Person: CİNEL, İSMAİL HAKKI
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CİNEL
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İSMAİL HAKKI
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Publication Metadata only Terapötik Hipotermi Sonrası Gelişen Enfeksiyonların Öngörülmesinde Hematoloji Parametrelerinin Kullanımı(2017-10-29) HAKLAR, GONCAGÜL; GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; GÜL F., ÇEVLİK T., ARSLANTAŞ M. K., KASAPOĞLU U. S., HAKLAR G., CİNEL İ. H.Publication Open Access Renal Resistive Index is Unsusceptible to Systemic Hemodynamics in Fluid Responsive Critically III Patients(GALENOS YAYINCILIK, 2019-11-12) BİLGİLİ, BELİZ; Gul, Fethi; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ayhan, Secil Ozcan; Cinel, IsmailObjective: The primary goal of fluid resuscitation in critically ill patients is to improve oxygen delivery to ensure adequate organ perfusion. Little evidence is known about renal response to fluids in the acute phase, so renal monitoring after the fluid challenge is fundamental during critical care stay. This study aimed to evaluate changes in the renal resistive index (RRI) and to compare these changes with hemodynamic parameters after fluid challenge in fluid responsive critically ill patients. Materials and Methods: Thirty patients older than 18 years who underwent sedation and received mechanical ventilation were prospectively studied. Twenty patients were fluid responsive and were included in the study. An increase of cardiac output (CO) by 10% or more after PLR measured by ultrasonic CO monitor suspected fluid responsiveness. 500 mL of isotonic solution was administered intravenously for 30 minutes. CO measurements were performed at 0, 1 and 30 minutes. RRI and mean arterial pressure (MAP) were measured by Doppler ultrasonography at 0 and 30 minutes. Repeated measures ANOVA method was used for statistical analysis and p<0.05 was considered significant. Results: CO increased significantly after fluid challenge when compared to baseline (from 3.48 +/- 1.14 to 4.34 +/- 1.43 L/min, p<0.001). MAP increased significantly after fluid administration when compared to baseline (80 +/- 19 to 86 +/- 17, p=0.002). RRI did not significantly differ from baseline after fluid challenge (62 +/- 9 to 60 +/- 10, p=0.11). There was a negative correlation between RRI and MAP at baseline and after fluid challenge. Conclusion: The effect of hemodynamic changes on renal perfusion after fluid challenge is controversial. In our study, 500 mL of crystalloid treatment for 30 minutes increased MAP and CO, but did not contribute to the improvement of RRI in patients who were fluid responsive. We found that fluid challenge did not improve RRI in the early phase of the fluid resuscitation in fluid responsive critically ill patients and RRI is unsusceptible to systemic hemodynamic changes during this period.Publication Metadata only Treatment approach of cerebral ischemia after revascularization surgery of moyamoya disease: Case report(2019-05-05) GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; GÜL F., KABADAYI F., KASAPOĞLU U. S., CİNEL İ. H.Publication Metadata only Peripartum cardiomyopathy mimicking acute aortic dissection: successful salvage with extracorporeal membrane oxygenation support(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2014) KEPEZ, ALPER; Isbir, Selim; Ak, Koray; Aslantas, Mustafa; Kepez, Alper; Cinel, Ismail; Arsan, SinanIn this article, we report a case admitted with severe chest pain associated with ST segment elevation, pericardial effusion and aortic flap appearance in echocardiography at the 31 weeks of gestation, mimicking aortic dissection, but diagnosed with peripartum cardiomyopathy and successfully treated with extracorporeal membrane oxygenation after developing acute cardiogenic shock.Publication Open Access Sequential Measurements of Pentraxin 3 Serum Levels in Patients with Ventilator-Associated Pneumonia: