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    Comparison of hemodynamic response for intubation and propofol pain caused by lidocaine administration with infusion and tourniquet
    (Medicine Science, 2016) Deniz, Mohammed; Alparslan, Mustafa Muhlis; Ak, Koray; Altan, Hatice Aysel
    Propofol is one of the most widely used i.v. anesthetic agent. Nevertheless, pain following i.v. administration of propofol is an important problem in anesthesia induction. A wide range of studies have been performed related to lidocaine effects on propofol injection pain and hemodynamic response to intubation. However, effect of both situations are seldomly studied in the literature. In our study we compare lidocaine effects on propofol injection pain and hemodynamic response to intubation which is given by infusion or under tourniquet as i.v. bolus. 70 patients attended to the study are separated randomly into two groups of 35 patients. Prior to induction, lidocaine has been infused with infusion pump as to be completed in 2 minutes with concentration of 2%, total dosed 1mg/kg in infusion group (Group I, n=35). In this group, after half of the total lidocaine dose is infused (1st minute), anesthesia induction has been started by giving 40 mg propofol of 1% in 10 seconds with infusion pump. In tourniquet group (Group T, n=35) prior to induction 1mg/kg lidocaine has been given as bolus by applying tourniquet with 70 mm/Hg pressure to the arm that is established vascular access and tourniquet has been remained for 60 seconds. After opening the tourniquet, induction has been started by giving 40 mg propofol of 1% in 10 seconds with infusion pump. During induction, patient‟s consciousness was evaluated by questioning his/her name and age after administering 1/4 (VRS0), 1/2 (VRS1), and 3/4 (VRS2) of total propofol dose. Confused patients were eliminated and the sense of pain caused by propofol was evaluated in study patients. The results were recorded according to four-point categorical verbal rating scale (VRS). For groups, the pulse rates and mean arterial pressures before lidocaine administration (T0), after lidocaine (T1), immediately after intubation (T2) and 10th minute after intubation (T3) were recorded. No differences detected among the groups with regards to demographic data and side effects. (p>0.05). No significant differences statically detected when comparing the heart rate (HR), mean arterial pressure (MAP) and pain scores of groups for all times (p>0.05).
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    The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye
    (Galenos Publishing House, 2023) Gül, Fethi; Kasapoğlu, Umut Sabri; Sabaz, Mehmet Süleyman; Ay, Pınar; Oktay, Burçin Doruk; Çalışkan, Gülbahar; Demir, Nalan; Alparslan, Mustafa Muhlis
    Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear. Aims: To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19. Study Design: Multicenter prospective observational clinical study. Methods: This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ? 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated. Results: As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004). Conclusion: Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.