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AYKAÇ, ZEYNEP ZUHAL

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AYKAÇ

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ZEYNEP ZUHAL

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  • PublicationOpen Access
    Targeted bleeding management guided by non-invasive haemoglobin measurement in surgical patients
    (2022-10-01) AKDAĞ, ŞÜKRİYE; ZENGİN, SENİYYE ÜLGEN; UMUROĞLU, TÜMAY; AYKAÇ, ZEYNEP ZUHAL; SARAÇOĞLU, AYTEN; AKDAĞ Ş., ZENGİN S. Ü. , Cakmak G., UMUROĞLU T., AYKAÇ Z. Z. , SARAÇOĞLU A.
    © 2022 College of Physicians and Surgeons Pakistan. All rights reserved.Objective: To assess blood transfusion decisions in blood losses using a continuous total haemoglobin (SpHb) and non-invasive haemoglobin (Hb) device. Study Design: Double-blinded randomised controlled trial. Place and Duration of Study: Marmara University Hospital, Istanbul, Turkey, from March 2018 to December 2019. Methodology: One hundred and twenty adult patients scheduled for elective major surgery and expected to experience a blood loss greater than 20% of their total blood volume were divided into two groups. These groups were compared for bleeding management with conventional blood gas sampling (Group Hb, the control group) according to Hb monitoring versus SpHb measurement (Group SpHb, the study group). Results: In the postoperative measurement, there were fewer red blood cells (RBC) in the SpHb group than in the Hb group (p=0.020). There was a greater change in the amount of RBC from the perioperative to the postoperative period in the SpHb group compared to the Hb group (p<0.001). Postoperative Hb levels of patients in the intensive care unit (ICU) were higher in the SpHb group than in the Hb group (p<0.05). Conclusion: SpHb can provide effective patient blood management in cases of major surgery. It does not cause a delay in the decision of blood transfusion during surgery.
  • PublicationOpen Access
    Continuous hemoglobin measurement during frontal advancement operations can improve patient outcomes
    (2022-12-01) SARAÇOĞLU, AYTEN; ABDULLAYEV, RUSLAN; SAÇAK, BÜLENT; AYKAÇ, ZEYNEP ZUHAL; SAKAR, MUSTAFA; Saraçoğlu A., Abdullayev R., Sakar M., Saçak B., Incekoy F. G., Aykac Z.
    Massive hemorrhage in pediatric cranioplasty operations may necessitate blood transfusion, which may cause many complications. Radical-7 Pulse CO-Oximeter (Massimo Corporation, Irvine, CA) can provide continuous hemoglobin concentration (SpHb) measurements noninvasively. In this study, we aimed to evaluate the effects of SpHb measurement on perioperative transfusion management and postoperative patient outcomes. For this retrospective case-control study, we collected the data of pediatric patients undergoing fronto-orbital advancement surgery for plagiocephaly and trigonocephaly between 2018 and 2021. Perioperative SpHb monitoring was performed for patients in the SpHb Group. Other patients that were managed conventionally were considered as the control group (C Group). The data on patients\" demographic and clinical characteristics, intraoperative hemodynamic and laboratory variables such as blood gases, intraoperative blood losses, the amount of the transfused blood products, the length of postoperative intensive care unit (ICU) stay, and the duration of hospital stay were collected. The data of 42 patients were collected, and 29 of these patients were males (69%). In 16 of the patients, SpHb monitoring was performed. The demographic, clinical, and perioperative hemodynamic characteristics of the patients were comparable between the groups. Compared to the C Group, the SpHb Group had significantly lower perioperative packed red blood cell (PRBC) transfusion (136.3 +/- 40.1 vs. 181.5 +/- 74.8 mL, P = 0.015), less postoperative drainage (125.3 +/- 47.7 vs. 185.8 +/- 97.6 mL, P = 0.013), and shorter ICU stay (37.1 +/- 12.0 vs. 64.8 +/- 24.9 h, P < 0.001). There was a positive correlation between the amount of PRBC transfusion and the length of ICU stay (r = 0.459, P = 0.003). Patients with perioperative continuous SpHb measurement have lower intraoperative PRBC transfusion, less postoperative bleeding, and shorter ICU stay. When necessary, SpHb, together with clinical judgment and laboratory confirmation, can be used in decision-making for perioperative PRBC transfusion.
  • Publication
    Oxygen reserve index guided oxygen titration in one lung ventilation with low fresh gas flow
    (TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2021) SARAÇOĞLU, AYTEN; Saracoglu, Ayten; Sirzai, Esra Yamansavci; Yildizeli, Bedrettin; Yuksel, Mustafa; Aykac, Zeynep Zuhal
    Background/aim: Continuous oxygen reserve index (ORI) measurement with multiple wave pulse co-oximetry is a noninvasive measurement. The decrease in the ORI trend provides a prediction for the development of hypoxemia and provides information on hyperoxia. Our aim is to determine the effect of ORI-guided oxygen titration on hyperoxemia-mediated morbidity. Materials and methods: Consecutive 120 ASA I-III patients, 18-70 years of age, without severe obstruction or restriction, undergoing one lung ventilation (OLV), were included in the study. Patients were divided into 4 groups. Oxygen titration without ORI monitoring with low-flow anesthesia (1 L/min, Group 1, n = 25) and high-flow anesthesia (4 L/min, Group 2, n = 28). Oxygen titration by ORI monitoring with low flow anesthesia (1 L/min, Group 3, n = 25) and high flow anesthesia (4 L/min, Group 4, n = 25). FiO(2) increased up to 100% if necessary. OLV time, duration of surgery and anesthesia, FiO(2) applied during OLV, oxygen application time (T) over 60%, vital signs, hospital and ICU stay time, and complications were recorded. Results: There was a statistically significant difference in terms of FiO(2) used during OLV (p < 0.05). There was no difference in ORI values (p < 0.05). In Group 3, both PaO2 and SpO(2) were significantly lower than the others both before and during OLV. There was no significant difference in terms of ORI parameters between low flow and high flow anesthesia groups. There was a strong, positive correlation between the duration of hospital stay and FiO(2) used above 80% during OLV. Conclusion: We concluded that ORI-guided thoracic anesthesia may reduce hospital stay and increase patient safety.
  • Publication
    N-Acetylcysteine is ineffective on short-term neuron-specific enolase levels following coronary artery bypass graft surgery
    (SPRINGER TOKYO, 2012) SARAÇOĞLU, AYTEN; Ugur, Engin H.; Yapici, Nihan; Kudsioglu, Turkan; Ugur, Sinem Y.; Yapici, Mehmet F.; Saracoglu, Ayten; Saracoglu, Kemal T.; Aykac, Zuhal