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Inci K, Macit Aydın E, Aygencel G, Türkoğlu M. Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical ıntensive care unit patients. NUTR HOSP 2024. [PMID: 38450486 DOI: 10.20960/nh.05011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024] Open
Abstract
AIM critical illness often leads to malnutrition and diaphragmatic dysfunction (DD), common in intensive care units (ICU). Ultrasonography (US) is a potent tool for detecting DD. This study examines the connection between malnutrition risk and DD in ICU patients using ultrasonographic diaphragm measurements in medical ICU patients. METHODS we assessed nutritional risk using risk screening tools and mid-upper arm circumference measurements (MUAC). Diaphragm atrophy (DA) and DD were evaluated by measuring diaphragmatic excursion (DE), thickness, and thickening fraction (TF) by US. We then compared these diaphragmatic measurements in patients based on their nutritional risk scores. RESULTS of the fifty patients studied, 54 % to 78 % were at risk of malnutrition, 28 % exhibited diaphragm atrophy (DA), and 24 % showed DD upon ICU admission. Malnutrition risk diagnosed by all nutritional risk screening tools was significantly more frequent in patients with DD, while diagnosed by MUAC was considerably higher in patients with DA. A total of 16 patients (32 %) died during their ICU stay, with DD, DA, and malnutrition risks (as identified by the mNUTRIC Score) being more prevalent among non-survivors (p < 0.05). Malnutrition risk (as determined by the mNUTRIC Score) was an independent risk factor for DD [OR (95 % CI): 6.6 (1.3-34), p = 0.03]. CONCLUSION malnutrition risk may be significantly associated with DD and DA in medical ICU patients upon ICU admission.
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Affiliation(s)
- Kamil Inci
- Department of Internal Medicine. Division of Critical Care. Faculty of Medicine. Gazi University
| | | | - Gulbin Aygencel
- Department of Internal Medicine. Division of Critical Care. Faculty of Medicine. Gazi University
| | - Melda Türkoğlu
- Department of Internal Medicine. Division of Critical Care. Faculty of Medicine. Gazi University
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Dayıoğlu M, Gürsel G, Özercan S, Aydın EM, Nadastepe Ö. Performance of handheld ultrasound devices in diagnosis of pulmonary hypertension and right heart dysfunction in ICU patients. Echocardiography 2024; 41:e15721. [PMID: 38041481 DOI: 10.1111/echo.15721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/30/2023] [Accepted: 11/13/2023] [Indexed: 12/03/2023] Open
Abstract
AIM The use of handheld ultrasonography devices (HHUD) has increased recently but there are limited data about their performance in the evaluation of right heart dysfunction (RHD) and pulmonary hypertension (PHT). The aim of the study is to compare the performance of a HHUD with a conventional ultrasound device (CUD) in assessing PHT and RHD. METHODS This single-center prospective study was performed in a seven-bed teaching hospital intensive care unit (ICU). PHT and RHD criteria were compared by HHUD and CUD. Additional PHT criteria and right ventricle (RV) systolic and diastolic dysfunction criteria were also measured. RESULTS Forty-six patients were included in the study. There was no significant difference between the imaging rates and mean values of the parameters measured by both devices. When the positivity rates for additional PHT parameters and RHD criteria were compared, there were no significant differences between the devices. In Bland-Altman's analysis, there was good agreement and there was no bias between the measurements of the two devices but left ventricular end-systolic eccentricity index (LVSEI), right atrium area (RAA), and pulmonary artery diameter (PAD). Ninety percent of the patients had PHT probability, of whom 43% had a low, 37% had intermediate and 10% had a high probability of PHT. Ninety-two percent of the patients had RHD and there was no significant difference between the devices in the diagnosis of RHD (p = .212). When RV systolic and diastolic dysfunction evaluations of the devices were compared according to the British Society of Echocardiography (BSE) criteria there was no significant difference between the devices' measurements in the evaluation of systolic and diastolic function. CONCLUSION The imaging and measurement capabilities of the HHUDs for PHT and RHD parameters were similar to CUDs, and considering the inconsistent parameters, the HHUD can be useful in diagnosing these problems.
