This study aimed to compare optic nerve sheath diameter (ONSD) measurements obtained during hypercapnic and normocapnic periods in mechanically ventilated patients and to describe changes in ONSD in relation to ventilation-associated carbon dioxide levels. The study included sixty intubated patients admitted to the intensive care unit with a diagnosis of pneumonia and who underwent mechanical ventilation. ONSD measurements were performed during periods of hypercapnia identified during routine monitoring. After adjustment of ventilator settings, arterial blood gas analysis (ABG) was obtained one hour later, and ONSD measurements were repeated when normocapnia was achieved. The mean age of the patients was 61.6 ± 17.9 years. During the hypercapnic period, the mean ONSD (average of both eyes) was 4.88 ± 0.31 mm. Following the achievement of normocapnia, the mean ONSD decreased significantly to 4.61 ± 0.24 mm (p < 0.001). Furthermore, a significant positive correlation was found between the change (∆) in PaCO2 and the reduction in mean ONSD (r = 0.538, p < 0.001). ONSD measurements differed significantly between hypercapnic and normocapnic periods defined by PaCO₂ levels. These findings suggest that ONSD may reflect physiological responses across different ventilatory CO₂ states.

BRASH syndrome is a definition that encompasses complex causes of bradycardia. The use of atrioventricular node blockers, renal failure, hyperkalemia, bradycardia, renal hypoperfusion create a cascade that triggers each other. Additionally, hyperkalemic drugs such as angiotensin converting enzyme inhibitors may aggrevate the clinical condition. This is a clinical condition that can lead to shock and mortality if the diagnosis and mechanism are not considered or overlooked. We presented the BRASH clinic in 84-year-old female patient and discussed the approach. Finally, we created a graphical abstract summarizing this syndrome.

PURPOSE:Neurological injury remains a critical concern in cardiac surgery despite advancements in surgical and anaesthetic techniques. Hypothermia is commonly utilised for neuroprotection during cardiopulmonary bypass (CPB); however, the optimal temperature range remains undetermined. This study evaluates the neuroprotective effectiveness of mild versus moderate hypothermia by assessing neuron-specific enolase (NSE) and S100β levels, near-infrared spectroscopy (NIRS) cerebral oxygenation, and cognitive function in patients undergoing CPB-assisted open-heart surgery. METHODS:Forty elective coronary artery bypass grafting (CABG) patients were randomised to mild (32-34°C, n = 20) or moderate (28-32°C, n = 20) hypothermia groups. Serum NSE and S100β levels were measured preoperatively and at 0, 12, 24, and 48 hours postoperatively. Cerebral oxygenation via NIRS and Mini-Mental State Examination (MMSE) scores were evaluated preoperatively and at 24 and 48 hours postoperatively. This is a single-centre study. The primary outcome was the between-group difference in S100β levels at 24 and 48 hours; all other variables were predefined secondary outcomes. RESULTS:Postoperative NSE levels increased in both groups, with no significant intergroup differences (p > 0.05). However, S100β levels were significantly lower in the moderate hypothermia group at 24 and 48 hours (p = 0.012, p = 0.004). NIRS values and MMSE scores remained comparable between groups (p > 0.05). CONCLUSION:Our findings suggest that moderate hypothermia may offer improved neuroprotection by attenuating S100β release without adversely affecting cerebral oxygenation or cognitive outcomes. Although these results are encouraging, further validation through larger, multicentre studies is warranted before definitive conclusions can be drawn.

