Objective: To assess family satisfaction in the intensive care unit with a validated family satisfaction survey. Matherials and Methods: With the ethical commitee approval, family satisfaction survey was applied to family members of 553 patients admitted in Anestesiology and Reanimation Intensive Care Units. 133 family members who meet the inclusion criteria were included in the study. Patients' age, educational status, health insurance, additional diseases, cause of admission, duration of stay, coma status, mechanichal ventilation need and cardiopulmoner resutation need was recorded. Family members' age, sex and relationship with the patient were recorded. Also family members were asked to specify who gave them information about the patient along with how many times and for how long they visited the patient. Acute physiology and chronic health evaluation Scores of the patients were recorded in the first twenty-four hours of admission. A survey combined from two verified forms were used to assess family satisfaction. Results: Family members of patients that differ in the means of socio-cultural status, diagnosis, treatment plans and prognosis were highly satisfied (%86,4) from the ICU care. Family members were most satisfied. The most satisfactory subjects were identified as "proximity", "comfort" and "trust". Conclusion: In order to increase family satisfaction in our ICU, visiting hours can be increased in order to provide more closeness to the family members. Family members can also benefit from a more comfortable environment. Family meetings can be arranged at given intervals.

were decreased. While these parameters return to baseline values at the end of the surgery in the HES group, in the RL group, these changes remained until at the 24 th hour. The PPV and PPVHI values did not change in both groups (p40.05). MFI in small sized vessels in group HES were lower than in group RL (po0.05) but these values did not affect in both groups at any time (p40.05) Conclusion. We concluded that HES (130/0.4) could be used as the CPB priming solution in patients undergoing cardiac surgery but it may have not some advantages to improve microcirculation.

We retrospectively evaluated five maternal mortality cases that occurred in our institution within the last 10 years. Rate of maternal mortality was 24.5 per 100000 live births. Maternal mortality causes were cardiopulmonary failure secondary to veno-occlusive disease, septic shock secondary to osteosarcoma, pulmonary thromboembolism secondary to metastatic breast cancer, septic shock secondary to cholecystitis, and postpartum hemorrhage secondary to Niemann–Pick disease. Four out of five cases were evaluated as indirect maternal mortality cases. Three out of five cases ended up with a healthy newborn, while other cases ended up with abortus and postpartum exitus.

Background/aim: Knowledge regarding pain relief during labor remains insufficient. We aimed to determine and compare the effectiveness and safety of epidural analgesia, combined spinal-epidural analgesia, and parenteral meperidine on both mothers and fetuses. Materials and methods: This study was designed as an observational case-control study. We collected prospective data from patients whose labor pain management was conducted with meperidine in addition to retrospective cohort data of neuraxial methods; 138 patients were enrolled. Epidural analgesia group consisted of 68 patients, whereas combined spinal-epidural (CSE) analgesia group and meperidine group consisted of 50 and 20 patients, respectively. We compared the delivery patterns, labor durations, pain levels, side effects, maternal satisfaction levels, and neonatal outcomes of the various pain management methods. Results: Patient demographics, duration of first, second, and third labor stages, and instrumental delivery rates were comparable among groups (P > 0.05). Cesarean section tended to be less frequent in the CSE group. In the meperidine group, visual analog scale (VAS) values and sedation were significantly higher (P < 0.001) and maternal satisfaction lower (P < 0.001). Hypotension tended to be more frequent in the meperidine group. APGAR scores at the 1st and 5th min were similar among the groups and between meperidine subgroups defined by three different administration times (<1 h, 1-4 h, ≥4 h; P > 0.05). Conclusion: Neuraxial methods had no effect on instrumental delivery rates. CSE represented a near significant risk reduction in cesarean section. Our results demonstrated that regional analgesia methods were reasonably safe for both mother and fetus, and regional analgesia methods resulted in greater maternal satisfaction and pain control compared to meperidine.

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Perioperative management of bleeding in children can be challenging. Microvascular imaging techniques have allowed evaluating the effect of blood transfusion on the microcirculation, but little is known about these effects in children. We aimed to investigate the effects of blood management using macro-and micro-hemodynamic parameters measurement in children undergoing craniofacial surgery. This is a prospective observational repeated measurement study including fourteen children. The indications for blood transfusion were changes of hemoglobin/ hematocrit (Hct) levels, the presence of signs of altered tissue perfusion and impaired microcirculation images. Total and perfused vessel densities, proportion of perfused vessels, microvascular flow index, and systemic parameters (hemoglobin, Hct, lactate, mixed venous oxygen saturation, K þ , heart rate, mean arterial blood pressure) were evaluated baseline (T1), at the end of the surgical bleeding (T2) and end of the operation (T3). Four patients did not need a blood transfusion. In the other 10 patients who received a blood transfusion, capillary perfusion was higher at T3 (13[9 -16]) when compared with the values of at T2 (11[8 -12]) (P < 0.05) but only 6 patients reached their baseline values.Although blood transfusions increased Hct values (17 AE 2.4 [T2]-19 AE 2.8 [T3]) (P < 0.05), there was no correlation between microvascular changes and systemic hemodynamic parameters (P > 0.05). The sublingual microcirculation could change by blood transfusion but there was not any correlation between microcirculation changes, hemodynamic, and tissue perfusion parameters even with Hct values. The indication, guidance, and timing of fluid and blood therapy may be assessed by bedside microvascular analysis in combination with standard hemodynamic and biochemical monitoring for intraoperative bleeding in children.

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