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Affiliation(s)
- Mürüvvet Dayıoğlu
- Critical Care Fellowship Program, Gazi University School of Medicine, Ankara, Turkey
| | - Gül Gürsel
- Department of Pulmonary Disease, Division of Critical Care Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Seçil Özercan
- Critical Care Fellowship Program, Gazi University School of Medicine, Ankara, Turkey
| | - Eda Macit Aydın
- Critical Care Fellowship Program, Gazi University School of Medicine, Ankara, Turkey
| | - Özge Nadastepe
- Critical Care Fellowship Program, Gazi University School of Medicine, Ankara, Turkey
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3
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Güngör S, Ediboğlu Ö, Yazıcıoğlu Moçin Ö, Adıgüzel N, Tuncay E, Ekiz İşcanlı İG, Er B, Karakurt Z, Turan S, Kosovalı BD, Mutlu NM, Kayar D, Gökbulut Bektaş Ş, Uysal E, Seğmen F, Alp G, Erdem D, Has Selmi N, Güven P, Özçelik Z, Ocakcıoğlu M, Yazıcı Özgür C, Yılmaz R, Bilgi Özel D, Cebeci H, Güler B, Cansever C, Çakırca M, İnceöz H, Solmaz İ, Özkan Sipahioğlu F, Aydın EM, Dayanır H, Öner SF, Karatepe U, Özen S, Boran M, Ergül DF, Kasapoğlu US, Delen LA, Toy E, Altun K, Albayrak T, Yanal H, Zaim G, Yarar V, Kılınç G, Deniz M, Özdemir E, Soylu VG, Yılmaz A, Saygılı SM, Öztürk EK, Ergan B, Eyüpoğlu S, Şahin Y, Yüksel B, Bulut A, Sarıtaş A, Yeniay H, Genç M, Kargın F, Özcan O, Karakoç E, Karaca Ü, Sözütek D, Sarı S, Şenoğlu N, Aygün H, Yiğit AC, Kavruk N, Uzan ÇA, Bıçakcıoğlu M, Solak S, Kutbay Özçelik H, Uluç K, Yıldırım İ, Arar MC, Demirel İ, Küver SU, Özgür ES, Aydın K, Erdal Dönmez G, Aygencel G, Esmaoğlu A, Sebil Aydın B, Tokur ME, Korkmaz Ekren P, Aydemir Y, Çakır Güney B, Erdil ÖY, Tünay A, Bahadır T, Uçkun S, Kocaoğlu N, Pınar HU, Kutluer Karaca N, Gültekin H, Ayvat P, Belin Özer A, Eroğlu A, Kuyrukluyıldız U, Baytar Ç, Ayoğlu H, Mızrakçı S, Metin H, Zanbak Mutlu ÖP, Yılmaz H, Tüzüner F. Evaluation of Patients with COVID-19 Followed Up in Intensive Care Units in the Second Year of the Pandemic: A Multicenter Point Prevalence Study. Thorac Res Pract 2023. [PMID: 37994835 DOI: 10.5152/thoracrespract.2023.23024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVE A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic. MATERIAL AND METHODS All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded. RESULTS A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2/FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%). CONCLUSION The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem.