Background The aim of this study was to determine the prevalence of frailty using the Clinical Frailty Scale (CFS) in patients admitted to a tertiary intensive care unit (ICU) due to COVID-19 and to evaluate the association between this score and long-term mortality. Methods This single-center, prospective, observational cohort study was conducted at Selçuk University Faculty of Medicine Hospital between January 1 and June 4, 2022, and included 137 patients admitted to the intensive care unit (ICU) with COVID-19. CFS, SOFA and APACHE II scores were evaluated along with demographic, clinical, laboratory and mortality data of the patients. Risk factors associated with six-month mortality were analyzed using multivariate logistic regression. The prognostic performance of the CFS was determined via Receiver Operating Characteristic (ROC) curve analysis. Results The prevalence of clinical frailty was found to be 57.7%. The six-month mortality rate was 68.6%. CFS, SOFA, and APACHE II scores were significantly associated with six-month mortality ( p < 0.001). The AUC value of the CFS in predicting six-month mortality was 0.765, and the optimal cut-off value was identified as 4.5. In addition, albumin, lymphocyte, and platelet levels were higher in survivors, whereas ferritin, CRP/albumin ratio, and procalcitonin levels were found to be higher in non-survivors. Conclusions Clinical Frailty Score is an independent risk factor for predicting long-term mortality in patients with COVID-19.. CFS is a valuable prognostic tool that can be used in addition to classical scoring systems for patient management and resource planning in intensive care units. Trial registration: ClinicalTrials.gov identifier: NCT06330883

Achromobacter xylosoxidans is an emerging opportunistic pathogen increasingly encountered in intensive care units (ICUs). Data on clinical characteristics and factors associated with outcomes remain limited. This study aimed to describe the clinical characteristics and the differences observed between survivors and non-survivors among critically ill patients with A. xylosoxidans bacteremia. This retrospective cohort study included 26 ICU patients with confirmed A. xylosoxidans bacteremia meeting Sepsis-3 criteria. Demographic characteristics, comorbidities, infection sources, disease severity scores (SOFA and APACHE II), and dynamic changes in inflammatory markers (WBC, CRP, and procalcitonin) were analyzed. The mean age was 60.7 ± 14.9 years and the overall mortality rate was 26.9

Background and Objectives: Thoracic trauma usually results in high morbidity and mortality. It is the leading cause of death in patients within the first four decades of life. In this study, we aimed to identify risk factors for intensive care mortality and to evaluate factors affecting clinical outcomes and complications in patients with thoracic trauma who were treated in the intensive care unit (ICU). Materials and Methods: This was a retrospective, single-center study. Patients diagnosed with thoracic trauma and followed up in the ICU between 1 May 2023 and 1 January 2025 were included. Critically ill patients aged 18 years and older whose admission blood values were available and who had undergone radiological imaging were included in the study. Patients were grouped as Survivors or Non-survivors. The primary outcome was to determine risk factors for mortality. The secondary outcome was to evaluate factors affecting clinical outcomes and complications. The tertiary outcome was to determine the predictive value of the Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Glasgow Coma Scale (GCS) for mortality. Results: A total of 104 patients (male/female ratio: 76/28) were included in the study. Twenty-four patients (23.1%) died, and eighty (76.9%) were discharged. Age in the Non-survivor group was found to be significantly higher (59.33 ± 22.21 vs. 40.50 ± 17.71; p < 0.001), and the proportion of women was also significantly higher in the Non-survivor group (p = 0.0082). Mortality was associated with advanced age, female sex, lower GCS score (p < 0.001), higher APACHE II scores (p < 0.001), and the presence of comorbid conditions (p = 0.003), including head trauma (p = 0.024) and cardiac arrest before ICU admission (p = 0.011). The Non-survivor group more frequently required mechanical ventilation (p < 0.001), vasopressor support (p < 0.001), and continuous renal replacement therapy (p < 0.001), and they developed ventilator-associated pneumonia (p < 0.001) and acute respiratory distress syndrome (p < 0.001) at higher rates. ICU length of stay was also significantly longer in the Non-survivor group (p = 0.045). The APACHE II score demonstrated the highest discriminatory performance, emerging as the strongest clinical predictor of mortality (AUC = 0.751, 95% CI: 0.630–0.872; p < 0.001). Age (OR: 1.06) and serum lactate levels (OR: 1.57) consistently emerged as strong independent predictors of mortality. The presence of head trauma significantly increased the risk of mortality, particularly in the APACHE II-adjusted model (OR: 9.08). The APACHE II–based model yielded high specificity (96.3%) and accuracy (88.5%), with good discrimination (AUC = 0.894) and the highest Nagelkerke R2 (0.548). Conclusions: Factors that may shorten the length of ICU stay include infection control, early correction of acidosis, and maintenance of hemodynamic stability, which may reduce mortality. APACHE II was more closely related to overall clinical severity than the other scoring systems. Our data indicate that age-related frailty and acute physiological derangement, as best represented by the APACHE II score, are more significant determinants of survival than anatomic injury severity alone.

