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Öğe Anesthetic Management for Left Ventricular Assist Device Implantation Through Left Thoracotomy: Evaluation of On-Pump Versus Off-Pump(Elsevier Science Inc, 2017) Sahutoglu, C.; Turksal, E.; Bilic, U.; Kocabas, S.; Askar, F. Zekiye; Ozturk, P.; Ertugay, S.; Engin, C.; Yagdi, T.; Ozbaran, M.Background. Ventricular assist devices (VADs) are alternative approaches to medical treatment in patients with acute or chronic heart failure. The goal of this study was to compare an anesthetic approach in patients undergoing implantation of a VAD with (on pump) or without (off-pump) cardiopulmonary bypass (CPB) through left thoracotomy. Methods. A total of 32 patients were divided into 2 groups: on-pump (group 1) and off pump (group 2). A standard anesthesia protocol was used in all patients. Baseline characteristics of the patients, intraoperative hemodynamic and respiratory variables, anesthetic agents and vasoactive drugs administered, the amount of blood products, extubation, length of hospital stay and intensive care unit stay, and postoperative complications were recorded. Results. Patients' mean age was 54.7 +/- 13.3 years (range, 18-74 years). Eighteen patients underwent surgery with CPB. Demographic data of the patients, preoperative characteristics, intraoperative use of blood products, intraoperative complications, and anesthetic drugs used were similar between groups (P >.05). The duration of surgery (219 +/- 23 vs 273 +/- 56 minutes) and anesthesia (274 +/- 38 vs 323 +/- 57 minutes) were shorter in group 2; there was no difference between the 2 groups in terms of mechanical ventilation time, length of stay in the intensive care unit, and length of hospital stay. There was no decrease in postoperative oxygen parameters and an increase in patient lactate levels with the use of CPB. The use of fresh frozen plasma and platelet suspension in the postoperative period was significantly higher in group 1 (P <.05). The rate of complications and mortality rate were comparable between the 2 groups (P >.05). Conclusions. Our study results show that the use of CPB during VAD implantation via left thoracotomy increases operation time and use of blood products, while causing no change in the rate of complications.Öğe Anesthetic Management for Left Ventricular Assist Device Implantation Without Using Cardiopulmonary Bypass: Case Series(Elsevier Science Inc, 2015) Karaca, N.; Sahutoglu, C.; Kocabas, S.; Orhaner, B. T.; Askar, F. Z.; Ertugay, S.; Engin, C.; Yagdi, T.; Ozbaran, M.Purpose. Ventricular assist devices are an alternative to medical treatment in patients with hemodynamic disturbances related to acute or chronic congestive heart failure. In this case series, we present our anesthesia management for implantation of left ventricular assist device (LVAD) with thoracotomy. Method. Sixteen patients with end-stage heart failure undergoing LVAD implantation via thoracotomy between November 2012 and August 2014 were analyzed prospectively. Preoperative characteristics, intraoperative hemodynamic and respiratory parameters, use of anesthetic and blood products, and durations of mechanical ventilation, hospital, and intensive care stays were recorded. Results. Sixteen patients (mean age, 54.6 +/- 13 years) were investigated. Single-lung ventilation was applied to 2 patients. Cardiopulmonary bypass (CPB) was required in 5 patients. Intraoperative ketamine, midazolam, fentanyl, and rocuronium requirements were 112 +/- 63 mg, 5.5 +/- 3.5 mg, 438 +/- 187 mu g, and 179 +/- 49 mg, respectively. Requirements of fresh donor blood, fresh frozen plasma, and thrombocyte and erythrocyte suspension were 1.19 +/- 1, 1 +/- 0.8, 0.44 +/- 0.5, and 0.25 +/- 0.7 U, respectively. Durations of mechanical ventilation, intensive care unit, and hospital stay were 46 53 hours, 8.2 +/- 6.6 days, and 20.5 +/- 11.6 days, respectively. Twelve patients were discharged from hospital with full recovery and 2 patients died; 2 patients are still receiving treatment in the hospital. Conclusion. A left thoracotomy approach can be used without CPB, because it reduces the incidences of pump complications and blood transfusion. In addition, this case series showed that the implantation of LVAD by thoracotomy can be implemented securely with single-lumen endotracheal tube without single-lung ventilation.