Browsing by Author "Gülhas, N."

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Comparison of the Error Rates of an Anesthesiologist and Surgeon in Estimating Perioperative Blood Loss in Major Orthopedic Surgeries: Clinical Observational Study
(Anestezi Dergisi, 2019) Yüzkat, N.; Soyalp, C.; Gülhas, N.
Objective: Since the anesthesiologist and surgeon have different observation angles in the intraoperative period, their predictions based on clinical observation vary greatly. Whether these predictions accurately reflect actual blood loss is still a matter of debate. The aim of this study was to compare the clinical observations of anesthesiologists and surgeons on perioperative blood loss and transfusion requirements with laboratory results. Methods: Sixty patients who were scheduled for major orthopedic surgery were included in the study. Same anesthesiologist and the same surgeon were asked to estimate the amount of blood loss, and whether blood transfusion was needed during the perioperative period. The amount of blood loss was calculated synchronously using the perioperative hemoglobin value and the total blood volume. The blood loss estimates of the anesthesiologist and the surgeon were compared, with blood loss calculated in the laboratory. Results: The anesthesiologist's and the surgeon's estimates of perioperative mean blood loss volume were found to be lower than the blood volume calculated in the laboratory (p=0.01). When the estimated blood loss was less than 600 mL, it was considered as overestimation, and when it was more than 600 mL then it was interpreted as 20% underestimation (p=0.01). According to our findings, the rate of error in the perioperative blood loss estimates was 28.72%. When the blood loss was more than 1000 mL, the error rate of predictions was 34.03%; when it was less than 1000 mL, the error rate of predictions was 25.18%. Conclusion: We believe that when blood loss is more than 1000 mL in major orthopedic surgeries, the error in the estimation is increased, the amount of blood loss is difficult to predict, and the anesthesiologist makes a better prediction than the surgeon. © Copyright Anesthesiology and Reanimation Specialists' Society.
Effects of Increasing Positive End-Expiratory Pressure (Peep) Values on Intraabdominal Pressure and Hemodynamics: a Prospective Clinical Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Dumanlidağ, U.S.; Yuzkat, N.; Soyalp, C.; Gülhas, N.
In the present study, the purpose was to compare the effects of Positive End-Expiratory Pressure (PEEP), which is applied to intensive care patients, on Intraabdominal Pressure (IAP) and hemodynamic parameters. The patients were selected from among the patients who received mechanical ventilator support and PEEP at various levels in Intensive Care Unit, who were between 18-80 years of age, who did not have abdominal surgery. In the present study, a total of 64 patients were divided into 3 groups. Those who had PEEP value at 4 cmH2O were included as Group 4, those with PEEP value between 5-8 cmH2O were included in Group 8, and those with PEEP value between 9-12 cmH2O were included in Group 12. The intraabdominal pressures, central venous and arterial blood pressures, heart rates, peripheral oxygen saturation values, body temperatures, fluid balances and urine volumes were measured at 0, 6, 12, 18 and 24th hours. The Intra-Bladder Pressure Measurement Method was employed to measure the intra-abdominal pressure. The lowest IAP values were measured in Group 4, and the highest values were measured in Group 12. The IAP values that were measured in Group 12 were higher than the other groups at a significant level. The intra and inter-group blood pressures, body temperatures, urine outputs, central venous pressures, and fluid balance values were similar in all groups. In the present study, it was concluded that IAP was low in low PEEP values, and the IAP was high in higher PEEP levels; and this increase caused mild intrabdominal hypertension; however, did not affect hemodynamics. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effects of Sugammadex on Coagulation in Pregnant Rats
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Keskin, M.E.; Kaplan, H.S.; Gülhas, N.; Bayram, Y.; Basbugan, Y.
Some studies have reported that sugammadex affects coagulation parameters. However, the effects of sugammadex on coagulation in pregnant women have not been adequately evaluated. This study investigated the effects of sugammadex administration on routine coagulation tests and levels of coagulation factors (FII, FV, FVII, FVIII, FIX, and FX) in pregnant rats. After ethics committee approval (2019/06), 24 female Wistar albino rats (n = 12; 19–20 days of gestation; weight 230–380 g) were randomly divided into four groups: control (n = 6), sugammadex (n = 6), pregnant (n = 6), and pregnant sugammadex (n = 6). Ketamine (50 mg/kg) and xylazine (10 mg/kg) were administered intraperitoneally to all groups. Saline (SF) (1 ml/kg) was administered to the control and pregnant groups. Sugammadex was administered to the sugammadex and pregnant sugammadex groups at a dose of 16 mg/kg. Blood samples were collected at 30 min after SF and sugammadex administration in all rats. The levels of PT, INR, aPTT, fibrinogen and coagulation factors were measured in plasma obtained from blood samples. All animals were sacrificed by cervical dislocation after the procedure. The mean weights of the rats were significantly higher in the pregnant groups (pregnant and pregnant sugammadex groups) than in the non-pregnant groups (control and sugammadex groups). The mean PT and INR values were significantly lower in the pregnant than non-pregnant groups. No significant differences were observed in any of the parameters evaluated between the sugammadex-and SF-administered groups. Sugammadex administration did not affect routine coagulation tests or the levels of coagulation factors in pregnant rats. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.