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Affiliation(s)
- Sinem Güngör
- Department of Respiratory Intensive Care, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Özlem Ediboğlu
- Department of Intensive Care Unit, University of Health Sciences İzmir Dr. Suat Şeren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
| | - Özlem Yazıcıoğlu Moçin
- Department of Respiratory Intensive Care, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Nalan Adıgüzel
- Department of Respiratory Intensive Care, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Eylem Tuncay
- Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - İnşa Gül Ekiz İşcanlı
- Department of Respiratory Intensive Care, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Berrin Er
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Zuhal Karakurt
- Department of Respiratory Intensive Care, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Sema Turan
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | | | - Nevzat Mehmet Mutlu
- Department of Critical Care, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Duygu Kayar
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | | | - Elmas Uysal
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Fatih Seğmen
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Gürayalp Alp
- Department of Intensive Care, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Deniz Erdem
- Department of Intensive Care, University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | - Nazan Has Selmi
- Medical Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | - Pınar Güven
- Department of Intensive Care, Prof. Dr. Feriha Öz Emergency and Pandemic Hospital, İstanbul, Turkey
| | - Zerrin Özçelik
- Department of Intensive Care, Prof. Dr. Feriha Öz Emergency and Pandemic Hospital, İstanbul, Turkey
| | - Merve Ocakcıoğlu
- Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Canan Yazıcı Özgür
- İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Rabia Yılmaz
- Department of Intensive Care, University of Health Sciences Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Deniz Bilgi Özel
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Halil Cebeci
- University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Bahar Güler
- Department of Intensive Care, University of Health Sciences Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Canan Cansever
- University of Health Sciences Ankara City Hospital, Ankara, Turkey
| | | | - Hansa İnceöz
- University of Health Sciences Gülhane Training and Research Hospital, İstanbul, Turkey
| | - İlker Solmaz
- University of Health Sciences Gülhane Training and Research Hospital, İstanbul, Turkey
| | - Fatma Özkan Sipahioğlu
- Department of Intensive Care, Clinic of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkey
| | - Eda Macit Aydın
- Department of Intensive Care, Clinic of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkey
| | - Hakan Dayanır
- University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | | | | | - Serkan Özen
- Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Maruf Boran
- Department of General Intensive Care Unit, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Turkey
| | - Dursun Fırat Ergül
- Department of General Intensive Care Unit, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Turkey
| | - Umut Sabri Kasapoğlu
- Department of Intensive Care, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Leman Acun Delen
- Department of Anesthesiology and Reanimation, Malatya Training and Research Hospital, Malatya, Turkey
| | - Erol Toy
- Karabük Training and Research Hospital, Karabük, Turkey
| | - Koray Altun
- Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Hülya Yanal
- Department of Anesthesiology and Reanimation, İlhan Özdemir Public Hospital, Giresun, Turkey
| | - Gizem Zaim
- Giresun Prof. Dr. A. İlhan Özdemir Public Hospital, Giresun, Turkey
| | - Volkan Yarar
- Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | | | - Mustafa Deniz
- Department of Intensive Care, İzzet Baysal State Hospital, Bolu, Turkey
| | | | - Veysel Garani Soylu
- Department of General Intensive Care, Kastamonu University, Kastamonu, Turkey
| | - Ayşe Yılmaz
- Kastamonu Training and Research Hospital, Kastamonu, Turkey
| | - Saba Mukaddes Saygılı
- Department of Intensive Care Unit, University of Health Sciences İzmir Dr. Suat Şeren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Turkey
| | - Ejder Kamil Öztürk
- Department of Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Begüm Ergan
- Department of Intensive Care, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | | | - Yiğit Şahin
- Giresun University Training and Research Hospital, Giresun, Turkey
| | - Beyza Yüksel
- Giresun Training and Research Hospital, Giresun, Turkey
| | - Azime Bulut
- Giresun Training and Research Hospital, Giresun, Turkey
| | - Aykut Sarıtaş
- Department of Intensive Care Unit, University of Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Hicret Yeniay
- Department of Intensive Care Unit, University of Health Sciences İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Mürşide Genç
- University of Health Sciences Prof. Dr. Cemil Taşçıoğlu City Hospital, İstanbul, Turkey
| | - Feyza Kargın
