Background Perioperative hypothermia is an unintended decrease in the core temperature of patients. Hypothermia has many proven complications. The aim of this study is to investigate the perioperative temperature monitoring rates and the difficulties encountered during monitoring, particularly in patients undergoing neuraxial anesthesia. Methods Two hundred anesthesiologists were included in the study who work in Turkey and actively work in an operating room. A questionnaire was applied to the participants via printed form or e-mail. Results In Turkey, the overall temperature monitoring ratio was measured as 5.5%. Temperature monitoring was the most frequently used for cardiovascular surgery patients group. In neuraxial anesthesia, temperature monitoring was only 1.5%. The most common reason for not using a temperature monitor was the lack of appropriate equipment (45%). The most common temperature monitoring area was the axillary zone (48%). Conclusion Participants were aware of the importance of temperature monitoring but concluded that it was not sufficient in practice. Where and how to measure core temperature in awake patients is a controversial issue. Furthermore, the accuracy of measurements in neuraxial anesthesia should be discussed. Interestingly, raising awareness about this issue was not effective in the resolution of the problem. Still, in order to keep this issue up to date, the importance of perioperative temperature monitoring should be emphasized more frequently in anesthesia meetings and education programs.

Hanging is used worlwide for suicide. It is generally ends with sudden death. But if the person is reached in a short time after hanging attempt, the patient can be saved. But we may come across some medical problems like pulmonary edema, cervical vertebra instability, impaired cognitive functions. 28 year old female patient had been taken to our hospital after incomplete hanging attempt with suicide intention. While she was in our hospital she had pulmonary complication. She had mechanical ventilation need. We supported her with mechanical ventilation both invasively and noninvasively. After 4 days of mechanical ventilation support she was discharged to the psychi atry clinic without any sequel.

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Ventilator-Associated Pneumonia (VAP) is defined as a nosocomial infection which develops within 48-72 hours after receiving mechanical ventilator (MV) support (1). The incidence of VAP varies among countries and is between 8.7-38.6% in Turkey. Although there were differences between hospitals ABSTRACT Ventilator-associated pneumonia (VAP) is a nosocomial infection that can develop in patients receiving mechanical ventilator (MV) support. VAP has a high mortality rate and cost due to prolonged hospitalisation. Some procedures have s hown that VAP can be prevented. However, the incidence of VAP is still high in Turkey. In this study, we aim to investigate how increased compliance with VAP prevention bundle training for health personnel affects the incidence of VAP, the onset day of VAP , the duration of mechanical ventilation, and mortality rates. This prospective case control study was started after obtaining permission from the Van Yuzuncu Yil University (VYYU) Medicine School Ethics Committee. It was conducted between November 2017 an d June 2018 at the Anesthesiology and Reanimation Intensive Care Unit (ICU) of the Dursun Odabaş Medical Center, VYYU Medicine School. In this study, the study group (VAP prevention bundle group after healthcare staff training) included 68 patients who rec eived MV support. The control group consisted of 100 patients who received the VAP prevention bundle between January 2016 and June 2017 in the anaesthesia ICU. The Centers for Disease Control and Prevention (CDC) criteria were used for the diagnosis of VAP. In both groups, compliance with the Prevention Bundle, the incidence of VAP, the onset day of VAP, the duration of mechanical ventilation, th e day of tracheostomy operation and mortality rates were recorded. Patient groups were compared statistically. The demographic data, diagnosis and cultured microorganisms in VAP patients were similar and there was no statistically significant difference. The effect of four parameters [Endotracheal tube with subglottic secretion drainage (SSD-ETT), 0.12% chlorhexidine oral care, peptic ulcer prophylaxis and deep venous thrombosis (DVT) prophylaxis] that were included in the VAP Prevention bundle could not be evaluated separately because of the mean fit. The mean fit in holding the bed head position at an angle of 30°-45° was 100% in the VAP Prevention bundle group, while in the control group the average was 90.67% (85-100%). The relationship between this and the development of VAP was statistically significant (p=0.036). ETT cuff pressure of 20-25 cm H2O was maintained at 97.96% in the VAP Prevention Bundle group and at 93.13% in the control group. The difference between the groups according to the accordance to the ETT cuff pressure was statistically significant (p=0.01). In our study, VAP was detected in 12 patients (17.6%) in the study group and 9 patients (9%) in the control group. There was no statistically significant difference between the groups in terms of VAP or the duration of mechanical ventilation support (30.29 ± 24.5/26.11...

P14 Facial continuous positive airway pressure therapy for cardiogenic pulmonary oedema: a study of its efficacy in an emergency department setting within the UK

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Peripheralperfusionindex(PI) provides information about vascular tone and fluid status by interpreting the data obtained from pulse oximetry. However, the vascular tone may be affected by anxiety in patients. Impaired perfusion index in patients with high anxiety may cast a shadow on the predictive power of the PI. In the present study, we aimed to evaluate the relationship between anxiety and perfusion index values. Preoperatively, anxiety scores of the patients were measured by APAIS and STAI tests. Perfusion index values were also recorded in the preoperative room. The correlation between these values was evaluated. 95 patients aged 18-65 years were included in the present study. Mean anxiety scores of all patients were 48.354.42. Perfusion index values were significantly lower in the patients with higher anxiety. In addition, we have found a negative and significant correlation between anxiety and perfusion index. The perfusion index is a non-invasive, easy to apply and cost-effective method. It has been used in the important studies such as predicting the development of hypotension induced by anesthesia. However, according to the results of our study, this technique is affected by the anxiety levels of the patients. It may be misleading in patients whose anxiety is not obvious. Anxiety levels should be questioned in awake patients and it should be kept in mind that perfusion index may decrease in high anxiety levels.

The aim of this study was to determine the demographic and clinical characteristics of patients fed with total parenteral nutrition who were hemodynamically unstable in the ICU. This study was performed retrospectively in the medical intensive care unit of a university hospital. Information was obtained from the patients' files, the hospital electronic registry system and nutrition unit registration forms. This study included 51 patients. The mean age of the patients was 57 ± 19 years, of the patients 47% were male and 53% were female. When the reasons for total parenteral nutrition were evaluated, it was found that the most common causes of total parenteral nutrition were because of septic shock (47%) and gastrointestinal bleeding (23%). The daily caloric intake of the patients was 1,389 ± 286 kcal, and the target caloric value was 1,824 ± 256. The number of days with mechanical ventilation was 5 (median 0-42), the number of days stayed in the intensive care unit was 9 (median 1-125) and the number of days stayed in the hospital was 13 (median 1-155). The mortality rate of the patients was 71%. Serum albumin levels were found to be lower in patients who died than in those who lived, and these low albumin levels were statistically significant (p=0.015). In this study, it was seen that total parenteral nutrition was most commonly applied to the patients in a state of septic shock who had vasopressor support and to the patients who had gastrointestinal bleeding. In addition, it was determined that the target energy value could not be reached.