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    COMPARISON OF RISK INDEXES USED IN DETERMINING THE POSTOPERATIVE RESPIRATORY INSUFFICIENCY RISK
    (Nobel Ilac, 2013) Kavalci, Gulsum; Arar, Cavidan; Colak, Alkin; Turan, Nesrin; Kavalci, Cemil
    Objective: Postoperative respiratory failure is an important complication of anesthesia. In this study, we aimed to compare the effectiveness of respiratory failure risk index and pneumonia risk index in determining postoperative respiratory failure. Material and Method: 3000 patients were included in our study. We calculated the patients' scores of respiration insufficiency risk indexes and postoperative pneumonia risk indexes in preoperative period. The factors that could play a role in intensive care unit requirement have been inquired through multiple variability regression analysis. Results: Through multiple variability regression analysis we concluded that; intensive care unit requirement and postoperative pulmonary complications were effected by age, gender, low albumin levels, high urea levels, functional state, chronic obstructive lung disease, having more than 4 unit blood transfusion, peripheric vessel surgery, extremity surgery, brain surgery, spinal column surgery and urgent surgery (p<0.05). Respiration insufficiency risk index and postoperative pneumonia risk index scores had similar effects in determining the intensive care unit requirement and postoperative pulmonary complications. Conclusion: We conclude that respiration insufficiency risk index and postoperative pneumonia risk index have similiar effects in determining the intensive care unit requirement and postoperative pulmonary complications.
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    Fatal Lactic Acidosis Due to Metformin
    (Aves, 2010) Kavalci, Cemil; Guldiken, Sibel; Taskiran, Bengur; Kavalci, Gulsum
    [Abstract Not Available]
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    Intravenous paracetamol reduced the use of opioids, extubation time, and opioid-related adverse effects after major surgery in intensive care unit
    (W B Saunders Co-Elsevier Inc, 2010) Memis, Dilek; Inal, Mehmet Turan; Kavalci, Gulsum; Sezer, Atakan; Sut, Necdet
    Background: This study assessed the analgesic efficacy, side effects, and time to extubation of intravenous paracetamol when administered as an adjuvant to intravenous meperidine after major surgery in intensive care unit (ICU). Material: Patients were randomized postoperatively into 2 groups in ICU. Patients received either 100 mL of serum saline intravenous (IV) every 6 hours and IV meperidine (n = 20 group M) or IV paracetamol 1 g every 6 hours and IV meperidine (n = 20, group MP) into a peripheral vein for 24 hours. Behavioral Pain Scale (BPS) is used until extubation, and visual analog score (VAS) is used after extubation. When BPS and VAS values were more than 4, meperidine, I mg/kg IV, was administered and noted in 2 groups. Pain scores, total meperidine consumption, time to extubation, sedation scores, and side effects are 24-hour postoperatively noted. Results: Behavioral Pain Scale and VAS scores are significantly lower in group paracetamol-meperidine at 24 hours (P<.05). In group MP, postoperative meperidine consumption (76.75 +/- 18.2 mg vs. 198 +/- 66.4 mg) and extubation time (64.3 +/- 40.6 min vs. 204.5 +/- 112.7 min) were lower than in group M (P<.01). In addition to, postoperative nausea-vomiting and sedation scores were significantly lower in group MP when compared with group M (P<.05). Conclusion: We have demonstrated important clinical benefits by the addition of 4 g/d of paracetamol to meperidine after major surgery. This benefit has been shown in a range of patients under routine clinical conditions and therefore has important practical consequences in ICU. These data suggest that intravenous paracetamol is a useful component of the multimodal analgesia model, especially after major surgery. (C) 2010 Elsevier Inc. All rights reserved.
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    METHANOL POISONING CASE REPORT
    (Aves, 2011) Kavalci, Cemil; Sezenler, Eylem; Kavalci, Gulsum; Cevik, Yunsur; Turan, Mustafa
    Methanol intoxication may be cause of severe illness and death. A 26 years old male presented to the emergency department with the complaints of abdominal pain, nausea and blurred vision. It was learned from his history that he took 500 mL of spirit and 200-300 ml of cologne to be well primed with liquor. The patient was accepted as methanol poisoning and 10% ethanol solution was given as 10 ml/kg in % 5 dextrose loading dose, and 1.5 ml/kg every hour infusion. Because of the severe acidosis, 1 m Eq/kg NaHCO3 was given patient and he was taken to dialysis. Fomepizole was given as 15 mg/kg loading dose, and then three times 10 mg/kg every 12 hours was given. The patient was sent to intensive care unit and he was discharged after 6 days by cure.