- Department of Intensive Care, University of Health Sciences Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey
| | - Osman Özcan
- Department of Anesthesiology and Reanimation, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ebru Karakoç
- Department of Anesthesiology and Reanimation, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ümran Karaca
- University of Health Sciences Bursa Yüksek İhtisas Traning and Research Hospital, Bursa, Turkey
| | - Didem Sözütek
- Department of Intensive Care, University of Health Sciences Adana City Hospital, Adana, Turkey
| | - Sema Sarı
- Niğde Training and Research Hospital, Çankaya, Turkey
| | - Nimet Şenoğlu
- Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey
| | - Hakan Aygün
- Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey
| | | | - Nilgün Kavruk
- Department of Anesthesiology and Reanimation, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
| | | | - Murat Bıçakcıoğlu
- Department of Anaesthesiology and Reanimation, İnönü University Faculty of Medicine, Malatya, Turkey
| | | | - Hatice Kutbay Özçelik
- University of Health Sciences Yedikule Chest Diseases and Thoracic Surgery Education and Research Hospital, İstanbul, Turkey
| | - Kamuran Uluç
- Department of Anesthesiology and Reanimation, University of Health Sciences Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - İlker Yıldırım
- Tekirdağ Namık Kemal University Hospital, Tekirdağ, Turkey
| | | | | | | | - Eylem Sercan Özgür
- Department of Chest Diseases, Mersin University Faculty of Medicine, Mersin, Turkey
| | | | - Gül Erdal Dönmez
- University of Health Sciences Süreyyapaşa Chest Disease and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gülbin Aygencel
- Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Aliye Esmaoğlu
- Department of Anesthesiology and Reanimation, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Berrak Sebil Aydın
- Department of Anesthesiology and Reanimation, Karadeniz Ereğli Public Hospital, Ereğli, Turkey
| | | | - Pervin Korkmaz Ekren
- Department of Pulmonary Disease, Ege University Faculty of Medicine, İzmir, Turkey
| | - Yusuf Aydemir
- Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Başak Çakır Güney
- University of Health Sciences Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Ömer Yavuz Erdil
- Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Abdurrahman Tünay
- University of Health Sciences İstanbul Training and Research Hospital, İstanbul, Turkey
| | | | - Serkan Uçkun
- Department of Anaesthesiology and Reanimation, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
| | - Nazan Kocaoğlu
- Department of Anaesthesiology and Reanimation, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
| | - Hüseyin Ulaş Pınar
- Department of Anaesthesiology and Reanimation, KTO Karatay University Faculty of Medicine, Konya, Turkey
| | - Nurcan Kutluer Karaca
- Department of Anaesthesiology and Reanimation, Erzincan Binali Yıldırım University Faculty of Medicine, Erzincan, Turkey
| | - Hamza Gültekin
- Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Pınar Ayvat
- İzmir Democracy University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Belin Özer
- Department of Anesthesiology and Reanimation, İnönü University Faculty of Medicine, Malatya, Turkey
| | - Ahmet Eroğlu
- Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | | | - Çağdaş Baytar
- Department of Anaesthesiology and Reanimation, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Hilal Ayoğlu
- Department of Anaesthesiology and Reanimation, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | | | - Hatice Metin
- Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Hakan Yılmaz
- Department of Anesthesiology and Reanimation, Ufuk University Faculty of Medicine, Ankara, Turkey
| | - Filiz Tüzüner
- Department of Anesthesiology and Reanimation, Ufuk University Faculty of Medicine, Ankara, Turkey
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4
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Gül F, Kasapoğlu US, Sabaz MS, Ay P, Doruk Oktay B, Çalışkan G, Demir N, Sayan İ, Kabadayı F, Altuntaş G, Gümüş A, Kırca H, Şanlı D, Acil F, Dedeoğlu A, Ural SG, Akın Şen İ, Macit Aydın E, Dayanır H, Yelken B, Ceylan İ, Aydın OÖ, Eskidemir G, Aytekin A, Cengiz M, Arslan Ü, Akdağ D, Alay GH, Tekin E, Yarar V, Saracoğlu KT, Gök F, Alparslan V, Tuna V, Yıldız M, Şenoğlu N, Kıraklı C, Yıldırım S, Saçar Kübüç K, Erer A, Gültekin H, Özmen Süner K, Kuzgun Ö, Öztürk ÇE, Karahan A, Deveci O, Ay M, Tüfek Öztan D, Akıncı SB, Solak MY, Bozbay S, Özçiftçi S, Gönderen K, Küçük AO, Uyan B, Elay G, Boyacı N, Timurkaan M, Karakoç E, Doğan L, Yalçınkaya E, Kazancıoğlu L, Erdal Dönmez G, Yılmaz B, Ergül DF, Boran M, Özkarakaş H, Karakaş B, Ergin Özcan P, Anaklı İ, Bayar MK, Yüksel D, Akdağ Ş, Pişkin Ö, Temur S, Eyüpoğlu S, Tekir Yılmaz E, Avcı GZ, Turan R, Alkan Bayburt F, Şahintürk H, Güçyetmez B, Alparslan MM, Yarıcı M, Yıldırım F, Yektaş A, Yaman G, Demirkıran O, Cinel İ. The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye. Balkan Med J 2023; 40:435-444. [PMID: 37867428 PMCID: PMC10613737 DOI: 10.4274/balkanmedj.galenos.2023.2023-6-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023] Open
Abstract
Background 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.