Background: The pan-immune-inflammation (PIV) score is a hematological index derived from neutrophil, platelet, monocyte and lymphocyte counts. It has been demonstrated that it has high prognostic value in oncological patients. The aim of this study was to evaluate the association between PIV and 28-day mortality in elderly (≥65 years) critically ill patients admitted to the intensive care unit (ICU) with a diagnosis of sepsis. Methods: This single-centre retrospective study included 96 patients aged ≥65 years who were admitted to the ICU with a diagnosis of sepsis according to the Sepsis-3 criteria between 15 July 2024 and 15 July 2025. Patients were divided into low- and high-PIV groups based on the median PIV. Cox proportional hazards regression analysis and Kaplan-Meier survival analysis were performed. Results: The overall 28-day mortality rate was found to be 55.2% (n = 53). The median PIV was 866.58 (IQR: 497.34-1978.43). The PIV was shown not to be a significant predictor of 28-day mortality (AUC: 0.550; p = 0.400). No difference in survival was observed between the low- and high-PIV groups in the Kaplan-Meier analysis (log-rank p = 0.662). In multivariate Cox regression, high creatinine (HR: 2.683; p < 0.001), high calcium (HR: 2.312; p = 0.004), a low partial thromboplastin time (HR: 0.396; p = 0.005) and a requirement for vasopressors (HR: 2.225; p = 0.025) were identified as independent predictors of mortality. In the Kaplan-Meier analysis for 28-day survival, chronic obstructive pulmonary disease (p = 0.023) and chronic renal disease (p = 0.034) were found to be significantly associated with poorer survival. Conclusions: The PIV is unable to predict 28-day mortality in elderly critically ill patients diagnosed with sepsis. This finding suggests that immunosenescence and inflammaging reduce the predictive power of composite hematological indices. Markers of organ dysfunction, coagulopathy and hemodynamic instability remain more reliable prognostic indicators in geriatric patients with sepsis.

Introduction:Previous studies have reported that diaphragm atrophy and dysfunction might occur during mechanical ventilation (MV), but the frequency, effect on mortality, underlying causes and functional outcomes of diaphragm and lung parenchymal changes during routine MV have not yet been fully understood. Materials and Methods:The lung parenchyma and diaphragm of 50 patients were investigated using ultrasound (USG) on day 1, 5, and 10 of MV therapy. Result:Mean age of the patients was 64.90 ± 15.96 years. Mean MV duration was 90.18 ± 21.09 days. Mean thickening fraction (TFdi) on day 1, 5, and 10 was 40.77 ± 15.42, 39.85 ± 16.85, and 43.57 ± 19.10, respectively. Mean diaphragm amplitude on day 1, 5, and 10 was 1.70 ± 0.74, 1.76 ± 0.74, and 1.70 ± 0.71, respectively. Mean diaphragmatic thickness at the end of expiration (Tde) on day 1, 5, and 10 was 0.18 ± 0.08, 0.17 ± 0.06, and 0.16 ± 0.05, respectively. There was no significant change between measurement days by TFdi, diaphragmatic amplitude (DA), and Tde values. On admission, TFdi was less than 20% in 8% of the patients, DA was less than 1 cm in 12%, and Tfde was less than 0.2 cm in 52%. There was no significant difference by the TFdi, DA and lung ultrasonography (LUS) scores of the non-surviving and surviving patients. An analysis of imaging results and LUS scores indicated that LUS values were measured higher in patients with infiltration on chest radiography. In addition, LUS scores significantly decreased from day 1 to day 5 and day 10, and from day 5 to day 10. Conclusions:Diaphragm dysfunction may occur as a result of MV therapy or associated with an inflammatory process, including sepsis. Assessment of diaphragmatic function by USG on admission to the intensive care unit may help to better recognize and manage diaphragmatic dysfunction. LUS provides information about the lung parenchyma as important as chest X-ray and facilitates bedside patient evaluation.

