Person: GÜL, FETHİ
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GÜL
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FETHİ
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Publication Open Access Management of Crush-related Acute Kidney Injury After Disasters(2023-03-08) KANDEMİR, ERSİN; GÜL, FETHİ; KANDEMİR E., GÜL F.Publication Metadata only Transmission route of acinetobacter baumannii infection in earthquake survivors(2023-05-07) GÜL, FETHİ; Ciğeroğlu A., Bilir A., Kutlu Ç., Sabaz M. S., Gül F.Publication Metadata only Hemoadsorption therapy for earthquake victims with crush injury(2023-05-07) GÜL, FETHİ; Kandemir E., Kutlu Ç., Bilir A., Gül F.Introduction: Recently, a huge earthquake struck south-eastern Turkey causing the death of tens of thousands of people. In this case report, we share our experience of usage of extracorporeal hemoadsorption filter in two patients with crush injury and acute kidney injury.Case: A 59 year-old male patient was under rubble for 24 hours with his left leg trapped. The patient was transported to our hospital on the second day after the incident. At the admission, he had cardiac arrest with the rhythm of ventricular fibrillation. He was defibrillated two times and resuscitated for 30 minutes. Serum potassium, phosphorus levels were 8.5 mEq/L, 9 mg/dL respectively. Intravenous calcium,dextrose+insulin was given immediately and continuous renal replacement therapy was started. Initial creatine kinase (CK) level was 82000 U/L. He has undergone an urgent surgery for amputating his left leg which was necrotic. The day after his admission, extracorporeal hemoadsorption therapy (JAFRON-HA330) was started five hours a day for five consecutive days. CK levels gradually decreased to 60187-46852-16954-11600 U/L in daily order. Vasopressors were stopped on the third day of admission. A 32-year-old male patient had been extricated after 24 hours of entrapment. He had fifteen minutes of CPR following a cardiac arrest from hyperkalemia. Initial levels of CK, potassium, phosphorus were 72116 U/L, 6.5 mEq/L, 7.3 mg/dL respectively. CRRT with hemadsorption filter (Jafron® HA330) was started. CK levels gradually decreased to levels of 64271-35670-25441-12475-10469 U/L in daily order. He got free of vasopressors on the third day and extubated on the fourth day of admission.Discussion: Crush injury is a hyperinflammatory state with circulating cytokines causing multisystemic organ dysfunctions. Hemoadsorption techniques may adsorb molecules which potentially play a role during pathogenesis of rhabdomyolysis.The use of hemoadsorption therapy in our patients with severe traumatic rhabdomyolysis was associated with a significant reduction in plasma concentrations CK so it is a potentially attractive adjunctive treatment for this condition.Publication Open Access Overseas experience and requests in intensive care doctors(2023-02-01) GÜL, FETHİ; Ayvat P., Türkan H., Kupeli İ., Sarıtaş A., Atılgan A. Z., Gül F., Demirkıran O.Publication Metadata only The role of the thrombolytic therapy in acute ıschemic stroke: Two case reports(2023-05-07) GÜL, FETHİ; Bilir A., Şahin N. O., Oktay B. D., Gül F.Publication Open Access A pilot study for treatment of severe COVID-19 pneumonia by aerosolized formulation of convalescent human immune plasma exosomes (ChipEXO™)(2022-11-01) GÜL, FETHİ; CİNEL, İSMAİL HAKKI; Gül F., Gönen Z. B. , Jones O., Taşlı N. P. , Zararsız G., Ünal E., Özdarendeli A., Şahin F., Eken A., Yılmaz S., et al.This is a single-center prospective, open-label, single arm interventional study to test the safety and efficacy of recently described ChipEXO™ for severe COVID-19 pneumonia. The ChipEXO™ is a natural product derived from convalescent human immune plasma of patients recovered from moderate COVID-19 infection. In September 2021, 13 patients with pending respiratory failure were treated with ChipEXO™ adapted for aerosolized formulation delivered via jet nebulizer. Patients received 1-5x1010 nano vesicle/5 mL in distilled water twice daily for five days as an add-on to ongoing conventional COVID-19 treatment. The primary endpoint