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Affiliation(s)
- Fethi Gül
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Umut Sabri Kasapoğlu
- Clinic of Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Türkiye
| | - Mehmet Süleyman Sabaz
- Clinic of Critical Care Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Pınar Ay
- Department of Public Health, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Burçin Doruk Oktay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Gülbahar Çalışkan
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Bursa Faculty of Medicine, Bursa, Türkiye
| | - Nalan Demir
- Division of Critical Care Medicine, Clinic of Chest Diseases, University of Health Sciences Türkiye, Ankara City Hospital, Ankara, Türkiye
| | - İsmet Sayan
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Feyyaz Kabadayı
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Gülsüm Altuntaş
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ayça Gümüş
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Hülya Kırca
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Deniz Şanlı
- Clinic of Critical Care Medicine, Batman Training and Research Hospital, Batman, Türkiye
| | - Fatma Acil
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Andaç Dedeoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Sedef Gülçin Ural
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - İrem Akın Şen
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - Eda Macit Aydın
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Hakan Dayanır
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Birgül Yelken
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - İlkay Ceylan
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Bursa High Specialization Training and Research Hospital, Bursa, Türkiye
| | - Osman Özcan Aydın
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - Güneş Eskidemir
- Clinic of Critical Care Medicine, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye
| | - Ahmet Aytekin
- Clinic of Anesthesiology and Reanimation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
| | - Melike Cengiz
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Ülkü Arslan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Devrim Akdağ
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Adana City Hospital, Adana, Türkiye
| | - Gülçin Hilal Alay
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
| | - Esra Tekin
- Clinic of Critical Care Medicine, Denizli State Hospital, Denizli, Türkiye
| | - Volkan Yarar
- Clinic of Critical Care Medicine, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
| | - Kemal Tolga Saracoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
| | - Funda Gök
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
| | - Volkan Alparslan
- Clinic of Critical Care Medicine, Hatay Training and Research Hospital, Hatay, Türkiye
| | - Verda Tuna
- Clinic of Critical Care Medicine, Adıyaman Training and Research Hospital, Adıyaman, Türkiye
| | - Murside Yıldız
- Clinic of Critical Care Medicine, Ağrı Training and Research Hospital, Ağrı, Türkiye
| | - Nimet Şenoğlu
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Cenk Kıraklı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Süleyman Yıldırım
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Kübra Saçar Kübüç
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Van Training and Research Hospital, Van, Türkiye
| | - Ayşen Erer
- Clinic of Critical Care Medicine, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdag, Türkiye
| | - Hamza Gültekin
- Clinic of Critical Care Medicine, Şırnak State Hospital, Şırnak, Türkiye
| | - Kezban Özmen Süner
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Özge Kuzgun
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Çağatay Erman Öztürk
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Samsun Training and Research Hospital, Samsun, Türkiye
| | - Aydın Karahan
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Okan Deveci
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Mustafa Ay
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Dilara Tüfek Öztan
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Seda Banu Akıncı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melahat Yalçın Solak
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Süha Bozbay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Serhat Özçiftçi
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Kamil Gönderen
- Department of Critical Care Medicine, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Ahmet Oğuzhan Küçük
- Division of Critical Care Medicine, Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Berna Uyan
- Department Critical Care Medicine, Gaziantep Şehit Kamil State Hospital, Gaziantep, Türkiye
| | - Gülseren Elay
- Division of Critical Care Medicine, Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Nazlıhan Boyacı
- Division of Critical Care Medicine, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Timurkaan
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ebru Karakoç
- Department of Critical Care Medicine, Çankırı State Hospital, Çankırı, Türkiye
| | - Lerzan Doğan
- Department of Critical Care Medicine, Altunizade Acıbadem Hospital, İstanbul, Türkiye
| | - Erdem Yalçınkaya
- Department of Critical Care Medicine, Sivas Numune Hospital, Sivas, Türkiye
| | - Leyla Kazancıoğlu
