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    Investigation of the Factors Affecting Prolonged Intensive Care Unit
    (Galenos Yayincilik, 2020) Kiray, Guven; Inal, Mehmet Turan; Memis, Dilek; Turan, Fatma Nesrin
    Objective: As a result of advanced mechanical ventilation and hemodynamic support applications, the duration of intensive care stay is prolonged. Investigation of effective causes of prolonged ICU stay is important in terms of effective use of intensive care units. Materials and Methods: Patients who were hospitalized for more than 24 hours in the ICU during one year were included into the study. Age, gender, Body Mass index, hospitalization, location (emergency, operating room, service), presence of operation, presence of emergency / elective operation, need for vasopressor, Glaskow coma score (GCS), Full Outline of Unresponsiveness score (FOUR), Acute Physiology and Chronic Health Evaluation score, simplified acute physiology (SAPS III) score, hemogram profile, biochemical profile and coagulation profile values were recorded. All patients were classified as stay in the intensive care unit for shorter than 14 days and 14 days and more. We tried to investigate factors affecting prolonged admission by comparing these values. Results: Advanced age, high urea value, low GCS, low FOUR score, high SAPS III value, need for MV and need for vasoactive agent were found to be effective factors in prolonged intensive care hospitalization. Conclusion: We think that extensive studies should be done in this area as more effective use of intensive care units may be possible as a result of trying to reveal the factors affecting prolonged intensive care.
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    Pulmonary Embolism During Hepatoblastoma Resection
    (Aves, 2020) Colak, Alkin; Basaran, Umit Nusret; Copuroglu, Elif; Sag, Fatih; Cakici, Zafer; Kiray, Guven
    Although hepatoblastoma is rare, it is the most malignant tumour of childhood. Treatment is usually done by surgical resection and chemotherapy. The mortality and morbidity have decreased due to improvements in the treatments. In this process, hepatic resection has a risk of pulmonary embolism, and this condition could be fatal. In this case, a 9-month-old patient who was treated with chemotherapy and then underwent hepatectomy was presented. We used non-invasive methods such as the perfusion index (PI), the plethysmographic variability index (PVI) (Massimo Radical 7) and non-invasive total haemoglobin measurement (SpHb) rather than invasive measurements. During closure of the surgical skin incision, the end-tidal CO2 (ETCO2) value dropped, after which arrhythmia and bradycardia resulted in cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated. However, the patient did not respond to CPR. We concluded that heparin may be administered to reduce the risk of thrombosis in patients undergoing liver surgery.