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UMUROĞLU, TÜMAY

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Author: ZENGİN, SENİYYE ÜLGEN × Has files: false ×

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    Goal-Directed Fluid Management Using Plethysmographic Variability Index in Patients Undergoing Laparoscopic Bariatric Surgery
    (MARY ANN LIEBERT, INC) ORHON ERGÜN, MELİHA; Ergun, Meliha Orhon; Zengin, Seniyye Ulgen; Umuroglu, Tumay
    Background: Optimal intraoperative fluid management is essential in surgical patients, including individuals with obesity undergoing bariatric surgery. The objective of this study was to assess the feasibility of pleth variability index (PVI) for intraoperative goal-directed fluid management in comparison with standard approach, in patients with obesity undergoing laparoscopic bariatric surgery. Methods: A total of 60 patients with obesity who underwent elective laparoscopic bariatric surgery were included in this single-blind prospective randomized study. Patients were randomly assigned to the PVI group or control. Patients were monitored for PVI, heart rate, noninvasive mean blood pressure, and perfusion index. In addition, administered fluids, amount of bleeding, and renal function parameters were recorded. Results: The PVI group received higher amounts of crystalloids (3053 +/- 275 mL vs. 1703 +/- 349 mL, p < 0.001) and colloids (277 +/- 208 mL vs. 17 +/- 91 mL, p < 0.001) intraoperatively, and it had higher perioperative urine output. In addition, the PVI group had decreases in blood urinary nitrogen (BUN), lactate, and creatinine levels; however, controls had increased BUN, lactate, and creatinine. Conclusions: Findings of this study suggest that PVI may represent a useful noninvasive strategy for intraoperative goal-directed fluid management in patients with obesity undergoing laparoscopic bariatric surgery.
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    Neutrophil gelatinase associated lipocalin in predicting postoperative acute kidney injury in elderly
    (SPRINGER LONDON LTD) ORHON ERGÜN, MELİHA; Orhon Ergun, Meliha; Zengin, Seniyye Ulgen; Mustafayeva, Aynur; Umuroglu, Tumay
    Background Elderly patients are at increased risk of developing acute kidney injury (AKI) following major surgery and rapid diagnosis is essential. Aim This study aimed to examine the potential utility of plasma neutrophil gelatinase associated lipocalin levels in early prediction of AKI in geriatric patients undergoing laparotomic oncological surgery. Methods This prospective single-center cohort study included 60 geriatric patients (>= 65 years of age) that underwent major oncologic surgery with laparotomy. Perioperative measurements of plasma creatinine, blood urinary nitrogen, plasma lactate, urine output, and neutrophil gelatinase associated lipocalin (NGAL) were made. Patients were followed for AKI development, which is the primary outcome measure, and predictive role of NGAL was investigated. Results At 48 h follow-up, AKI developed in 13 patients (21.7%). Significant differences in creatinine (p < 0.001), NGAL (p < 0.001), and urine output levels (p = 0.001) were evident over time between the two groups. High NGAL measurements at 6 and 24 h after surgery seem to be highly predictive of AKI development. At 6 h, a plasma NGAL level greater than 71.8 ng/mL has a sensitivity and specificity of 85% and 81% in predicting subsequent AKI development. Conclusions Plasma NGAL levels seem to represent an early and reliable marker for AKI in elderly patients undergoing laparotomic surgery with the potential to allow early diagnosis and prevent further renal deterioration. Further confirmatory studies are warranted. Trial registration The study was registered to ClinicalTrials.gov (number, NCT05030727). Implication statement Elderly patients are at increased risk of postoperative acute kidney injury (AKI). This study shows that plasma neutrophil gelatinase associated lipocalin is a helpful marker to predict AKI in elderly patients undergoing laparotomic major surgery, which will allow early diagnosis and prevent further renal deterioration in this vulnerable patient group.