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UMUROĞLU, TÜMAY

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UMUROĞLU

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TÜMAY

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Subject: Clinical Medicine (MED) ×

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    PublicationOpen Access
    Perioperative hypothermia and associated factors: A prospective cohort study
    (2023-01-01) ABDULLAYEV, RUSLAN; UMUROĞLU, TÜMAY; Kelleci Y., ABDULLAYEV R., Cakmak G., Ozdemir H., UMUROĞLU T., Saracoglu A.
    Objective: Perioperative hypothermia is deleterious with many consequences, including coagulopathy, decreased immune functions, prolonged drug clearance, and cardiovascular complications. In this study we aimed to demonstrate the incidence of perioperative hypothermia during general anesthesia, its associated risk factors, and outcomes. Methods: For this prospective cohort study patients aged 18-75 years with American Society of Anesthesiologists physical status I-III scheduled for any elective operation under general anesthesia in a one-month period were recruited. The patients’ body temperatures were measured in the preoperative unit, in the operating theatre before induction, at the second hour of the operation, at the end of the operation, at the postoperative recovery unit admission, and discharge using a medical infrared thermometer. The patients’ demographic and hemodynamic characteristics, magnitudes of surgery, surgery and anesthesia durations, warming methods, hospital and Intensive Care Unit (ICU) length of stays were recorded. Results: Sixty five out of 290 enrolled patients (22.4%) developed perioperative hypothermia. Anesthesia and surgery time was longer in patients with hypothermia (p<0.001). Hospital length of stay of the patients was also longer in the patients with hypothermia (p<0.001). Intensive care unit admission of the patients with hypothermia was significantly higher compared with those with normothermia (2.7 vs 9.2%, p=0.030). Conclusion: Perioperative hypothermia continues to be a challenge despite many published clinical application guidelines in this context. Intermediate and major type surgeries resulted in more perioperative hypothermia. Perioperative hypothermia was significantly associated with longer operation and anesthesia durations, hospital length of stays, and higher ICU admissions as well. Routine monitoring and active warming should be performed throughout the perioperative period to prevent hypothermia and current practice guidelines should be followed.
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    PublicationOpen Access
    Targeted bleeding management guided by non-invasive haemoglobin measurement in surgical patients
    (2022-10-01) AKDAĞ, ŞÜKRİYE; ZENGİN, SENİYYE ÜLGEN; UMUROĞLU, TÜMAY; AYKAÇ, ZEYNEP ZUHAL; SARAÇOĞLU, AYTEN; AKDAĞ Ş., ZENGİN S. Ü. , Cakmak G., UMUROĞLU T., AYKAÇ Z. Z. , SARAÇOĞLU A.
    © 2022 College of Physicians and Surgeons Pakistan. All rights reserved.Objective: To assess blood transfusion decisions in blood losses using a continuous total haemoglobin (SpHb) and non-invasive haemoglobin (Hb) device. Study Design: Double-blinded randomised controlled trial. Place and Duration of Study: Marmara University Hospital, Istanbul, Turkey, from March 2018 to December 2019. Methodology: One hundred and twenty adult patients scheduled for elective major surgery and expected to experience a blood loss greater than 20% of their total blood volume were divided into two groups. These groups were compared for bleeding management with conventional blood gas sampling (Group Hb, the control group) according to Hb monitoring versus SpHb measurement (Group SpHb, the study group). Results: In the postoperative measurement, there were fewer red blood cells (RBC) in the SpHb group than in the Hb group (p=0.020). There was a greater change in the amount of RBC from the perioperative to the postoperative period in the SpHb group compared to the Hb group (p<0.001). Postoperative Hb levels of patients in the intensive care unit (ICU) were higher in the SpHb group than in the Hb group (p<0.05). Conclusion: SpHb can provide effective patient blood management in cases of major surgery. It does not cause a delay in the decision of blood transfusion during surgery.
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    PublicationOpen Access
    Comparative efficacy of finger versus forehead plethysmographic variability index monitoring in pediatric surgical patients
    (2022-10-01) FİDAN, SEYFULLAH; ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; UMUROĞLU, TÜMAY; Fidan S., ZENGİN S. Ü. , ORHON ERGÜN M., UMUROĞLU T.
    Introduction The Plethysmographic Variability Index can be measured by both finger and forehead probes. Vasoconstriction may jeopardize the reliability of finger PVI measurements in pediatric patients undergoing surgery. However, forehead vasculature exhibits more marked resistance to alterations in the vasomotor tonus. Objective Our aim was to compare the Plethysmographic Variability Index measured via finger or forehead probes in mechanically ventilated pediatric surgery patients in terms of their ability to predict fluid responsiveness as well as to determine the best cut-off values for these two measurements. Materials and Methods A total of 50 pediatric patients undergoing minor elective surgery were included after provision of parental consent and ethics committee approval. Perfusion index measured at the finger or forehead and Plethysmographic Variability Index monitoring comprised the primary assessments. Hemodynamic parameters monitored included perfusion index, Plethysmographic Variability Index, and cardiac output. A >= 15% increase in cardiac output following passive leg raise maneuver was considered to show fluid responsiveness. Two groups were defined based on fluid responsiveness: Group R (responsive) and Group NR (non-responsive). Student\"s t-test, Mann-Whitney U test, DeLong test, and ROC were used for statistical analysis. Results The area under curve for finger and forehead Plethysmographic Variability Index prior to passive leg raise maneuver were 0.699 (p = .011) and 0.847 (p < .001), respectively. The sensitivity for finger and forehead measurements at a cut-off value of <= 14% was 92.9% and 96.4%, and 45.4% and 72.7%, respectively. Conclusion Although forehead and finger Plethysmographic Variability Index monitoring were similarly sensitive in predicting fluid responsiveness in pediatric surgical patients, the former method provided higher specificity. The best cut-off value for PVI measurements with forehead and finger probes was found to be 14%.