Person: BİLGİLİ, BELİZ
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BİLGİLİ
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BELİZ
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Publication Open Access Reduction of nosocomial infections in the intensive care unit using an electronic hand hygiene compliance monitoring system(2021-12-01) GÜL, FETHİ; YAKUT, NURHAYAT; BİLGİLİ, BELİZ; KASAPOĞLU, UMUT SABRİ; ARSLANTAŞ, MUSTAFA KEMAL; KEPENEKLİ KADAYİFCİ, EDA; Akkoc G., Soysal A., GÜL F., KEPENEKLİ KADAYİFCİ E., Arslantas M. K., Yakut N., BİLGİLİ B., Demir S. O., Haliloglu M., Kasapoglu U. S., et al.Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections. Methodology: This pre-and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios. Results: The rate of healthcare-associated infections in the electronic hand-hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively). Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings.Publication Open Access MSC transplantation in eight severe covid-19 patients: can cytokine storm be reversed(2020-05-01) BİLGİLİ, BELİZ; Bilgili B.Background: In this clinical case report, we evaluated the clinical and the efficacy outcomes of Mesenchymal Stem Cells (MSCs) transplantation in eight severe COVID-19 patients with pneumonia Methods: MSCs were administered to eight severe/critically severe patients, unresponsive to treatment algorithms patients were also reviewed without MSC transplantation. Results: could not achieve clinical improvement and passed away. In all eight patients, compared to the baseline, there was a significant decrease in CRP (p=0.036), fibrinogen (p=0.012) and Hb (p=0.03) values on post treatment day 5. While there was an increase in lymphocyte count between baseline and post treatment, the change didn’t reach statistical significance (p=0.06). There was no statistically significant change in ferritin, neutrophil count, respiratory rate, oxygen saturation, troponin and platelet count (p>0.05) between baseline and post-treatment day 5. Conclusion: Four patients were discharged from the ICU after MSC transplantation. Although there was an immediate significant improvement in their prognostic markers, the other four patients remained in critically severe condition and passed away. In two severe patients, the recovery was faster after MSC transplantation than the other two critically severe recovered patients. This may indicate the potential benefit of MSC transplantation performed in an earlier clinical stage. Moreover, we can advise MSC transplantation when the poor prognostic markers (decrease in lymphocyte number, increase in fibrinogen and CRP) are observed in the severe COVID-19 patients, to overcome alveolar damage due to “cytokine storm.” This observation may introduce an algorithm for a supportive treatment with MSC transplantation for COVID-19 patients, which needs to be confirmed by broader randomized controlled trials.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 Yoğun bakım ünitesinde kültür örnekleri nasıl, ne zaman ve hangi sıklıkla alınmalıdır? Doğru değerlendiriyor muyuz(Akademisyen Yayınevi Kitabevi, 2023-05-01) BİLGİLİ, BELİZ; Bilgili B., Yiğit A. C.; Ekinci, Osman; Tavukçu Özkan, Sedef; Pekok, Abdullah UmutPublication Open Access The impact of the analgesic agents administered in recipients of liver transplants on graft results(2022-01-01) BİLGİLİ, BELİZ; A S., Çabakli G T., Y K., Bilgili B., C Y., T U.Introduction and Objective The ischemia-reperfusion injury that occurs in both the donor and the recipient during liver transplantation and the hemodynamic changes that may occur in graft afterward significantly affect the graft, sometimes triggering graft failure by causing hepatocyte damage. It is known that inhalation anesthetics provide ischemic preconditioning that prevents ischemia-reperfusion injury, but their effect on graft dysfunction caused by post-reperfusion syndrome has not yet been clarified. Our study aimed to reveal the effects of desflurane and sevoflurane used during liver transplantation on graft survival. Material and Method This retrospective study was conducted following the ethics