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Öğe A conflict choice of treatment during defibrillation in cardiopulmonary resuscitation: Lidocaine, amiodarone or both? A retrospective study(Hacettepe Üniversitesi, 17.10.2024) Bayram, ErkanObjective: Cardiopulmonary arrest is considered to be an unpredicted event leading to sudden death. The primary purpose of the study is to investigate the effects of antiarrhythmic drugs during defibrillation within cardiopulmonary resuscitation (d-CPR) on survival outcomes. Materials and Methods: The antiarrhythmic drug treatment during d-CPR management in our hospital from 2015 to 2022 were evaluated retrospectively. Demographic information, and details related to resuscitation were obtained from the “Cardiopulmonary Resuscitation and Code Blue Forms”. According to inclusion criteria, from 898 patient data 135 were included. The treatment of anti-arrhythmic drugs administered during d-CPR management were lidocaine, amiodarone, or amiodarone&lidocaine together. Data recorded related to the present study were evaluated primarily according to the return of spontaneous circulation (ROSC) and survival outcomes. Results: The mean cardiopulmonary resuscitation duration was 31.82±22.37 minutes in patients with ROSC and 42.40±9.28 minutes in non-ROSC, p<0.01. Amiodarone administration during d-CPR was the highest preffered treatment from 2015 to 2022, when compared with the usage of amiodarone&lidocaine together (14.1%), p<0.01. However the administration of lidocaine during d-CPR (39.3% of all) appered to be performed before 2020 in our hospital. Additionally amiodarone revealed a positive effect on systolic blood pressure and mean arterial pressure in ROSC patients (p=0.02, p=0.04 respectively), while the choice of antiarrhythmic drug treatment during d-CPR management showed no significant difference on survival status. Conclusion: The observed ROSC was 42.2%. The choice of antiarrhythmic drug treatment during d-CPR management showed no significant difference on survival status, although amiodarone revealed a positive effect on systolic blood pressure and mean arterial pressure in the patients with ROSC.Öğe Effects of atropine on blood gas parameters and pulmonary shunt fraction(Bayrakol Medical Publisher, 2023) Bayram, Erkan; Ozenc, EcderAim: Atropine has been used for a long time in anesthesia management to inhibit salivary and bronchial secretions and laryngospasm before administration of an anesthetic agent. The objective of this study was to investigate the effects of atropine blood gas parameters and pulmonary shunt fraction for the first time in the literature.Material and Methods: A total of 24 patients aged 20-75 years, hospitalized in the intensive care unit under mechanical ventilation were included in the study. 0.01 mg/kg atropine was administered intravenously and arterial and venous blood gas samples were taken at 15, 45 and 90 minutes, and the shunts were calculated. pH, PO2, PCO2, H+, HCO3 and SO2 values were measured and recorded. In addition, pulmonary shunt (QS/QT) fraction was calculated at 0, 15, 45 and 90 minutes.Results: pAO2 values were statistically significantly higher at the 15th minute (109.63 +/- 7.95) compared to the 0th minute (107.00 +/- 5.99) (p=0.006) and 90th minutes (107.55 +/- 8.28) (p=0.022). CaO2 values were statistically significantly lower at the 45th minute (13.70 +/- 1.43) compared to the 0th minute (14.70 +/- 1.66) (p=0.013) and 90th minute (14.40 +/- 1.59) (p=0.008). Shunt (Qs/Qt) values were statistically significantly lower at the 45th minute (0.12 +/- 0.17) compared to the 0th minute (0.04 +/- 0.04) (p=0.040) and 90th minutes (0.07 +/- 0.10) (p=0.007).Discussion: Administration of atropine significantly increased the pulmonary shunt, regardless of the current pathology, mechanical ventilation and treatment applied. Atropine increased the shunt at the maximum level, especially at the 45th minute. In this study, the shunt emerged as the gold standard in determining the treatment modality.Öğe The Evaluation of YouTubeTM Videos Pertaining to Intraoperative Anaesthesia Awareness: A Reliability and Quality Analysis(Springernature, 2023) Kartufan, Fatma F.; Bayram, ErkanAim The objective of this study was to evaluate the reliability and quality of YouTubeTM (Google, Inc., Mountain View, CA) videos pertaining to anaesthesia awareness. Methods We evaluated the most commonly viewed 100 videos pertaining to anaesthesia awareness. The YouTubeTM videos??? image type, qualification of the uploaders, video content, video length in minutes, upload time, time since upload, total view count, daily view count and comment and like counts were recorded. The quality of the YouTubeTM videos was evaluated using the Global Quality Scale (GQS), and the reliability was determined using the modified DISCERN scale. Results Of all videos, 34 (34%) were uploaded directly by physicians, 16 (16%) by patients, 14 (14%) by health channels, 13 (13%) by TV shows and 23 (23%) by others. The mean video length was 11.48??11.96 minutes. The average DISCERN score was 4.47??0.58 in the professional and 3.28??0.65 in the non-professional video group (p<0.001). The mean GQS score was 4.47??0.52 in the professional and 3.35??0.67 in the non-professional video group (p<0.001). Conclusion The results of this study indicate that a significant portion of the YouTubeTM videos pertaining to anaesthesia awareness were uploaded directly by physicians or by health channels. Physicians and professional health institutions should be promoted to provide accurate and more reliable videos to direct patients to the right solutions for their problems. YouTubeTM videos should be subjected to supervision before they can be publicly viewed.Öğe The effect of two different surgical positions on pulmonary functions ın laparoscopic sleeve gastrectomies: reverse Trendelenburg vs beach chair(Springer, 2025) Seyit, Hakan; Dolğun, İlke; Bayram, Erkan; Şener, Fevkiye Nur; Çiçek, MüslümBackground: The aim of our study is to compare the effect of the 30° reverse Trendelenburg position combined with the beach chair position on respiratory parameters in laparoscopic sleeve gastrectomy (LSG) with the 30° reverse Trendelenburg position alone. Material and method: Fifty patients with body mass index > 30 were included in the study. The patients were divided into two groups; in the control group, the standard 30° reverse Trendelenburg. In the beach chair group, the feet were positioned at 30° flexion from the hips after a 30° RTP. For both positions, blood pressures, pulses, saturations, EtCO2, respiratory rate, inspiratory pressure (Pins), positive end-expiratory pressure (PEEP), minute volume, tidal volume, peak airway pressure (Ppeak), and dynamic compliance were recorded. In addition, the general surgeon was asked about his satisfaction with the intra-abdominal operation site view and whether he was uncomfortable with the position. Results: Regardless of the group, the average age of the cases was 36.7 ± 12.1 years. There was no difference between the groups in terms of age, gender, BMI, operation time, blood pressures, heart rates, EtCO2, respiratory rate, PEEP, minute volume, tidal volume, and postoperative oxygen saturation (p > 0.05). Inspiratory and peak pressure were lower and dynamic compliance was higher in the beach chair position (p < 0.05). It was observed that the beach chair position decreased inspiratory and peak pressures and increased dynamic compliances in patients with a BMI between 35.1 and 40 (p < 0.05). Surgical satisfaction was high for both positions and there was no discomfort with the position. Conclusion: It was determined that the beach chair position in LSGs reduced inspiratory and peak pressures and increased dynamic compliance. These parameters were related to BMI, and the beach chair position was more positive in terms of intraoperative lung pressures and dynamic compliance, especially in patients with a BMI between 35.1 and 40. ClinicalTrials.gov ID: NCT06402474.