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye
| | - Gül Erdal Dönmez
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Barış Yılmaz
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Dursun Fırat Ergül
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Maruf Boran
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Hüseyin Özkarakaş
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İzmir Bozyaka Training and Research Hospital, İzmir, Türkiye
| | - Buğra Karakaş
- Clinic of Critical Care Medicine, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Perihan Ergin Özcan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - İlkay Anaklı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Kemal Bayar
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Didem Yüksel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Şükriye Akdağ
- Department of Anesthesiology and Reanimation, Yasar Eryılmaz Ağrı Doğubeyazıt State Hospital, Ağrı, Türkiye
| | - Özcan Pişkin
- Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Sibel Temur
- Department of Anesthesiology and Reanimation, Yeditepe University Faculty of Medicine, İstanbul, Türkiye
| | - Selin Eyüpoğlu
- Clinic of Critical Care Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Elvan Tekir Yılmaz
- Clinic of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Gizem Zaim Avcı
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Raziye Turan
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Fatma Alkan Bayburt
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Helin Şahintürk
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, Türkiye
| | - Bülent Güçyetmez
- Department of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Muhlis Alparslan
- Clinic of Anesthesiology and Reanimation, Aksaray University Training and Research Hospital, Aksaray, Türkiye
| | - Metin Yarıcı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Fatma Yıldırım
- Department of Chest Diseases, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Abdulkadir Yektaş
- Department of Anesthesiology and Reanimation, Siirt University Faculty of Medicine, Siirt, Türkiye
| | | | - Oktay Demirkıran
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - İsmail Cinel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
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5
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Çınar Z, Aydın EM, Naurzvai N, Mammadova A, Kodalak S, Abbasova A, Gürsel G. Impact of neurological problems on mechanical ventilation and intensive care unit outcomes in pulmonary intensive care unit patients: a retrospective analysis of a single-center cohort. Monaldi Arch Chest Dis 2023; 94. [PMID: 37074127 DOI: 10.4081/monaldi.2023.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/11/2023] [Indexed: 04/20/2023] Open
Abstract
Neurological problems (NPs) are frequently connected with different critical illnesses in intensive care unit (ICU) patients, and they may influence ICU outcomes. This study aims to examine the effects of NPs on ICU outcomes, especially in pulmonary ICU patients. This is a retrospective observational study comprising adult pulmonary critical care patients who were hospitalized between 2015 and 2019. The frequency of NPs at admission, their impact on mechanical ventilation (MV), ICU outcomes, the rate of NP development during the ICU stay, and risk factors for them were investigated. A total of 361 patients were included in the study, and 130 of them (36%) had NPs (group 1). The noninvasive ventilation requirement rate in patients with NPs was less than in those without NPs (group 2), and the requirement of MV was significantly more frequent in this group (37% and 19%, p<0.05). The duration of MV (19±27 and 8±6 days, p=0.003) and sepsis rate (31% and 18%, p=0.005) were also higher in group 1. NPs developing after ICU admission increased the MV requirement 3 times as an independent risk factor. Risk factors for ICU-acquired NPs were the existence of sepsis during admission [odds ratio (OR): 2.01, confidence interval (CI) 95%: 1.02-4, p=0.045] and longer MV durations before ICU admission (OR: 1.05, CI 95%: 1.004-41.103, p=0.033). NPs were not independent risk factors for mortality (OR: 0.67, CI 95%: 0.37-1.240, p=0.207). NPs did not increase mortality but more frequently caused MV requirement, more extubation failure, and a longer ICU stay in this study population. Additionally, our data suggest that having sepsis during admission and a longer length of MV prior to admission may increase the neurological complication rate.
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Affiliation(s)
- Zeynep Çınar
- Division of Critical Care Medicine, Department of Anesthesiology, Gazi University School of Medicine, Ankara.
| | - Eda Macit Aydın
- Division of Critical Care Medicine, Department of Anesthesiology, Gazi University School of Medicine, Ankara.
| | - Nurgul Naurzvai
- Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara.
| | - Ayshan Mammadova
- Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara.
| | - Sümeyye Kodalak
- Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara.
| | - Aygül Abbasova
- Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara.
| | - Gül Gürsel
- Division of Critical Care Medicine, Department of Pulmonary Medicine, Gazi University School of Medicine, Ankara.
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