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Öğe Approach to HELLP syndrome in intensive care unit (seven case report)(2004) Kaygusuz, Kenan; Gürsoy, Sinan; Kunt, Nur; Kafali, HalukHELLP Syndrome is characterised by hemolysis, elevated serum levels of aspartate aminotransferase and lactate dehydrogenase and low platelet count. The pathogenesis of HELLP Syndrome remains unclear. We presented the follow up of 7 HELLP syndrome cases in the intensive care unit between 2001-2003. Patients were between 18-28 years of age and gestational ages were between 26-38 weeks. HELLP syndrome occured in the antepartum period in 3 patients and in the postpartum period in the 4 patients. Three patients with Glasgow Coma Score between 3-4 died. Six cases required mechanical ventilation therapy. CT revealed brain edema in 3 patients. ARDS was diagnosed in 3 patients and acute renal failure developed in 2 patients. When respiratory functions and laboratory values returned to normal, 4 patients were transferred to obstetrics and gynecology ward. Because severe complications may develop in HELLP syndrome, we think that the patients must be observed in ICU until the clinical and laboratory findings recover.Öğe Early ischemic complication resulting with amputation of the thumb after radial arter cannulation (case report)(2005) Gürsoy, Sinan; Kaygusuz, Kenan; Kunt, Nur; Kafali, Haluk; Mimaro?lu, CanerThe left radial artery of a 34 year old male patient who was scheduled for surgery due to rectum cancer was cannulated after performing the Allen's test in the operating room. In the first hour following the operation, it was seen that the area between the antecubitas and the hand was hyperemic. The tenar area of the hand and the thumb was cyanotic, so the cannula was removed. Doppler showed radial artery pulsations. Antithrombotic and anticoagulant treatment was started intraoperatively. Radial artery flow was weak with doppler on the first postoperative day. Since there was no response to the treatment, the thumb finger was amputed one month later. It was concluded that the patient experienced radial trombosis resulting from the cannulation.Öğe Epidemiological evaluation of burns(2002) Demirel, Yeltekin; Aydin, Cengiz; Kunt, Nur; Gökgöz, ŞehsuvarBurns and related injuries are important health problems in our country due to shortage of the special burn centers. Scalding and flame-related injuries are the most common mechanism of thermal injury. Males and children dominate the incidence of burn injury. Epidemiological studies demonstrate that loneliness and cigarettes smoking are major predisposing factors, preferentially involves low socioeconomic population and large proportion of burns are home related. Burn size of 1-10 % of body surface area and higher rate of upper extremity involvement are seen. While small burns are treated on an outpatient basis, major ones require hospitalization. Severe cases must be referred to special burn centers.Öğe Hasta kontrollü analjezi ile postoperatif ağrı tedavisinde morfin, meperidin ve fentanilin etkinliğinin karşılaştırılması(Cumhuriyet Üniversitesi, 1995) Kunt, Nur; Mimaroğlu, Caner45 ÖZET Bu çalışmada, ASA I ve II grup hastalarda postoperatif ağrılarının giderilmesi amacıyla morfin, meperidin ve fentanil hasta kontrollü analjezi yöntemi ile verildi. Analjezinin etkinliğinin değerlendirilmesi için VAS, solunum sayısı, kan basmcı, sedasyon skalası, nabız parametreleri kullanıldı. Her üç ilacın etkinliği istatistiksel olarak analiz edildi. 0, 6, 12, 24. saat değerleri gözden geçirildiğinde her üç ilacın da önemli farklılıklara yol açtığı gözlendi (p<0.01). Her üç ilacın yan etkileri değerlendirildiğinde sadece bulantıya neden oldukları görüldü. Morfin, meperidin ve fentanilin hasta kontrollü analjezide güvenli bir şekilde kullanılabileceğine karar verildi.Öğe The comparison of the method for cardiac output measurement in mechanically ventilated critical care unit patients(2005) Gürsoy, Sinan; Kaygusuz, Kenan; Kunt, Nur; Kafali, Haluk; Mimaro?lu, CanerAim: Although the thermodilution technique for cardiac output monitorization is the most common used clinical method, it is very invasive and has all risks of this. Therefore the importance of the noninvasive cardiac output measurement technique is increased. In this study we aimed to compare the safety of thermodilution method and partial CO2 rebreathing fick technique which is a noninvasive method, at the cardiac output measurement of mechanically ventilated critical care unit patients. Materials and Methods: The study was scheduled to 32 critical care unit patients who were between 23-75 ages and needed mechanical ventilation. Patients ventilated on controlled mechanical ventilation mode. Cardiac output measurements were done twice simultaneously in 4 hours intervals by invasive and noninvasively. Results: There were no statistically differences in cardiac output between the methods at the two measurement (p>0.05). There were a high correlation in cardiac output between the methods at the two measurement (p<0.05). Conclusion: The noninvasive partial CO2 rebreathing fick technique may be an alternative to the thermodilution method for cardiac output determination in mechanically ventilated patients.Öğe The effects of sedative agents used in intensive care unit on haemodynaemia and oxygen transport(2004) Kaygusuz, Kenan; Gürsoy, Sinan; Kunt, Nur; Kafali, HalukPurpose: Sedation is a part of the therapy which is applied in intensive care units. We investigated the effects of propofol, midazolam and remifentanil on haemodynaemia and oxygen transport Material-Methods: Forty-five patients dependent on ventilators in the intensive care unit were included in our study and were separated randomly into 3 groups. Sedation levels were adjusted to 3 to 4 according to Ramsey sedation score, with the continual administration of an infusion of remifentanil 0.05 ?g/kg/min (±0.01), propofol 35 ?g/kg/min (±7) and midazolam 1 ?g/kg/min (±0.2). Following the ECG and intraarterial monitoring, a pulmonary artery catheter was inserted. CVP, PAP, PCWP, CO, SvO2, PaO2, SaO2 and Hb levels were measured, and CI, SVR, PVR, DO2, VO2 and O2ER were calculated by the thermodilution method(1st measurement). When the doses reached expected sedation levels, measurements were repeated (2nd measurement). Results: It was found that following sedation, MAP, HR, PAP, DO2 and VO2 parameters decreased in all 3 groups compared to the control values (p<0.05). However, there were no significant differences among the groups (p>0.05). CO and CI values were significantly decreased in the remifentanil and propofol groups compared to control values (p<0.05), but in the midazolam Group, it was not significant (p>0.05). Conclusion: The heamodynamic effects of remifentanil, propofol and midazolam are not different when used in intensive care unit for sedation.
