Intranasal dexmedetomidine and midazolam are equally effective in decreasing anxiety upon separation from parents; however, midazolam is superior in providing satisfactory conditions during mask induction.

Pediatric patients undergoing cardiac catheterization usually need deep sedation. In this study, 60 children were randomly allocated to receive sedation with either a ketamine-propofol combination (KP group, n = 30) or a ketamine-propofol-dexmedetomidine combination (KPD group, n = 30). Both groups received 1 mg/kg of ketamine and 1 mg/kg of propofol for induction of sedation, and the KPD group received an additional 1 μg/kg of dexmedetomidine infusion during 5 min for induction of sedation and a maintenance infusion of 0.5 μg/kg/h. In both groups, 0.2 mg/kg of propofol was administered as a bolus to maintain a Ramsey sedation score (RSS) greater than 4 throughout the procedure. None of the patients in either group required intubation. In the KP group, one patient required mask ventilation. The chin-lift maneuver needed to be performed for eight patients in the KP group and one patient in the KPD group (p < 0.05). Adding dexmedetomidine to the ketamine-propofol combination decreased movement during the procedures. The heart rate in the KPD group was significantly lower after induction of sedation and throughout the procedure (p < 0.05). No significant differences in systolic blood pressure, diastolic blood pressure, or respiration rates were found between the two groups (p > 0.05). The mean recovery time was longer in the KP group (5.86 vs 3.13 min; p < 0.05). Adding dexmedetomidine to a ketamine-propofol combination led to a reduced need for airway intervention and to decreased movement during local anesthetic infiltration and throughout the procedure. The recovery time was shorter and hemodynamic stability good in the KPD group.

No abstract

: Perkutan santral venoz kateter (SVK) takilmasi yogun bakim unitesinde (YBU), acilde ve ameliyathanede hasta tedavisi icin bir gereklilik haline gelmistir. SVK takilmasi isleminde kateterin bir kilavuz tel uzerinden gonderildigi Seldinger teknigi rutin olarak kullanilmaktadir. Seldinger tekniginin diger yontemlere ustunlugu bilinmektedir ve dunya capinda tercih edilmektedir. Tecrubeli uygulayicilarda kilavuz tel kullanimi guvenli olmaktadir. Kilavuz telin SVK takilmasi sirasinda kaybolmasi hastaya ciddi zararlar verebilir, ek tetkiklere ve cikarilma islemine gereksinim duyulabilir. YBU'ne aspirasyon pnomonisi, hipoksemik solunum yetmezligi ve bilateral plevral efuzyon tanilariyla kabul edilen, Periferik damar yolu takilamamasindan dolayi SVK ihtiyaci olan, kateterizasyon islemi sirasinda kilavuz telin femoral vende kaldigi fark edilerek, kucuk cerrahi islemle cikartilan 88 yasinda kadin hasta olgusu sunulmustur.Keywords : Yogun bakim unitesi, komplikasyon, santral venoz kateterizasyon For your questions please send message to

No abstract

Astımlı hastaların çoğunda atak kontrolü kolayca elde edilir. Ancak, küçük bir kısmında astım ölümcül olabilir. Ancak, solunum yetmezliği gelişen astımlı hastalarda noninvaziv veya invaziv ventilasyon genellikle gerekli olabilmektedir. Astımlı hastada invaziv mekanik ventilasyon yoğun bakım ekibine zorluklar yaşatabilmekte ve sıklıkla permisif hiperkapni, derin sedasyon ve nöromüsküler blokaja gereklilik göstermektedir. Bu koruyucu yaklaşımlara rağmen, mekanik ventilasyon astımlı hastalarda yüksek komplikasyonlara neden olmaktadır. Bu nedenle astımlı hastalarda invaziv mekanik ventilasyon tercihi son çare olmalıdır. Astımlı hastalarda noninvaziv mekanik ventilasyon (NIV) kullanımı orotrakeal entübasyon ve mekanik ventilasyon ile ilişkili komplikasyonları azaltabilir. Birkaç çalışma astım ataklarında NIV kullanımını araştırmıştır. Ancak, sınırlı miktardaki verilere göre NIV akut astımda yararlı olabileceğini düşündürmektedir. Bu derlemede, astımda solunum yetmezliği mekanizmalarını ve önerilere göre astımda mekanik ventilasyon için tavsiyeleri değerlendirdik.

This study aims to evaluate the analgesic efficacy of dexmedetomidine added to levobupivacaine following anterior cruciate ligament (ACL) surgery. Fifty patients undergoing ACL reconstruction were included. Group DL (dexmedetomidin-levobupivacaine) received 20 mL 0.5% levobupivacaine plus 1 mL (100 μg) dexmedetomidine. Group L (levobupivacaine) patients received 20 mL 0.5% levobupivacaine plus 1 mL saline 10 minutes before tourniquet release. A patient-controlled analgesia (PCA) pump was then connected, delivering 0.5 mg at every 10 minutes and 1-mg morphine and 75-mg diclofenac sodium was used as a rescue analgesic. Postoperative pain was evaluated 0, 2, 4, 6, 12, and 24 hours after extubation at rest and during movement. A rehabilitation program was started after surgery. Postoperative continuous passive motion (CPM) starting time, postoperative leg flexion angle, and straight leg lifting time were evaluated for each group. There were no significant differences between the groups in terms of demographic data and operation time. Morphine consumption, analgesic requirements, and visual analogue scale (VAS) assessments were significantly lower in group DL during the 24-hour period after surgery. The time to start CPM in the postoperative period was significantly shorter in group DL. Passive joint flexion angle was significantly higher in group DL. Postoperative straight leg lifting time was significantly shorter in group DL. Adding dexmedetomidine to the intra-articular levobupivacaine provided better postoperative pain control and improved rehabilitation period after ACL surgery.

Candidial infection is associated with high mortality in critically ill patients. Fungal infections compose a major problem in intensive care units in both developed and developing countries. Candidemia is associated with a prolonged hospital stay, resulting in increasedcosts, and high mortality. MethodsThis study was conducted in a 12-bed adult respiratory intensive care unit (>18 years). Clinical and laboratory data from patients with candidial infection were collected retrospectively.