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ORHON ERGÜN, MELİHA

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ORHON ERGÜN

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MELİHA

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2016 - 201942020 - 202321
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    PublicationOpen Access
    Determining the factors affecting the development of perioperative complications according to aging stages
    (2022-06-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; ÇORMAN DİNÇER, PELİN; UMUROĞLU, TÜMAY; ORHON ERGÜN M., ZENGİN S. Ü., ÇORMAN DİNÇER P., UMUROĞLU T., AYKAÇ Z. Z.
    Objective: This study aimed to examine perioperative complication risks in elderly patients stratified by age. Method: Elderly patients (youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ≥85 years) and controls (20-30 years) who underwent surgical intervention under general anesthesia were included in this prospective observational study. Results: Two-hundred-sixty patients were included. Different age subgroups showed a different course in terms of perioperative complications. For any combined end-point of any perioperative complication, having a body mass index>28 [odds ratio (OR): 2.4; 95% confidence interval (CI): 1.2-4.6; p=0.012] and being on multi-pharmacy regimen at baseline (OR: 1.9; 95% CI: 1.1-3.5; p=0.029) emerged as significant independent predictors. In reference to controls, each elderly age group emerged as a significant independent predictor: youngestolds (OR: 4.9; 95% CI: 2.2-10.8; p<0.001); middle-olds (OR: 2.5; 95% CI: 1.1-5.4; p=0.025); oldest-olds, (OR: 5.6; 95% CI: 2.5-12.6; p<0.001). Conclusion: Elderly patients appear to have higher risk for intraoperative and postoperative complications when compared to the young patients, and each age group appears to have increased risk for different type of complications.
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    Kemik iliği aspirasyonu ve lomber ponksiyon sırasında pediyatrik sedasyon
    (istanbul tıp kitabevi, 2022-01-01) ORHON ERGÜN, MELİHA; ORHON ERGÜN M.; Atalay, Yunus Oktay; Öz, Hüseyin
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    Anestezi pratiğinde simülasyon eğitiminin önemi
    (Akademisyen Yayınevi Kitabevi, 2022-03-01) ORHON ERGÜN, MELİHA; Orhon Ergün M.
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    The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery
    (2022) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Orhon Ergun, Meliha; Gunal, Omer
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    PublicationOpen Access
    Pediatrik hastalarda postoperatif deliryum gelişmesi ile analjezi nosisepsiyon index değerleri arasındaki ilişkinin belirlenmesi
    (2022-01-01) ORHON ERGÜN, MELİHA; ÇORMAN DİNÇER, PELİN; UMUROĞLU, TÜMAY; ZENGİN, SENİYYE ÜLGEN; ÖZALTUN F., ZENGİN S. Ü., ORHON ERGÜN M., ÇORMAN DİNÇER P., UMUROĞLU T.
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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%.
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    İntraoperatif dönemde transözefageal ekokardiyografi ile ilk kez ventriküler septal defekt tanısı konan olgu
    (2017-05-27) ORHON ERGÜN, MELİHA; KARARMAZ, ALPER; ORHON ERGÜN M., KARARMAZ A., HIZAL A.
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    Eroin bağımlısı hastada postoperatif ağrı yönetimi
    (2016-10-30) ÇORMAN DİNÇER, PELİN; ORHON ERGÜN, MELİHA; ÇORMAN DİNÇER P., CEBECİK TEOMETE G., ORHON ERGÜN M., ARSLANTAŞ M. K., AYANOĞLU H. Ö.
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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.