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ARSLANTAŞ, MUSTAFA KEMAL

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ARSLANTAŞ

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MUSTAFA KEMAL

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2015 - 20204
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End date: 2021 × Subject: Sepsis ×

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Now showing 1 - 4 of 4
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    PublicationOpen Access
    Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study
    (BMC, 2018-12) ARSLANTAŞ, MUSTAFA KEMAL; Baykara, Nur; Akalin, Halis; Arslantas, Mustafa Kemal; Hanci, Volkan; Caglayan, Cigdem; Kahveci, Ferda; Demirag, Kubilay; Baydemir, Canan; Unal, Necmettin
    Background: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. Methods: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded. Results: Of the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1: 4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients. Conclusions: A high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality.
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    PublicationOpen Access
    Serum vitamin D level variation in SIRS, sepsis and septic shock
    (MARMARA UNIV, FAC MEDICINE, 2019-10-31) BİLGİLİ, BELİZ; Gul, Fethi; Arslantas, Mustafa K.; Bilgili, Beliz; Besir, Ahmet; Kasapoglu, Umut S.; Karakurt, Sait; Cinel, Ismail
    Objectives: Vitamin D has potent immunomodulatory effects with the capability of acting as an autocrine and paracrine agent, and inhibits inflammatory signaling. In this study, our aim was to evaluate the relationship between vitamin D levels in systemic inflammatory response syndrome (SIRS), sepsis and, septic shock patients and outcomes. Patients and Methods: A total of 45 patients whose vitamin D levels were measured within the first 48 hours of Intensive Care Unit (ICU) admission and 20 healthy controls were studied prospectively. The patients were grouped as, SIRS (Group-I,n=10), sepsis (Group-II, n=25), septic shock (Group-III, n -10) and healthy subjects (Group-IV, n=20). Serum vitamin D levels were categorized as a deficiency (<= 15ng/mL), insufficiency (16-29ng/mL) and sufficiency (>= 30ng/mL). Demographic characteristics, Acute Physiology and Chronic Health Assessment II (APACHE-II) scores, and biochemical parameters were noted. Results: Vitamin D levels were significantly lower in all study groups compared to the control group (p<0.01), but were similar among the study groups. The hospital and ICU length of stay (LOS), and biochemical parameters were similar among the study groups. The mortality rates were 40% in Group I, 57 % in Group II, and 80 % in Group III. Conclusion: In our study patients with SIRS, sepsis and septic shock had lower serum 25-OH vitamin D levels compared to the control group. Our results are in line with the literature that supports a relationship between vitamin D deficiency and inflammation.
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    PublicationOpen Access
    Sepsis-Induced Myocardial Depression and Takotsubo Syndrome
    (GALENOS YAYINCILIK, 2015-08-05) CİNEL, İSMAİL HAKKI; Arslantas, Mustafa Kemal; Altun, Gulbin Tore; Cinel, Ismail
    Sepsis induced temporary myocardial dysfunction characterized as impairment of myocardial contraction is an important cause of mortality and morbidity in intensive care units. Takotsubo syndrome (TS) is temporary ballooning and dysfunction of the apical part of left ventricle without significant stenosis of coronary arteries. Recently, it was suggested that impairment in regional catecholamine distribution caused by stress factors and excessive cardiac sympathetic activity mechanism play role in sepsis such as other causes of TS. Additionally, vasopressor agents (as noradrenaline) which are widely used in sepsis treatment may be triggering factor. Serial case reports of sepsis associated TS are reported, however pathophysiology, diagnosis and treatment strategies of these two different syndromes is not obvious.
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    PublicationOpen Access
    Dental follicle mesenchymal stem cells regulate responses in sepsis
    (MARMARA UNIV, FAC MEDICINE, 2020-01-31) GÜL, FETHİ; Gul, Fethi; Genc, Deniz; Arslantas, Mustafa Kemal; Zibandeh, Noushin; Topcu, Leyla; Akkoc, Tunc; Cinel, Ismail
    Objective: Sepsis-induced immune alterations are associated with secondary infections and increased risk of death. The use of mesenchymal stern cells (MSCs) has been described as a novel therapeutic strategy. We evaluated the immunomodulatory effects of human dental follicle (DF-MSCs) on lymphocytes of sepsis and septic shock patients. Materials and Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood samples of sepsis, septic shock and healthy subjects. PBMCs were co-cultured in the presence and absence of DF-MSCs with or without interferon-gamma (IFN-gamma) for 72 hours. CD4+CD25+FoxP3+regulatory T (Treg) cell frequency, lymphocyte proliferation, cytokine levels and apoptosis were evaluated via flow cytometry. Results: DF-MSCs significantly suppressed proliferation of lymphocytes in sepsis group compared to septic shock group (p<0.005). DP-MSCs remarkably increased Treg ratio in sepsis compared to control group (p<0.05). Reduction of lymphocyte apoptosis in cocultures of DF-MSCs and PBMC was significant in both sepsis and septic shock groups. IFN-gamma stimulation of DF-MSCs ameliorated shift in the T-cell subsets from Th2 to Th1 phenotype in septic shock. Conclusion: Our findings revealed that DEL MSCs have immunoregulatory effects both in sepsis and septic shock, by reducing interleukin-4 (IL-4) and increasing IFN-gamma levels. This immunoreactivity regulation may open new therapeutic approaches for septic shock patients.