committee approval (protocol no: 09.2021.1004/03.09.2021) and included 60 donors and recipients of liver transplantation procedures performed between 2015 and 2021. The patients were divided into two groups depending on the agent administered for anesthesia maintenance after Anesth Crit Care 2022; 4 (1): 43-51 DOI: 10.26502/acc.037 Anesthesia and Critical Care 44 standard anesthesia induction: desflurane group (Group 1, n=30) and sevoflurane group (Group 2, n=30). Recorded patient data included age, gender, body mass index, smoking status, comorbidities, presence of renal disease, total liver volume, graft volume, remaining liver volume, total ischemic time, and duration of anesthesia and surgery, graft survival, hospital stay, diastolic blood pressure measured at the beginning and the end of the procedure, systolic blood pressure; and the values of aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalized ratio (INR), albumin, total bilirubin, blood urea nitrogen, creatinine, platelet count, and hemoglobin at the postoperative 1, 7, and 30 days. Results Demographic data and length of hospital stay of the recipients were similar (p>0.05). Intraoperative urine output of the recipient patients in the desflurane group (Group 1: 1909.52 1269.90, Group 2: 918.75618.14), ALT level at postoperative 7th day, and total bilirubin value at the 6th month were found to be significantly higher compared to the sevoflurane group (p <0.01). Discussion and Conclusion Our study revealed that preconditioning with sevoflurane during liver transplantation may have greater positive effects on early hepatic and renal functions as compared to desflurane. However, we think that it is necessary tocarry out further prospective randomized studies.Publication Open Access Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients(2022-03-01) ORHON ERGÜN, MELİHA; UMUROĞLU, TÜMAY; BİLGİLİ, BELİZ; ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN M., ZENGİN S. Ü., BİLGİLİ B., UMUROĞLU T.Aim: This study was designed to determine the effects of pleth variability index (PVI) guided monitoring on the optimal intravascular volume replacement during hip and knee arthroplasty in geriatric patients, and whether using PVI could reduce blood transfusion and vasopressor requirements. Methods: One-hundred geriatric patients who underwent elective hip and knee arthroplasty were included, assigned to either PVI group (volume replacement was PVI guided) or to a control group (volume replacement was based on traditional methods). Sealed envelope technique was used for randomization. Perioperative hemodynamic parameters, infusion rate of crystalloids, colloids, blood/blood products, ephedrine hydrochloride requirements and perioperative urine outputs were recorded. Results: Crystalloid infusion rate was higher (9.5 vs. 6.8 ml/kg/h, p<0.001) and ephedrine requirement was lower (2.0% vs. 38.0%, p<0.001) in group PVI. Postoperatively, the percentage of patients with high BUN, creatinine, and lactate levels were higher among controls (p<0.001). PVI group had significantly lower mean heart rate intraoperatively. Conclusions: Our findings suggest that intraoperative fluid replacement guided by PVI monitoring provides hemodynamic stability, preserves normal levels of BUN, creatinine, and lactate, and reduces unnecessary use of vasopressor agents in elderly surgical patients.Publication Open Access Candida Infections in Intensive Care Unit Patients: How to Diagnose?(AVES, 2020-01-09) BİLGİLİ, BELİZ; Bilgili, BelizCandida infection is a serious problem associated with increased morbidity and mortality in intensive care unit (ICU). Multiple risk factors and severe diseases make patients vulnerable to fungal infections in ICUs. Diagnosis of Candida infections should be established rapidly in order to initiate the efficient treatment early. Diagnosis of Candida infections is a very challenging process for clinicians due to comorbidities and complex clinical conditions in the critically ill patients. Growth of the agent in blood, sterile body fluid and tissue cultures or histopathological diagnosis are the main methods for the diagnosis. The biomarkers