Background/aim: The aim of this study was to determine mortality rates and to evaluate clinical features of patients with active tuberculosis (TB) requiring intensive care unit (ICU) admission. Materials and methods:The medical records of active TB patients requiring ICU admission were retrospectively reviewed over a 5-year period.Results: Sixteen patients with active TB admitted to the ICU were included in the study. Seven (43.8%) patients died in the ICU. The cause of mortality was septic shock in 5 patients and respiratory failure in 2 patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were higher in patients who died (P = 0.012 and 0.048, respectively). Six of the 8 immunosuppressed patients and 1 of the 8 nonimmunosuppressed patients died (P = 0.041). The median mechanical ventilation (MV) duration was longer in patients who died (11 (5-45) days) than in patients who survived (4.5 (3-7) days) (P = 0.036). Seven of the 8 patients with nosocomial infection and/or coinfection died, while all of the patients without additional infection survived (P = 0.01). Conclusion:Active TB patients admitted to the ICU had higher mortality rates, especially patients with immunosuppression, nosocomial infection, high APACHE II and SOFA scores, and patients receiving MV.

rointestinal, merkezi sinir ve böbrek sistemlerini ciddi şekilde etkileyebileceğinden, yoğun bakım ünitesi yönetimi esastır. Salgın hasta bakımı için multidisipliner bir yaklaşım gerektirir. Yoğun bakımcılar ve yoğun bakım üniteleri en ağır vakaların tedavisinde çok önemli bir yer tutar. Bu durum, mevcut YBÜ yataklarının doygunluğuna yol açar ve sağlık hizmetleri sistemleri ve sağlayıcıları üzerinde ciddi bir yük oluşturur. Bu makale, yoğun bakım ünitesinde (YBÜ) COVID-19 hastalarını yöneten yoğun bakım doktorlarını desteklemek için öneriler sunmaktadır. Covid-19 hastalarının yoğun bakımda tedavisi için klinik pratik üzerinden önerilerle literatürü özetledik.

IntroductionBiomarkers are useful for diagnosing infection and sepsis in adults, but data are limited in elderly patients. Furthermore, clinical symptoms of infection in elderly patients are usually atypical or unclear. We aimed to assess the usefulness of PCT, CRP, and WBC in distinguishing elderly patients infected with sepsis from infected without sepsis and those with no infection.We also aimed to find a cut-off value for diagnosing sepsis and infection without sepsis in elderly critically ill patients. MethodsIn this single-center and prospective observational study, patients older than 65 years were enrolled. Serum levels of PCT, CRP, and WBC were measured within 24 hours. Patients were allocated into sepsis(S), infected without sepsis (IWS), and no-infection (NI) groups. Data were analyzed with Mann-Whitney's U test and Kruskal-Wallis test. The Receiver Operating Characteristic (ROC) curves were used to assess the accuracies of the biomarkers in diagnosing IWS and S. ResultsWe analyzed 188 patients with a mean age of 77,05 ±7.4 in the study; 95 (50.5%) of them were women. 64 (34%) of whom were classified as IWS, 29 (15%) as S, and 95 (50.5%) as NI group.There were significant differences in the PCT, CRP levels between the IWS and NI, S and NI (p<0. 001, p<0.001, p< 0.001, p<0.01, respectively). The PCT levels were significantly different when the NI group was compared to IWS (p<0.001) and S (p<0.001) groups. The CRP levels were also different when the NI group was compared to both IWS (p<0.001) and S (p<0.001). PCT was significantly higher in S compared to IWS (p<0.001), while CRP and WBC were not (p< 0.80, p<0.07, respectively). The value of PCT for discrimination of patients with IWS was highest with an AUC of 0.886, followed by CRP (AUC = 0.787; p<0.001), and WBC (AUC = 0.695; p<0.001).PCT also yielded the highest value for discrimination of patients with S with an AUC of 0.994, followed by CRP (AUC = 0.795:p<0.001) and WBC (AUC=0.768,p<0.01).The PCT cut-off values were 0.485μ/L and 1.245 μg / L for the discrimination of patients with IWS and S, respectively. The cut-off values of CRP level were 59.45 mg / L and 57.50 mg/L for infected without sepsis and sepsis, respectively. ConclusionsPCT was found to be a more valuable marker than CRP and WBC for the discrimination of elderly patients with infected without sepsis and sepsis.

<b><i>Background:</i></b> Influenza can cause severe acute respiratory illness (SARI), which occurs as local outbreaks or seasonal epidemics with high intensive care unit (ICU) admission and mortality rates. Mortality is mainly due to SARI. <b><i>Objective:</i></b> The aim of this study was to evaluate the outcome of patients admitted to ICU due to influenza-related SARI in 2017–2018 flu season in Turkey. <b><i>Methods:</i></b> A retrospective multicenter study was conducted in 13 ICUs with a total of 216 beds from 6 cities in Turkey. All adult patients (over 18 years) admitted to the ICUs in 2017–2018 flu season (between September 1, 2017, and April 30, 2018) because of SARI and with a positive nasopharyngeal swab for influenza were included in the study. <b><i>Results:</i></b> A total of 123 cases were included in the study. The mean age of patients was 64.5 ± 17.5 years, and 66 (53.7%) patients were older than 65 years. The ICU mortality was 33.9%, and hospital mortality was 35.6%. Invasive mechanical ventilation (IMV), acute kidney injury (AKI), hematologic malignancy, and &#x3e;65 years of age were the factors affecting mortality in influenza. <b><i>Conclusion:</i></b> SARI due to influenza carries a high mortality rate, and IMV, AKI, presence of hematologic malignancy, and older age are independent risk factors for mortality.