Browsing by Author "Tekeli, A.E."

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Anesthesia Management in Laparoscopic Sleeve Gastrectomy Cases
(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Tekeli, A.E.; Eker, E.; Bartın, M.K.; Öner, M.Ö.
Obesity is a rapidly growing health condition worldwide and negatively affects the quality and duration of life. Anesthesia for morbidly obese patients is considered to be a real challenge to the anesthetist. In this study we aimed to evaluate difficult tracheal intubation and anesthesia management for obese patients. This study included 60 patients who had undergone laparascopic sleeve gastrectomy (LSG) between July 2012 and July 2017.We recorded gender, age, and body mass index (BMI) at the time of LSG, intraoperative incident, comorbidities, length of intensive care unit (ICU) admission. The relation of weight with difficult intubation was statistically significant, but it was not correlated with height and bod y mass index. Weight and BMI were found to have a statistically significant relationship with neck extension limitation. Difficult cases of intubation were seen mostly by 28% of patients. In this retrospective study, it was determined that laparoscopic sleeve gastrectomy and intubation difficulty was independent of body mass index. More extensive studies should be done to demonstrate the specific airway management and anesthesia of laparoscopic sleeve gastrectomy. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Icu Residents' Views on General Ethical Issues Regarding the Opt-In System of Deceased Organ Donation in Turkey: a Focus Group Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2022) Sevimli, S.; Tekeli, A.E.
This descriptive study explores the views of resident physicians working in intensive care units (ICUs) concerning deceased organ donation and examines the various ethical issues surrounding organ donation encountered by residents. This was a qualitative, descriptive study utilizing sol o interviews with participants together with focus group discussions. The participants' experiences and views were elicited via interviews and focus group discussions covering the following topics: ethical thoughts about deceased organ donation, barriers t hat impede or prevent organ donation, its effect on the next of kin, and its relationship with futile treatment. The discussions were reviewed using qualitative content analysis. The residents commented that deceased organ donation is a complex and stress ful process for the family of the potential donor as well as the transplant team, and still lacks wide acceptance in Turkish society. The opt-in system requires informed consent, thus creating a major barrier for both the patient’s family and the ICU team to overcome. The participants stated that new legal, ethical, and medical arrangements are needed to increase organ donation rates in Turkey. In order to increase rates of deceased organ donation and reduce cases of futile treatment, improved communicatio n between the ICU, transplant team, and patient relatives is critical to ensure that ethical issues are properly managed. On a societal level, the subject of deceased organ donation needs to receive greater attention from public health authorities to increase public awareness. Residents can make valuable contributions to the deceased organ donation process as physicians and as psychosocial support for patients and their families. © 2022, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Our Five Years’ Experience on the Patients With Brain Death Diagnosis: Two Centered Retrospective Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Andic, O.; Demirkiran, H.; Bahar, I.; Tekeli, A.E.; Gulhas, N.
Brain death (BD) diagnosis is a clinical diagnosis, but in many countries, other confirmatory tests are obligatory. The study was aimed to investigate the clinical effects of the current process of BD in Turkey. This study was performed retrospectively by evaluating BD-diagnosed patients’ files and computer records in the Van Yuzuncu Yil University Hospital’s Anesthesiology Intensive Care Unit (ICU) and in a Private Istanbul Hospital’s general ICU. This study was conducted between 2012 and 2017 in Turkey. Of the 57 patients included in the study, 63.2% were male (n = 36), and 36.8% were female (n = 21). The most common causes of hospital admissions were cerebral hemorrhage (38.6%; n = 22) and trauma (36.8%; n = 21). Of the patients who accepted organ transplantation, 80% (n = 4) were diagnosed at an average of 60 hours (min 24, max 120). The rates of using imaging methods in the clinical diagnosis of BD were as follows: 75.4% (n = 43) for Computerized Tomography Angiography (CTA), 17.6% (n = 10) for Magnetic Resonance Angiography (MRA), and 7% (n = 4) for Transcranial Doppler (TD) Ultrasonography. Of the patients, 8.78% (n = 5) were used as donors. Studies in the literature have indicated that the short duration of BD diagnosis will lead to an increase in organ donation acceptance rates. This study found that the diagnosis time was longer than presented in the literature and that CTA was the most commonly used imaging modality in addition to the apnea test. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Transesophageal Echocardiography From Upper Respiratory Endoscopic Processes
(Springer International Publishing, 2023) Tekeli, A.E.; Kılıç, M.
Transesophageal echocardiography (TEE) is a semi-invasive procedure that has an important place in the perioperative management of cardiac surgery and in guiding diagnosis and treatment in hemodynamically unstable patients. TEE is used to evaluate the anatomical structure, pressure, and function of the heart valves, aorta, atrium and ventricles, atrioventricular septum, pulmonary vein, and pulmonary arteries. Intraoperative TEE is very important in guiding the treatment/surgery for heart valve repair or replacement in cardiac surgery and increasing the chance of success of the surgery. Transthoracic echocardiography may sometimes be insufficient in the evaluation of echocardiographic functions in critically ill patients. TEE provides fast and necessary information at the bedside for the management of patients who are hemodynamically unstable for any reason. Complication rates related to TEE performed in the outpatient clinic, perioperative period, and intensive care units vary. Complications related to TEE performed in the intensive care and intraoperative period may be slightly higher. Most of the complications of TEE are associated with probe insertion and manipulation. In cases where TEE is absolutely contraindicated, it is recommended using alternative echocardiographic imaging methods. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.