Öğe Anesthetic Management for Left Ventricular Assist Device Implantation Without Using Cardiopulmonary Bypass: Case Series(Elsevier Science Inc, 2015) Karaca, N.; Sahutoglu, C.; Kocabas, S.; Orhaner, B. T.; Askar, F. Z.; Ertugay, S.; Engin, C.; Yagdi, T.; Ozbaran, M.Purpose. Ventricular assist devices are an alternative to medical treatment in patients with hemodynamic disturbances related to acute or chronic congestive heart failure. In this case series, we present our anesthesia management for implantation of left ventricular assist device (LVAD) with thoracotomy. Method. Sixteen patients with end-stage heart failure undergoing LVAD implantation via thoracotomy between November 2012 and August 2014 were analyzed prospectively. Preoperative characteristics, intraoperative hemodynamic and respiratory parameters, use of anesthetic and blood products, and durations of mechanical ventilation, hospital, and intensive care stays were recorded. Results. Sixteen patients (mean age, 54.6 +/- 13 years) were investigated. Single-lung ventilation was applied to 2 patients. Cardiopulmonary bypass (CPB) was required in 5 patients. Intraoperative ketamine, midazolam, fentanyl, and rocuronium requirements were 112 +/- 63 mg, 5.5 +/- 3.5 mg, 438 +/- 187 mu g, and 179 +/- 49 mg, respectively. Requirements of fresh donor blood, fresh frozen plasma, and thrombocyte and erythrocyte suspension were 1.19 +/- 1, 1 +/- 0.8, 0.44 +/- 0.5, and 0.25 +/- 0.7 U, respectively. Durations of mechanical ventilation, intensive care unit, and hospital stay were 46 53 hours, 8.2 +/- 6.6 days, and 20.5 +/- 11.6 days, respectively. Twelve patients were discharged from hospital with full recovery and 2 patients died; 2 patients are still receiving treatment in the hospital. Conclusion. A left thoracotomy approach can be used without CPB, because it reduces the incidences of pump complications and blood transfusion. In addition, this case series showed that the implantation of LVAD by thoracotomy can be implemented securely with single-lumen endotracheal tube without single-lung ventilation.Öğe Anesthetic Management for Left Ventricular Assist Device Implantation Without Using Cardiopulmonary Bypass: Case Series(Elsevier Science Inc, 2015) Karaca, N.; Sahutoglu, C.; Kocabas, S.; Orhaner, B. T.; Askar, F. Z.; Ertugay, S.; Engin, C.; Yagdi, T.; Ozbaran, M.Purpose. Ventricular assist devices are an alternative to medical treatment in patients with hemodynamic disturbances related to acute or chronic congestive heart failure. In this case series, we present our anesthesia management for implantation of left ventricular assist device (LVAD) with thoracotomy. Method. Sixteen patients with end-stage heart failure undergoing LVAD implantation via thoracotomy between November 2012 and August 2014 were analyzed prospectively. Preoperative characteristics, intraoperative hemodynamic and respiratory parameters, use of anesthetic and blood products, and durations of mechanical ventilation, hospital, and intensive care stays were recorded. Results. Sixteen patients (mean age, 54.6 +/- 13 years) were investigated. Single-lung ventilation was applied to 2 patients. Cardiopulmonary bypass (CPB) was required in 5 patients. Intraoperative ketamine, midazolam, fentanyl, and rocuronium requirements were 112 +/- 63 mg, 5.5 +/- 3.5 mg, 438 +/- 187 mu g, and 179 +/- 49 mg, respectively. Requirements of fresh donor blood, fresh frozen plasma, and thrombocyte and erythrocyte suspension were 1.19 +/- 1, 1 +/- 0.8, 0.44 +/- 0.5, and 0.25 +/- 0.7 U, respectively. Durations of mechanical ventilation, intensive care unit, and hospital stay were 46 53 hours, 8.2 +/- 6.6 days, and 20.5 +/- 11.6 days, respectively. Twelve patients were discharged from hospital with full recovery and 2 patients died; 2 patients are still receiving treatment in the hospital. Conclusion. A left thoracotomy approach can be used without CPB, because it reduces the incidences of pump complications and blood transfusion. In addition, this case series showed that the implantation of LVAD by thoracotomy can be implemented securely with single-lumen endotracheal tube without single-lung ventilation.