was patient safety and survival over a 28-day follow-up. The secondary endpoint was longitudinal assessment of clinical parameters following ChipEXO™ to evaluate treatment response and gain insights into the pharmacodynamics. ChipEXO™ was tolerated well without any allergic reaction or acute toxicity. The survival rate was 84.6% and 11 out of 13 recovered without any sequel to lungs or other organs. ChipEXO™ treatment was effective immediately as shown in arterial blood gas analyses before and two hours after exosome inhalation. During the 5 days of treatment, there was a sustainable and gradual improvement on oxygenation parameters: i.e. respiratory rate (RR) [20.8% (P < 0.05)], oxygen saturation (SpO2) [6,7% (P < 0.05)] and partial pressure of oxygen to the fraction of inspired oxygen (PaO2/FiO2) [127.9% (P < 0.05)] that correlated with steep decrease in the disease activity scores and inflammatory markers, i.e. the sequential organ failure assessment (SOFA) score (75%, p < 0.05), C-reactive protein (46% p < 0.05), ferritin (58% p = 0.53), D-dimer (28% p=0.46). In conclusion, aerosolized ChipEXO™ showed promising safety and efficacy for life-threatening COVID-19 pneumonia. Further studies on larger patient populations are required to confirm our findings and understand the pathophysiology of improvement toward a new therapeutic agent for the treatment of severe COVID-19 pneumonia.Publication Metadata only Yoğun bakım ünitesinde konvelesan plazma kullanımının covid-19 hastalarında mortalite üzerindeki etkisi(2022-03-17) GÜL, FETHİ; BİLGİLİ, BELİZ; CİNEL, İSMAİL HAKKI; Sabah M. S., Gül F., Bilgili B., Kaplan S. T., Oktay B. D., Cinel İ. H.Publication Metadata only An unusual presentation of hydatid disease with isolated cardiac cysts: A case report(2023-05-07) GÜL, FETHİ; Kandemir E., Bilir A., Kutlu Ç., Kan M., Gül F.Publication Metadata only The diagnostic impact of transesophageal echocardiography in a patient after post-cardiac arrest syndrome(2023-05-07) GÜL, FETHİ; Oktay B. D., Şahin N. O., Korkmaz G., Gül F.Introduction: The impairment of coagulation and fibrinolysis processes may be observed after cardiac arrest. Echocardiography is important for determining the causes of the cardiac origin of pulmonary embolism, and, simultaneously, mobile thrombi can be rarely visualized in the ventricule. In this report, we present a case of the intraventricular mobil thrombus that we detected with trans-esophageal echocardiography (TEE) in a patient who underwent CPR for 35 minutes after out of hospital cardiac arrest. Case: A 54-year-old male patient with coronary artery disease (CAD) and 2-vessel stents was admitted to the emergency service after cardiac arrest. He was admitted to the intensive care unit (ICU) and targeted temperature management could not be applied since it was too late. Brain MRI revealed hypoxic ischemic encephalopathy. Due to recurrent Grampositive infections despite appropriate antibiotic treatment, in addition to other screening tests, a bedside TEE performed by an intensivist revealed a 27x23 mm mobile thrombus in the left ventricle (Figure 1). Surgical intervention methods were not considered by cardiovascular surgens, then antithrombotic treatment was administered. After the achievement of infection control with effective antibiotherapy, the patient was discharged to the palliative center on the 99th day of hospitalization with the tracheostomy and percutaneous endoscopic gastrostomy Discussion: It is crucial that elucidation of the culprit of the recurrent infections in intensive care patients and focal control should be ensured as soon as possible. In our patient, we investigate the presence of vegetation in heart with the TEE following recurrent Gram-positive cocci growth in blood cultures. Guidelines recommend TEE as the first test for suspected infective endocarditis, usually combined with TTE, so we think that intensivists should use it more widely in intensive care practice.Publication Metadata only Drainage insufficiency should be sought and addressed during extracorporeal membrane oxygenation (ECMO)(2023-05-07) GÜL, FETHİ; Gül F.