu yapılmış olan 23 hastanın verileri retrospektif olarak incelendi. Tüm hastaların demografik verileri, kısa bağırsak sendromu nedenleri, peroperatif hemodinamik verileri, kan gazı değerleri, kan replasmanı ve postoperatif ilk 48 saat erken dönem mortalite oranları kaydedildi. Mortaliteyi etkileyen parametreleri tanımlamak için istatistiksel analiz yapıldı. Bulgular: Hastaların yaş ortalaması 34,54±15,2 olup, 13'ü kadın, 10'u erkek hastaydı. Erken dönem mortalite toplam 4 hastada gerçekleşti. Mortalite ile demografik ve klinik veriler karşılaştırıldığında istatistiksel olarak fark saptanmadı. Kan gazı ve elektrolit değerlerinin reperfüzyon öncesi ve sonrası karşılaştırılmasında sodyum, pH, HCO3, BE değerleri arasında anlamlı fark vardı. Aynı veriler erken dönem mortalite ile karşılaştırıldığında ise istatistiksel olarak anlamlı fark saptanmadı. Sonuç: İnce bağırsak transplantasyonu yapılan hastalarda mortalite üzerinde birçok değişken mevcuttur. Erken dönem mortaliteyi azaltmak açısından peroperatif dönemde hemodinamik ve metabolik değişikliklerin dikkatle izlenmesi gerektiğini düşünmekteyiz.
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