Öğe Evaluation of The Analgesic Effect of Caudal Anesthesia In Pediatric Lower Extremity Orthopedic Surgery(Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Duşmez, A.; Sargın, A.; Sahutoglu, C.; Sertoz, N.; Balcıoğlu, T.The aim of this study is to evaluate the preoperative and postoperative effects of caudal analgesia in pediatric orthopedic lower extremity surgery. A total of 92 children who underwent lower extremity osteotomy under general anesthesia were included in the study retrospectively. For caudal analgesia, 0.5 ml/kg 0.25% levobupivacaine a nd 20 mcg/kg morphine were used routinely. The effect of caudal analgesia on hemodynamic parameters (heart rate, mean arterial pressure, oxygen saturation, sevoflurane concentration) and procedural success rates were evaluated using objective pain scale s cores (OPS). The mean age of the patients was 5.6±3.7 (1-13) years, and 54.3% of them were male. The mean operation time was 100±94 minutes. Side effects (nausea-vomiting) were detected in 12% of the cases. Caudal block suppressed the response to the surgical incision, and caused a decrease i n heart rate, mean arterial pressure, and sevoflurane values (p <0.05). The OPS’s were found to be ? 5 in 8.7% of the patients, and in these patients’ caudal block was considered to be unsuccessful for achieving a satisfactory analgesic effect. The time to the first analgesic administration to the patients was 526 ± 242 (85-1110) minutes after caudal analgesia. In the first 24 hours, 40.2% of the patients did not need additional analgesics. Caudal block is an anesthesia technique with high success rate, eas y application, and low complication rate. In addition, it can provide long-term analgesia both peri operatively and postoperatively in pediatric patients undergoing subumblical surgery with a single injection technique. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.Öğe Heartmate 3 versus Heartmate 2: Is New Always Better ?(Elsevier Science Inc, 2018) Ozturk, P.; Demir, E.; Sahutoglu, C.; Engin, C.; Yagdi, T.; Nalbantgil, S.; Ozbaran, M.Öğe THE PREDICTIVE VALUE OF BRAIN ARREST NEUROLOGICAL OUTCOME SCALE ON MORTALITY AFTER CARDIAC ARREST(Springer, 2010) Sahutoglu, C.; Uyar, M.; Demirag, K.; Isayev, H.; Moral, A. R.Öğe Pump Thrombosis in HeartWare HVAD Left Ventricular Assist Devices: Single Center Experience(Elsevier Science Inc, 2018) Demir, E.; Nalbantgil, S.; Ozturk, P.; Sahutoglu, C.; Engin, C.; Yagdi, T.; Ozbaran, M.Öğe Short-term Results of Heartmate 3 Ventricular Assist Device Implantation for End-Stage Heart Failure(Elsevier Science Inc, 2017) Ozturk, P.; Ertugay, S.; Sahutoglu, C.; Engin, C.; Nalbantgil, S.; Yagdi, T.; Ozbaran, M.Objective. To report our initial experience with Heartmate 3 ventricular assist device (HM3) in cases with end-stage heart failure (ESHF). Methods. Charts of 8 ESHF patients who underwent HM3 implantation in our clinic from January to June 2016 (group 1) and 16 patients who underwent HM2 implantation during 2015 (group 2) were reviewed retrospectively. Demographics as well as pre and early postoperative medical data were noted and statistically analyzed between the 2 groups. Results. No statistical difference was found in age or sex distribution between groups (P >.05). Mean Interagency Registry for Mechanically Assisted Circulatory Support scores were 2.13 +/- 0.99 and 3.38 +/- 0.72 in groups 1 and 2, respectively (P =.020). Mean cardiopulmonary bypass time, and chest tube drainage fluid volume and blood product requirement during intensive care unit (ICU) stay were 64.0 +/- 13.9 minutes, 1,112.5 +/- 516.7 mL, and 318.8 +/- 271.2 mL, respectively, in group 1 and 89.0 +/- 33.3 minutes, 2,081.3 +/- 1,696.0 mL, and 1,118.8 +/- 1,010.8 mL in group 2 (P =.027, P =.019, and P =.040, respectively). Need for surgical revision and early mortality were not evident for group 1, although 4 cases (25.0%) required revision surgery, and early mortality was seen in 3 cases (18.8%) in group 2 (P =.121 and P =.190, respectively). Mean durations of ICU stay and total postoperative hospitalization were 5.9 +/- 2.0 and 18.3 +/- 5.5 days, respectively in group 1 and 6.2 +/- 4.3 and 18.0 +/- 6.9 days in the surviving 13 patients of the group 2 (P =.645 and P =.697, respectively). Conclusions. With its shorter implantation time and reduced blood product requirement in the early postoperative period, the HM3 system was found to be safe and effective in ESHF treatment.Öğe Treatment of Pump Thrombosis With Low Dose Thrombolytic Therapy in Heartware HVAD Left Ventricular Assist Devices: Single Center Experience(Elsevier Science Inc, 2018) Demir, E.; Nalbantgil, S.; Ozturk, P.; Sahutoglu, C.; Engin, C.; Yagdi, T.; Ozbaran, M.