A Nested Case-Control Study(HINDAWI LTD, 2018) BİLGİLİ, BELİZ; Bilgin, Huseyin; Haliloglu, Murat; Yaman, Ali; Ay, Pinar; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ozdemir, Filiz Ture; Haklar, Goncagul; Cinel, Ismail; Mulazimoglu, LutfiyePurpose. The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP). Materials and Methods. We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study. VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines. Results. The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults (p < 0.05). Procalcitonin and CRP levels did not significantly differ. Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78). Conclusions. With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.Publication Metadata only Comparing the accuracy of predictors of mortality in ventilator associated pneumonia(2016-04-20) BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HALİLOĞLU M., BİLGİLİ B., KASAPOĞLU U. S., SAYAN İ., SÜZER ASLAN M., YALÇIN A., CİNEL İ. H.Publication Metadata only Lazer cerrahisi sırasında gelişen trakeobronşial inhalasyon yanığı- olgu sunumu(2017-10-29) KASAPOĞLU, UMUT SABRİ; GÜL, FETHİ; YUMUŞAKHUYLU, ALİ CEMAL; UMUROĞLU, TÜMAY; CİNEL, İSMAİL HAKKI; KASAPOĞLU U. S., GÜL F., ARSLANTAŞ M. K., YUMUŞAKHUYLU A. C., YAMANSAVCI E., UMUROĞLU T., CİNEL İ. H.Publication Metadata only Dirençli septik şokta desmopressin(2015-12-06) BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HALİLOĞLU M., BİLGİLİ B., KASAPOĞLU U. S., SAYAN İ., ÇİFTÇİ M., CİNEL İ. H.Publication Metadata only Renal Resistive Index Measurement by Transesophageal Echocardiography: Comparison With Trans lumbar Ultrasonography and Relation to Acute Kidney Injury(W B SAUNDERS CO-ELSEVIER INC, 2015) KARARMAZ, ALPER; Kararmaz, Alper; Arslantas, Mustafa Kemal; Cinel, IsmailObjectives: The aim of this study was to evaluate the relationship between transesophageal ultrasonography-derived renal resistive index values (RRITEE) and a standard translumbar renal ultrasound-derived RRI (RRITLUSG). The effectiveness of each method to predict acute kidney injury (AKI) after cardiac surgery also was compared. Design: A prospective observational study. Setting: A teaching university hospital. Participants: Sixty patients undergoing cardiac surgery. Interventions: First, RRI was measured with both methods after anesthesia induction. Second, another measurement was performed with TEE after cardiopulmonary bypass and immediately following the surgery with translumbar ultrasound. To test the correlation between the 2 methods and to plot a Bland-Altman graph, preoperative RRI values measured by both techniques were used. Receiver operating characteristic curves also were plotted to compare the diagnostic values of RRI measured intraoperatively by TEE after cardiopulmonary bypass and by RRITLUSG after surgery. Measurements and Main Results: There was a statistically significant correlation between the 2 RRI measurement approaches (r = 0.86, p < 0.0001). The Bland-Altman plot indicated good agreement between the methods. The area under the curve (AUC) of RRITEE in predicting AKI was 0.82 (95% confidence interval (Cl] = 0.64-0.9, p = 0.001), and the AUC of RRITLUSG after surgery was 0.85 (95% Cl = 0.7-0.98, p < 0.0001). In predicting AKI, an uncertainty zone for RRITEE values between 0.68 and 0.71 was computed by the gray-zone approach. Conclusions: RRITEE showed clinically acceptable agreement with RRITLUSG. Indeed, RRI measured intraoperatively with TEE was comparable to RRITLUSG in terms of detecting postoperative AKI. (C) 2015 Elsevier Inc. All rights reserved.Publication Metadata only Scatter-conductivity (VCS) parametres may predict infections and possible sepsis during therapeutic hypothermia(2017-05-13) GÜL, FETHİ; KASAPOĞLU, UMUT SABRİ; CİNEL, İSMAİL HAKKI; HAKLAR, GONCAGÜL; GÜL F., ARSLANTAŞ M. K., ÇEVİK T., KASAPOĞLU U. S., HAKLAR G., CİNEL İ. H.
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