Browsing by Author "Doganay, Z."

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High, Low, and Minimal Flow Anaesthesia Management: Effects on Oxygen Reserve Index and Arterial Partial Oxygen Pressure
(2023.01.01) Dastan, R.; Celik, H.K.; Doganay, Z.
Objective: To determine the oxygen reserve index (ORI) as a supporting parameter to the arterial partial oxygen pressure (PaO2) in blood gases in hypoxia and hyperoxia monitoring with different fresh gas flows (FGF) in patients undergoing abdominal surgery. Study Design: Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Samsun Education and Research Hospital, Turkey, from January to September 2020. Methodology: The study population of ninety patients was divided into three groups. After the high-flow period, the inspired oxygen fraction (FiO2) and flow-guided ventilation (FGF) were set to be 4 L/m and 40% in Group H (high-flow), 1 L/m and 50% in Group L (lowflow), and 0.5 L/m and 68% in Group M (minimal-flow), respectively. Results: There was a very high statistically positive correlation between PaO2 and ORI in H, L, and M groups. When using a cut-off value of 0.005 for ORI for the detection of PaO2 >100 mmHg, the area under the curve (AUC) was 0.97 (p<0.001) with a sensitivity of 94.4% and specificity of 95.3%. The AUC was detected to be 0.95 in receiver operating characteristic (ROC) analysis when the hyperoxia cutoff value of ORI was used to determine PaO2 >150 mmHg in the estimation of hyperoxia. Conclusion: ORI can be used to complement SpO(2) in low-flow anaesthesia in patients undergoing abdominal surgeries, provide guidance for PaO2, give information about tissue oxygen delivery, and contribute to the individualisation of oxygen therapy, and will therefore be included in the standard monitoring in the future.
High, Low, and Minimal Flow Anaesthesia Management: Effects on Oxygen Reserve Index and Arterial Partial Oxygen Pressure
(2023) Dastan, R.; Çelik, H.K.; Doganay, Z.
Objective: To determine the oxygen reserve index (ORI) as a supporting parameter to the arterial partial oxygen pressure (PaO2) in blood gases in hypoxia and hyperoxia monitoring with different fresh gas flows (FGF) in patients undergoing abdominal surgery. Study design: Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Samsun Education and Research Hospital, Turkey, from January to September 2020. Methodology: The study population of ninety patients was divided into three groups. After the high-flow period, the inspired oxygen fraction (FiO2) and flow-guided ventilation (FGF) were set to be 4 L/m and 40% in Group H (high-flow), 1 L/m and 50% in Group L (low-flow), and 0.5 L/m and 68% in Group M (minimal-flow), respectively. Results: There was a very high statistically positive correlation between PaO2 and ORI in H, L, and M groups. When using a cut-off value of 0.005 for ORI for the detection of PaO2 >100 mmHg, the area under the curve (AUC) was 0.97 (p<0.001) with a sensitivity of 94.4% and specificity of 95.3%. The AUC was detected to be 0.95 in receiver operating characteristic (ROC) analysis when the hyperoxia cut-off value of ORI was used to determine PaO2 >150 mmHg in the estimation of hyperoxia. Conclusion: ORI can be used to complement SpO2 in low-flow anaesthesia in patients undergoing abdominal surgeries, provide guidance for PaO2, give information about tissue oxygen delivery, and contribute to the individualisation of oxygen therapy, and will therefore be included in the standard monitoring in the future.
The Effects of Propofol and Ketofol on Hemodynamics, End-Tidal Carbon Dioxide, Integrated Pulmonary Index and Recovery in Patients Undergoing Endoscopy and Colonoscopy
(2023.01.01) Askin, A.; Çelik, H.K.; Doganay, Z.
BACKGROUND/AIMS: In this study, we aimed to compare the effects of propofol and ketofol on hemodynamics, end-tidal carbon dioxide (EtCO2), integrated pulmonary index (IPI), peripheral oxygen saturation (SpO(2)) and sedation quality during endoscopy and colonoscopy performed under anesthesia. MATERIALS AND METHODS: One hundred patients aged 18-79 years with American Society of Anesthesiology class I-III were randomly divided into two groups: the propofol group (1%) and the ketofol mixture group (group P and group K, respectively). Sedation was achieved with 0.15 mL/kg doses of both drugs, followed by additional 0.05 mL/kg doses based on the patients' Ramsey Sedation Scores. Before the procedure, the basal values of heart rate (HR), EtCO2, IPI, and SpO(2) were obtained, as well as instantaneous trend data. systolic blood pressure, diastolic blood pressure, and mean blood pressure values were recorded prior to the procedure (baseline values), at the 1st, 5th, 10th, 15th, 25th, 30th minutes, and at the conclusion of the procedure. The duration of anesthesia and the procedure, the amount of propofol administered, the rate of spontaneous eye opening, and recovery parameters were also recorded. RESULTS: The mean blood pressure values at the 1st, 5th, 10th, 15th, 20th minutes, at the end of the intervention, and at the 5th minute after the procedure were found to be higher in group K compared to group P. HR, SpO(2), EtCO2 and IPI values were higher in group K than in group P. Time to spontaneous eye opening was significantly lower in group K compared to group P. In addition, the recovery period during which the modified Aldrete score was >9 did not differ between groups. Additional doses and total propofol consumed during the procedure were significantly lower in group K than in group P. CONCLUSION: Ketofol appears superior to propofol in endoscopic procedures due to its superior hemodynamic and respiratory stability, without affecting recovery time. Incorporating non-invasive EtCO2 and IPI measurements into standard respiratory monitoring equipment improves monitoring quality and facilitates its execution.
