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BEKİROĞLU, GÜLNAZ NURAL

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BEKİROĞLU

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GÜLNAZ NURAL

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2010 - 20152
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Author: BOSTANCI, KORKUT ×

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    PublicationOpen Access
    Postoperative psychiatric disorders in general thoracic surgery: incidence, risk factors and outcomes
    (OXFORD UNIV PRESS INC, 2010-05) YILDIZELİ, BEDRETTİN; Ozyurtkan, Mehmet Oguzhan; Yildizeli, Bedrettin; Kuscu, Kemal; Bekiroglu, Nural; Bostanci, Korkut; Batirel, Hasan Fevzi; Yuksel, Mustafa
    Objective: Postoperative psychiatric disorders (PPDs) may complicate the post-surgical outcome. We analysed the types, incidences, risk factors and outcomes of the PPDs in non-cardiac thoracic surgery patients. Methods: All patients (n = 100) undergoing major non-cardiac thoracic surgery from January 2004 to March 2005 were investigated prospectively. The diagnosis of PPD was made based on the Diagnosis and Statistical Manual of Mental Disorders. The patients were grouped into two according to the presence (group I) or absence (group II) of PPD. Data on pre-, per- and postoperative factors, and the adverse outcomes were analysed. Results: Eighteen patients (18%) developed PPD, including delirium in 44%, adjustment disorders in 22%, panic attack in 17%, minor depression in 11% and psychosis in 6%. The patients who developed PPD were older (58 +/- 17 vs 50 +/- 15 years, p = 0.05), had a longer operation time (6 +/- 1 vs 5 +/- 2 h, p = 0.015) and hospital stay (13 +/- 9 vs 8 +/- 5 days, p = 0.019). The morbidity and mortality rates were not significantly different between the groups (67% vs 46%; 11% vs 1%, respectively). The causative factors in the development of PPD were older age, longer operation time, abnormal serum chemistry values of sodium, potassium, calcium and glucose, hypoalbuminaemia, the presence of the postoperative respiratory distress and infection and blood transfusion (p < 0.05). Conclusions: PPDs are associated with adverse outcomes including a longer hospital stay, and increased morbidity and mortality rates. The identification, detection and elimination of these risk factors are recommended. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
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    PublicationOpen Access
    Effect of the amount of intraoperative fluid administration on postoperative pulmonary complications following anatomic lung resections
    (MOSBY-ELSEVIER, 2015-01) KARARMAZ, ALPER; Arslantas, Mustafa Kemal; Kara, Hasan Volkan; Tuncer, Beliz Bilgili; Yildizeli, Bedrettin; Yuksel, Mustafa; Bostanci, Korkut; Bekiroglu, Nural; Kararmaz, Alper; Cinel, Ismail; Batirel, Hasan F.
    Objective: Excessive fluid administration during lung resections is a risk for pulmonary injury. We analyzed the effect of intraoperative fluids on postoperative pulmonary complications (PCs). Methods: Patients who underwent anatomic pulmonary resections during 2012 to 2013 were included. Age, weight, pulmonary function data, smoking (pack-years), the infusion rate and the total amount of intraoperative fluids (including crystalloid, colloid, and blood products), duration of anesthesia, hospital stay, PCs, and mortality were recorded. PCs were defined as acute respiratory distress syndrome, need for intubation, bronchoscopy, atelectasis, pneumonia, prolonged air leak, and failure to expand. Univariate analyses and multivariate logistic regression were performed. A Lowess curve was drawn for intraoperative fluid threshold. Results: In 139 patients, types of resections were segmentectomy-lobectomy (n = 69; extended n = 37; video-assisted thoracoscopic surgery n = 19) and pneumonectomy (n = 9; extended n = 5). One hundred sixty-one PCs were observed in 76 patients (acute respiratory distress syndrome [n = 5], need for intubation [n = 9], atelectasis [n = 60], need for bronchoscopy [n = 19], pneumonia [n = 26], prolonged air leak [n = 19], and failure to expand [n = 23]). Overall mortality was 4.3% (6 out of 139 patients). Mean hospital stay was 8.5 +/- 4.8 days. Univariate analyses showed that smoking, intraoperative total amount of fluids, crystalloids, blood products, and infusion rate as well as total amount of crystalloids and infusion rate during the postoperative first 48 hours were significant for PCs (P = .033, P < .0001, P = .001, P = .03, P < .0001, P = .002, and P < .0001, respectively). In multivariate logistic regression analysis intraoperative infusion rate (P < .0001) and smoking were significant (P = .023). An infusion rate of 6 mL/kg/h was found to be the threshold. Conclusions: The occurrence of postoperative PCs is seen more frequently if the intraoperative infusion rate of fluids exceeds 6 mL/kg/h.