BackgroundVentilator-associated pneumonia (VAP) which is an important part of all nosocomial infections in intensive care unit (ICU) is a serious illness with substantial morbidity and mortality, and increases costs of hospital care. We aimed to evaluate costs and risk factors for VAP in adult ICU.MethodsThis is a-three year retrospective case-control study. The data were collected between 01 January 2000 and 31 December 2002. During the study period, 132 patients were diagnosed as nosocomial pneumonia of 731 adult medical-surgical ICU patients. Of these only 37 VAP patients were assessed, and multiple nosocomially infected patients were excluded from the study. Sixty non-infected ICU patients were chosen as control patients.ResultsMedian length of stay in ICU in patients with VAP and without were 8.0 (IQR: 6.5) and 2.5 (IQR: 2.0) days respectively (P < 0.0001). Respiratory failure (OR, 11.8; 95%, CI, 2.2–62.5; P < 0.004), coma in admission (Glasgow coma scale < 9) (OR, 17.2; 95% CI, 2.7–107.7; P < 0.002), depressed consciousness (OR, 8.8; 95% CI, 2.9–62.5; P < 0.02), enteral feeding (OR, 5.3; 95% CI, 1.0–27.3; P = 0.044) and length of stay (OR, 1.3; 95% CI, 1.0–1.7; P < 0.04) were found as important risk factors. Most commonly isolated microorganism was methicillin resistant Staphylococcus aureus (30.4%). Mortality rates were higher in patients with VAP (70.3%) than the control patients (35.5%) (P < 0.003). Mean cost of patients with and without VAP were 2832.2+/-1329.0 and 868.5+/-428.0 US Dollars respectively (P < 0.0001).ConclusionRespiratory failure, coma, depressed consciousness, enteral feeding and length of stay are independent risk factors for developing VAP. The cost of VAP is approximately five-fold higher than non-infected patients.

Spouses and family members of relatively young patients had higher rates of anxiety and depression. In contrast to the literature, depression was more common than anxiety among the relatives of ICU patients. Further research is needed on the impact of cultural and regional differences on anxiety and depression rates in family members of ICU patients.

Background/aim: Colistin is gaining popularity against multidrug-resistant bacteria. The primary concern with colistin is its nephrotoxicity (NT). The aim of this study was to evaluate the incidence and risk factors for NT and to evaluate the risk factors for mortality in the toxicity group.Materials and methods: NT was defined according to the RIFLE criteria. Data of patients who did or did not develop NT were compared. Positive and negative predictive values, risk ratio, and correlation coefficients were calculated.Results: NT was seen in 39 patients (70%). Hypoalbuminemia, old age, and the use of vasopressors (VPs) were associated with NT. The use of VPs had the highest positive predictive value, while age had the highest negative predictive value and risk ratio. The only variable that was associated with mortality in the toxicity group was VP use. Conclusion:Aging, hypoalbuminemia, and the use of VPs were shown to be risk factors for NT, while the last of these was the only significant risk factor for mortality in the toxicity group.

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Zehirlenme nedeniyle pek çok hasta acil servislere kabul edilmekte, bunların bir bölümünde ise yoğun bakım izlemi gerekmektedir. Çalışmamızda, zehirlenme nedeni ile acil servise başvuran hastaların hastane kayıtlarını geriye dönük inceleyerek yoğun bakım ünitemize yatışı gerçekleşenlerin; zehirlenme nedenleri, yoğun bakımda kalış süreleri, mekanik ventilasyon (MV) ve renal replasman tedavisi (RRT) gereksinimlerini araştırmayı ve mortalite ile ilişkili faktörleri değerlendirmeyi amaçladık. Yöntemler: Yoğun bakım ünitemize 1 yıl boyunca kabul edilen zehirlenme olguları geriye dönük incelendi. Hastaların demografik verileri, etken madde, yatış süreleri, MV ve RRT gereksinimleri ve mortalite ile ilişkili faktörler araştırıldı. Tüm veriler SPSS 22.0 paket programı kullanılarak analiz edildi. Bulgular: Bir yıl boyunca acil servise başvuran 470 zehirlenme olgusundan 11'i kadın 17 hasta yoğun bakım ünitemize kabul edildi. Hastaların yaş ortalaması 36 idi. Zehirlenme nedeni özkıyım olan olguların sayısı 15 (%88) idi. Antidepresan ilaçlar en sık neden olarak saptandı. Altı hastada önceden tanı almış psikiyatrik bozukluk saptandı. Beş hastada mekanik ventilasyon 4 hastada ise renal replasman tedavisi gerekti. Yoğun bakımda ortalama kalış süresi 29 gün olarak saptandı. Ölüm oranı ise %23,5 idi. Hastaların yaşı, MV (%29,4) ve RRT (%23,5) gereksinimleri ve Glasgow koma skalaları (GKS) mortalite ile ilişkili bulundu. Sonuç: Acil servise başvuran zehirlenme olgularında yoğun bakım gereksinimi düşük oranda (%3,6) saptandı. Antidepresanlar zehirlenmeye neden olan en sık etken olarak saptandı. Yoğun bakıma kabul edilen hastalarda MV ve RRT gereksinimi ve mortalite (%23,5) oranı yüksekti. Hastaların yaşı, GKS, MV ve RRT gereksinimleri mortalite ile ilişkili bulundu.