for fungal agents and various risk factors of the patient are also used for diagnostic purposes with clinical evaluation.Publication Open Access Cytokine Adsorption in Critically Ill COVID-19 Patients, a Case-Control Study(2022-09-01) ABDULLAYEV, RUSLAN; BİLGİLİ, BELİZ; SEVEN, SEDA; CİNEL, İSMAİL HAKKI; GÜL, FETHİ; Abdullayev R., Gül F., Bilgili B., Seven S., Cinel I.Aim: New coronavirus disease (COVID-19) has become an international emergency. As many of the intensive care unit (ICU) patients with the disease also present multiple organ failure, blood purification techniques might be a good choice in their treatment. In this study we aimed to investigate the role of cytokine removal in COVID-19 patients managed in ICUs. Methods: For this case-control study we have investigated the role of the cytokine removal by means of two resin membranes (HA330 and Mediasorb) in COVID-19 patients managed in ICUs. Particularly, we investigated the overtime variation in clinical severity scores, laboratory variables, and effects on hospital and ICU stay and mortality. Results: Seventy-two patients have been evaluated, of which half constituted Cytokine Filtration (CF) Group, and other half the Case-Control (CC) Group. Mortality was 55.6% and 50% in CF and CC groups, respectively. In the CF Group, there was decrease in C-reactive protein (CRP) and fibrinogen levels measured at the end of cytokine adsorption; lymphocyte count and ratio were increased, whereas neutrophile ratio was decreased. There were no differences between the groups regarding other laboratory variables, SOFA scores and vasopressor uses. Conclusions: We have demonstrated decrease in CRP, fibrinogen and increase in lymphocyte count in the patients having cytokine adsorption, but there was no clinical reflection of these benefits, and no decrease in mortality as well. Even though there is physio-pathologic rationale to use cytokine adsorption techniques for immunomodulation in critically ill COVID-19 patients, it is early to make strong suggestions about their benefits.Publication Open Access A new scoring system for early diagnosis of ventilator-associated pneumonia: LUPPIS(TERMEDIA PUBLISHING HOUSE LTD, 2020) BİLGİLİ, BELİZ; Haliloglu, Murat; Bilgili, Beliz; Bilginer, Huseyin; Kasapoglu, Umut Sabri; Sayan, Ismet; Aslan, Melek Suzer; Durmusoglu, Lutfiye Mulazimoglu; Cinel, IsmailIntroduction: The Clinical Pulmonary Infection Score (CPIS) based on chest X-ray has been developed to facilitate clinical diagnosis of ventilator-associated pneumonia (VAP); however, this scoring system has a low diagnostic performance. We developed the Lung Ultrasound and Pentraxin-3 Pulmonary Infection Score (LUPPIS) for early diagnosis of VAP and evaluated the performance of this new scoring system. Material and methods: In a prospective study of 78 patients with suspected VAP, we assessed the detection accuracy of LUPPIS for pneumonia in adult patients. We also evaluated the diagnostic performance of pentraxin-3 (PTX-3) findings of infection. On the day of the study, lung ultrasound was performed, PTX-3 levels were determined, and an endotracheal aspirate was obtained for Gram staining and culture. Results: No significant differences were found between groups with respect to age, mechanical ventilation time, APACHE II score, or SOFA score (p > 0.05). Procalcitonin and PTX-3 levels were significantly higher in the VAP (+) group (p < 0.001 and p < 0.001, respectively). The threshold for LUPPIS in differentiating VAP (+) patients from VAP (-) patients was > 7. In predicting VAP, LUPPIS > 7 (sensitivity of 84%, specificity of 87.7%) was superior to CPIS > 6 (sensitivity of 40.1%, specificity of 84.5%). Conclusions: LUPPIS appears to provide better results in the prediction of VAP compared to CPIS, and the importance of lung ultrasound and PTX-3 is emphasized, which is a distinctive property of LUPPIS.Publication Metadata only COVID-19 pnömonisine bağlı sitokin salınım sendromu gelişen hastalarda tocilizumabın etkinliğinin değerlendirilmesi(2022-03-17) BİLGİLİ, BELİZ; GÜL, FETHİ; CİNEL, İSMAİL HAKKI; Değirmencioğlu G., Bilgili B., Mardin E. E., Gül F., Cinel İ. H.