Value of integrated pulmonary index monitoring for the detection of adverse respiratory events in patients undergoing sedation for gastrointestinal system endoscopy
(2024.01.01) Celik, H.K.; Doganay, Z.; Askin, A.
Objective: To determine if the integrated pulmonary index detects changes in ventilation status early in patients undergoing gastrointestinal endoscopy under sedation, and to determine the risk factors affecting hypoxia. Method: The retrospective study was conducted at the endoscopy unit of a tertiary university hospital in Turkey and comprised data between October 2018 and December 2019 related to patients of either gender aged >18 years who were assessed as American Society of Anaesthesiologists grade I -III and underwent elective lower and upper gastrointestinal endoscopy. Monitoring was done with capnography in addition to standard procedures. Data was analysed using SPSS 23. Results: Of the 154 patients, 94(%) were females and 60(%) were males. The overall mean age was 50.88 +/- 11.8 years (range: 20-70 years). Mean time under anaesthesia was 23.58 +/- 4.91 minutes and mean endoscopy time was 21.73 +/- 5.06 minutes. During the procedure, hypoxia was observed in 42(27.3%) patients, severe hypoxia in 23(14.9%) and apnoea in 70(45.5%). Mean time between apnoea and hypoxia was 12.59 +/- 7.99 seconds, between apnoea and serious hypoxia 21.07 +/- 17.64 seconds, between integrated pulmonary index score 1 and hypoxia 12.91 +/- 8.17 sec, between integrated pulmonary index score 1 and serious hypoxia 21.59 +/- 14.13 seconds, between integrated pulmonary index score <7 and hypoxia 19.63 +/- 8.89 seconds, between integrated pulmonary index score <7 and serious hypoxia 28.39 +/- 12.66 seconds, between end -tidal carbon dioxide and hypoxia 12.95 +/- 8.33 seconds, and between end -tidal carbon dioxide and serious hypoxia 21.29 +/- 7.55 seconds. With integrated pulmonary index score 1, sensitivity value for predicting hypoxia and severe hypoxia was 88.1% and 95.7%, respectively, and specificity was 67% and 60.3%, respectively. With integrated pulmonary index score <7, the corresponding values were 100%, 100%, 42% and 64.1%, respectively. Conclusion: Capnographic monitoring, especially the follow-up integrated pulmonary index score, was found to be valuable and reliable in terms of finding both time and accuracy of the risk factor in the diagnosis of respiratory events.
Value of integrated pulmonary index monitoring for the detection of adverse respiratory events in patients undergoing sedation for gastrointestinal system endoscopy
(2024) Celik, H.K.; Doganay, Z.; Askin, A.
Objectives: To determine if the integrated pulmonary index detects changes in ventilation status early in patients undergoing gastrointestinal endoscopy under sedation, and to determine the risk factors affecting hypoxia. Methods: The retrospective study was conducted at the endoscopy unit of a tertiary university hospital in Turkey and comprised data between October 2018 and December 2019 related to patients of either gender aged >18 years who were assessed as American Society of Anaesthesiologists grade I-III and underwent elective lower and upper gastrointestinal endoscopy. Monitoring was done with capnography in addition to standard procedures. Data was analysed using SPSS 23. Results: Of the 154 patients, 94(%) were females and 60(%) were males. The overall mean age was 50.88±11.8 years (range: 20-70 years). Mean time under anaesthesia was 23.58±4.91 minutes and mean endoscopy time was 21.73±5.06 minutes. During the procedure, hypoxia was observed in 42(27.3%) patients, severe hypoxia in 23(14.9%) and apnoea in 70(45.5%). Mean time between apnoea and hypoxia was 12.59±7.99 seconds, between apnoea and serious hypoxia 21.07±17.64 seconds, between integrated pulmonary index score 1 and hypoxia 12.91±8.17 sec, between integrated pulmonary index score 1 and serious hypoxia 21.59±14.13 seconds, between integrated pulmonary index score <7 and hypoxia 19.63±8.89 seconds, between integrated pulmonary index score <7 and serious hypoxia 28.39±12.66 seconds, between end-tidal carbon dioxide and hypoxia 12.95±8.33 seconds, and between end-tidal carbon dioxide and serious hypoxia 21.29±7.55 seconds. With integrated pulmonary index score 1, sensitivity value for predicting hypoxia and severe hypoxia was 88.1% and 95.7%, respectively, and specificity was 67% and 60.3%, respectively. With integrated pulmonary index score <7, the corresponding values were 100%, 100%, 42% and 64.1%, respectively. Conclusions: Capnographic monitoring, especially the follow-up integrated pulmonary index score, was found to be valuable and reliable in terms of finding both time and accuracy of the risk factor in the diagnosis of respiratory events.