Search results

Bun/creatinine ratio and the inferior vena cava collapsibility index in ventilator associated pneumonia

Aim: The evaluation of the intravascular fluid status of critical patients is of significant importance. Many publications that suggest that measurement of

the inferior vena cava diameter is successful in indicating volume status are available. In this study, we aimed to compare the efficacy of the commonly used

scoring systems APACHE II, SOFA, and CPIS, the BUN/Cre ratio, and the inferior vena cava collapsibility index (IVC CI) in terms of mortality prediction among

patients diagnosed with VAP. Material and Method: Fifty-seven patients who had bacteria isolation in the specimens of the lower respiratory tract were included

in the study. The demographic characteristics, comorbid conditions of all patients were recorded. In addition, the biochemical parameters, BUN/Cre

ratio, MDRD, APACHE II, SOFA, CPIS, and the final status of each patient were recorded. Results: There was a statistically significant relationship between IVC

CI and BCR (p=0.003). A significant correlation was found between MDRD and BCR (p < 0.001). There was a positive correlation between procalcitonin and

SOFA score (r=0.618, p < 0.001). An increase in the CPIS value increases mortality to 3.52 times (p = 0.027). The mortality risk of those with an IVC CI value of

50 and above is 38.59 times greater than that of those with an IVC CI value below 50 (p=0.003). Discussion: Procalcitonin and CPIS may provide guidance for

predicting mortality in patients with VAP. We believe that the calculation of the IVC CI value is a sensitive method for determining and monitoring fluid therapy

in patients with VAP and in every patient admitted to the ICU.

Download attachments:

Can the clinician trust blood gas for serum electrolyte levels?

Aim: Electrolytes are charged elements that are required for proper cellular function in most tissues of the body. Almost all metabolic processes are dependent

on or performed by electrolytes. Electrolyte abnormalities may represent significant risks for life. Routinely, all electrolytes are measured from the serum

sample, using the automatic analysis devices at the central laboratories of the hospitals. However, this is time-consuming. In this study, our aim is to compare

the results of venous blood gas electrolyte, glucose and hemoglobin values with serum laboratory results and to investigate whether venous blood gas can

substitute serum. Material and Method: Our study was designed as a prospective cohort study. A total of 418 adult patients between 18-88 years old, who

were admitted to the nephrology outpatient clinic were included in the study. The demographic data of the patients and accompanying comorbidities were

recorded. In addition, blood gas electrolytes, glucose, and hemoglobin values of each patient were recorded. Results: The study included 174 female patients

and 244 male patients. In terms of both serum and blood gas hemoglobin, there was a statistically significant difference between the genders (p<0.001). A

strong positive correlation was detected between serum sodium, potassium, glucose and hemoglobin values and blood gas sodium, potassium, glucose and

hemoglobin values (p <0.001, r = 0.764, p <0.001, r = 0.867, p <0.001, respectively, r = 0.969; p <0.001, r = 0.846). The highest correlation coefficient was between

serum and blood gas glucose values, while the lowest correlation coefficient was between the sodium values. Discussion: In our study, we believe that in

CKD patients with a prominent fluid-electrolyte imbalance, in emergency departments, where critically ill patients are common in intensive care patients with a

life-threatening disease, the rapid blood gas tests may be considered for the treatment planning until the results of the biochemical examination are available.

Download attachments:

Resisted exercises for modulation of intraocular pressure in patients with primary open-angle glaucoma: A randomized clinical trial

Aim: Primary open-angle glaucoma (POAG) is the most common type of glaucoma. Daily administration of topical medications for lowering the intraocular

pressure (IOP) in POAG patients has many limitations, such as poor patient compliance and ocular allergy from repeated drug administration. Therefore, this

study was conducted to investigate the therapeutic efficacy of adding resisted exercises to routine medical treatment on patients with primary open-angle

glaucoma in comparison to routine medical treatment only. Material and Method: Thirty patients with primary open-angle glaucoma, aged between 40 and 50

years old, were randomly assigned into two equal groups: the study group and the control group. Both groups received their routine medical care. The study

group received also resisted exercises for the upper limb 3 times a week for four weeks. Intraocular pressure (IOP) was measured using Goldmann Applanation

Tonometry before (pre) and after (post) 4 weeks of application of resisted exercises treatment. Results: After training, significant improvements of IOP

(decrease) were obtained in both eyes of patients in the study group whereas nonsignificant decrease was obtained in the control group. In addition, This study

revealed that the reduction in IOP of both eyes (RT and LT) of patients in the study group post-exercise was significant in comparison to that of the control

group after one month of treatment (p=0.001 and 0,000 respectively). The percentages of reductions of IOP in both eyes (RT and LT) of the study group were

13.5% and16.45% respectively while in the control were 0.95% and 1.7% respectively. Discussion: Adding upper limb resisted exercises to the traditional medical

treatment of primary open-angle glaucoma has a clinical important in the reduction of intraocular pressure in those patients so open-angle glaucomatous

patients should be encouraged to practice resisted exercises.

Download attachments:
Page 5 of 477