Background: The aim of the present study was to evaluate the effect of second-hand smoke (SHS) and third-hand smoke (THS) on the incidence of postoperative emergence agitation (EA) in children. Methods: Six hundred children between the ages of 2- 12 were enrolled in this prospective cohort trial. The children were divided into three groups. Group I (Non-smoker; Children whose parents do not smoke and who are not regularly exposed to smoking environments), Group II (Second-hand smoker; Children whose parents smoke in their vicinity, causing them to inhale sidestream or mainstream smoke involuntarily), Group III (Third-hand smoker; Children exposed to pollutants from smoking parents via inhalation, ingestion or dermal contact, despite not directly inhaling sidestream or mainstream smoke). Emergence agitation, postoperative pain, shivering, nausea and vomiting were evaluated in the postanesthesia care unit. Watcha scale was used in the evaluation of emergence agitation. Results: In total, five hundred eighty-six patients completed the study, and the incidence of emergence agitation was higher in Group II (32.7%) and Group III (33.7%) compared to Group I (15.0%) (p < 0.001). The incidence of emergence agitation was dramatically increased in Group II and Group III compared to Group I (32.7% vs . 15.0%; odds ratio (95% confidence interval): 2.74 (1.68-4.48); p = 0.0001, and 33.7% vs . 15.0%; odds ratio (95% confidence interval): 2.87 (1.76-4.70); p < 0.0001, respectively). There was no difference between the groups in terms of postoperative pain, shivering, nausea and vomiting evaluated in the postanesthesia care unit. Conclusions: In conclusion, the results of the present study revealed that SHS and THS significantly increase the incidence of EA in children.

Aim: To compare the success rates and postoperative pain levels of caudal epidural block (CB) applications using ultrasound-guided out-of-plane technique and in-plane techniques in pediatric hypospadias surgery. Methods: One hundred sixty-two patients who underwent pediatric hypospadias surgery were randomized to either the in-plane or out-of-plane ultrasound-guided CB. The primary outcome was the success rate of CB. Secondary outcomes included postoperative pain levels (FLACC score), the first analgesia requirement time, the total amount of paracetamol consumption, and complications. Procedural data were collected by blinded observers. Results: There were differences in the primary outcome of the number of needle attempts 87.8% vs. 56.3%, p

Aim: The aim of the study was to determine the potential drug drug interactions of patients receiving inpatient treatment in the intensive care unit and infectious diseases ward and using quinolone group antibiotics by using different interaction software programs.Material and Methods: The prescriptions of 100 patients who received inpatient treatment in infectious diseases service and intensive care unit at Selçuk University Faculty of Medicine Hospital between January 2022 and December 2022 and who were treated with quinolone group antibiotics during treatment were analyzed retrospectively.Results: Of the patients included in the study, 62 were male and 38 were female. The mean age of men was 65.76 ± 16.22 years, while the mean age of women was 68.63 ± 16.29 years. While Medscape® detected a total of 1776 interactions, this number was 1432 in Lexicomp® and 1693 in Drugs®.While 0.33% of the interactions detected in the Medscape® software program were contraindicated, 3.77% of the interactions were contraindicated in Lexicomp®. Kendall W coefficient 0.94, Chi-Square test 281.12, p <0.001 were found to be statistically significant. The software programs used to detect pDDIs are highly compatible with each other. Conclusion: High agreement was found between software programs used to detect potential drug-drug interactions. Interaction classifications between software programs are different. Therefore, clinicians may benefit from different software programs.

