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    COVID-19-Related life-threatening complications: pneumothorax, pneumo mediastinum and subcutaneous emphysema
    (2023) kutlusoy, sevgi demirhan; AYDIN, AHMET; koca, erdinç
    Complications of COVID-19-related pneumothorax, subcutaneous emphysema, and pneumomediastinum are frequently observed in moderate and severe pneumonia cases. The aim of this study is to determine the incidence and potential risk factors of life-threatening complications such as pneumothorax, pneumo- mediastinum, and subcutaneous emphysema that develop in patients received in the tertiary ICUs of our hospital, which serves as a pandemic hospital and to analyze their relationship with mortality. Patients' demographic characteristics, comorbid diseases, length of hospital stay, day and duration of thoracic tube placement, discharge status, and hospitalization laboratory findings were recorded, and the relationship of these parameters with mortality due to pneumothorax, subcutaneous emphysema, and pneumomediastinum were investigated. Of these patients, 33 had pneumothorax, 12 had pneumomediastinum, and 28 had subcutaneous emphysema. Male and female patients were equally represented, and mortality rates were similar. While the rate of pneumothorax in the study patients was 2.21 %, the rate of all life-threatening sequelae such as pneumothorax, pneumomediastinum, and subcutaneous emphysema was 4.7 %, with a high mortality rate (90 %) in 70 patients with these complications. Patients diagnosed with COVID-19 pneumonia should be constantly monitored for life-threatening complications such as pneumothorax, pneumomediastinum, and subcutaneous emphysema during their long-term follow-up.
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    The effects of propofol-ketamine combination on QTc interval in patients with coronary artery disease
    (2021) koca, erdinç; Erdil, Feray Akgül; TOPRAK, Huseyin i.; GULHAS, Nurcin; Ersoy, Mehmet Özcan; Durmus, Mahmut
    The purpose of this study was to evaluate the effects of propofol-ketamine combination on QTc, T wave (Tp-e) interval, hemodynamics during the induction of anesthesia in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting (CABG). Patients were prospectively randomized, in a double blinded manner, to either the propofol group (Group P, n=41) or the propofol-ketamine combination group (Group PK, n=45). In both groups the drugs were infused at an IV dose of 2 mg/kg administered over 30 seconds. After that, 5?g/kg fentanyl and 0.1mg/kg vecuronium were administered and tracheal intubation was performed. ECG recordings were performed prior to induction of anesthesia (baseline, T1), 2 min after the beginning of study drugs (T2), 3 min after vecuronium (immediately before intubation, T3), and 30 s (T4), 1 min (T5) and 5 min (T6) after intubation. Eighty-six patients were evaluated in the study. The baseline QTc interval values were similar between the groups, In Group P, QTc interval increased significantly for T3-T6 in all periods according to baseline value. Also in Group P, QTc interval increased significantly in T4, T5, T6 according to T3. In group PK, QTc interval increased significantly in T3-T6 according to baseline value. Group PK increased significantly in T5 and T6 compared to T3. In both groups a statistically significant change was not found in Tp-e intervals of all periods. Following induction with propofol-ketamine combination, QTc interval did not increase, but it prolonged postintubation QTc interval just like propofol. Assuming that increased repolarization transmural dispersion (TDR) is a reliable indicator of risk of torsade de pointes (TdP), and lack of any change in Tp-e interval, in the presence of depressed hemodynamic response to intubation, we think that this combination can be safely used for the induction of anesthesia in patients with CAD undergoing CABG.
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    Ventilation with a full face mask in rhinoplasty: A new method
    (2024) koca, erdinç; koca, çiğdem fırat
    Effectual mask ventilation is necessary for confident airway administration in the course of general anesthesia. Following septoplasty procedures, nasal packing is often utilized and after rhinoplasty operations, plaster is often used on the nose. A face mask cannot be used to ventilate the patient after the rhinoplasty operation. We aimed to evaluate the efficacy of full face mask as an alternative in these patients. Our study was conducted a prospective study. 69 patients were included in this present study. After extubation, one group was ventilated using an oral mask, while the other group was ventilated using a full face mask. A numerically significance was detected in terms of the distribution of cough status according to the groups (p=0.046). Additionally, a numerically significance was detected in terms of agitation status according to the groups (p=0.046). A numerically significance was determined between the oral mask and full face mask groups in terms of SpO2 values at the 1st minute after extubation (p=0.001). We believe that the use of full face masks in ventilation after rhinoplasty is advantageous compared to the use of oral masks.