Abstract Background/Aims: This study aims to compare the reliability of the FOUR (Full Outline of Unresponsiveness) score and GCS (Glasgow Coma Score) when used by specialists from different medical disciplines. Methods: This prospective observational study was conducted at Selçuk University Faculty of Medicine between December 2023 and June 2024. Eighty-two patients in the Anesthesiology and Reanimation Intensive Care Unit (ICU) were assessed by three specialists—a pulmonologist, a neurologist, and an anesthesiologist—within 24 hours of ICU admission. The variation between evaluators of both scoring systems was analyzed using the Intraclass Correlation Coefficient (ICC). If the ICC coefficient was below 0.50, the agreement was interpreted as poor. Results: The study included 82 patients. There were no statistically significant differences in the FOUR and GCS scores assigned by the three specialists. The mortality rate among patients with low scores on both FOUR and GCS was higher than the hospital mortality rate. Conclusions: Scales used in the ICU should be simple, reliable and predictive. This study demonstrated that the FOUR score is at minimum equivalent to the GCS in meeting these criteria.

BACKGROUND: Interferon gamma release assay (IGRA) is an in vitro blood test to measure interferon gamma (IFN-gamma) released from antigen-specific T cells after stimulation with pathogen-specific peptides. In this study, it was aimed to investigate the T-cell response using IGRA and to compare various laboratory values in Coronavirus Disease (COVID-19) patients hospitalized either in hospital inpatient departments or in intensive care units. METHODS: A total of 100 patients (50+50) who were identified as positive for COVID-19 through the molecular method in Selcuk University Faculty of Medicine Infectious Diseases Service and Reanimation Intensive Care Unit were included in the study. IFN-gamma levels in blood samples collected from patients were determined using the QuantiFERON Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) (QIAGEN, Germany) kit. The patients' gender, age, c-reactive protein (CRP), aspartate aminotransferase (AST), alanine transaminase (ALT), interleukin (IL)-6, lymphocyte count, procalcitonin, and D-dimer results were obtained from the hospital automation system. RESULTS: Thirty-eight of the IGRA test results were negative, 44 were positive and 18 were inconclusive. The age of patients with negative IGRA test results was significantly higher (p<0.001) compared to patients with positive results. There were no significant differences between patients' IGRA test results and gender, prognosis, IL-6, lymphocyte counts, CRP, AST, and ALT values. Age, death rates, D-dimer, CRP, procalcitonin, AST and ALT values of patients hospitalized in the intensive care unit were significantly higher (p<0.001) compared to the those hospitalized in the inpatient department, while conversely, the lymphocyte values were lower (p<0.001). CONCLUSION: The relatively higher IGRA negative results in the elderly, negative and intermediate results in intensive-care patients, and low lymphocyte levels in intensive-care patients indicate that the cellular immune response is diminished and/or absent. The death rates, D-dimer, CRP, procalcitonin, AST and ALT values of the patients hospitalized in the intensive care unit were higher compared to those from the in-patient department, indicating the severity of inflammation and signaling the development of organ failure. In the light of these findings, we suggest that IGRA tests may serve as a guide in immunomodulatory therapy (Tab. 2, Fig. 2, Ref. 27). Text in PDF www.elis.sk

Aim: Thrombocytopenia is common in intensive care units (ICU) and is associated with high mortality. The aim of this study aimed to determine the incidence of thrombocytopenia in patients diagnosed with sepsis and its relationship with mortality and morbidity. Materials and Methods: This study was conducted in the reanimation ICU of a university hospital. Patients followed and diagnosed with sepsis between January 2014 and January 2018 were collected and the recorded data analyzed retrospectively. Demographic data, comorbidities, disease severity scores, hematological laboratory values, and outcome were recorded. Thrombocytopenia was defined as the platelet count to be less than 100x103/mu L. Patients were divided into two groups as with or without thrombocytopenia, and statistical analysis was performed.Results: The number of patients followed with the diagnosis of sepsis was 299. The median age of the patients was 68 years, and 62.9% (n=188) was male. The rate of invasive mechanical ventilation was 97.7%. Thrombocytopenia was detected in 36.8% of the patients. The Sequential Organ Failure Assessment score was higher in the thrombocytopenia group (p<0.0001). Additionally, the rate of acute renal failure was 24.1%, which was higher in the thrombocytopenia group (p=0.011). In the thrombocytopenia group, the blood product transfusion rates were higher (p=0.004). Median ICU hospitalization time was 15 (6-28) days. While the total mortality of sepsis patients was 43.1%, this rate was higher in the thrombocytopenia group (p=0.011).Conclusion: Thrombocytopenia, which is commonly seen in ICU's and especially in the septic patients, is thought to be associated with mortality and morbidity.

Obesity has become a serious problem not only in adult patients but also in pediatric patients. To evaluate whether obesity affects the recovery profile after general anesthesia in children. 40 children (aged 2–12 years) who underwent surgery under general anesthesia and had an American Society of Anesthesiologists (ASA) physical I and II. This prospective cohort study was conducted over a period of 3 months (January–April, 2021). The patients were divided into two groups according to body mass index (BMI): Group I comprised obese children (BMI ≥95th for age percentile) (n=20) and Group II comprised children with a normal BMI (25–75th for-age percentile) (n=20). Anesthesia induction and maintenance were performed as per standard guidelines in both the groups. The recovery profile was evaluated with the following parameters: time to spontaneous ventilation, laryngeal mask airway removal time, time to open eyes, and post-anesthesia care unit discharge time. When the recovery profiles were compared, no significant differences were found between the groups. Time to spontaneous ventilation [mean difference (95

Objectives: Inguinal hernia repair is one of the most common daily surgeries performed in pediatrics.This prospective randomized clinical trial aims to compare ultrasound (USG)-guided ilioinguinal/iliohypogastric (IL/IH) nerve block and pre-incisional wound infiltration (PWI) in terms of post-operative analgesia on pediatric unilateral inguinal hernia repair.Methods: After receiving ethics committee approval, 65 children aged 1-6 years who had unilateral inguinal hernia repair were allocated to USG-guided IL/IH nerve block (group IL/IH, n=32) and (group PWI, n=33).In both groups, 0.5 mg/kg 0.25% bupivacaine+2% prilocaine mixture was used by calculating the volume as 0.5 mL/kg for the block and infiltration.The primary outcome was to compare both groups' post-operative Face, Legs, Activity, Cry and Consolability (FLACC) scores.The secondary outcomes included the time to first analgesic request and the total acetaminophen consumption. Results:The FLACC pain scores at the 1 st , 3 rd , 6 th , and 12 th h were statistically significantly lower in group IL/IH than in group PWI (p=0.013,p<0.001, p<0.001, and p=0.037, respectively) (p<0.001).There was no difference between the groups at the 10 th and 30 th min and at 24 h (p=0.472,p=0.586, and p=0.419, respectively) (p>0.05).Conclusion: USG-guided IL/IH nerve block in pediatric patients with inguinal hernia repair was found to be superior to PWI in terms of lower pain scores, less additional analgesia requirement, and longer first analgesia requirement.

Aim: The aim of the present study is to compare the laboratory findings during the palliative care unit (PCU) admission of non-geriatric and geriatric patients and to evaluate the effects of these findings. Methods: In the present study medical records of the patients hospitalized in PCU between 18.10.2018-18.10.2020 were reviewed. The patients were evaluated in 2 groups: Group I; 65 years and older and Group II; 18-64 years old. Demographic data and laboratory values of the patients (C-reactive protein, glucose, urea, creatinine, sodium, potassium, albumin, mean platelet volume and platelet, lymphocyte, neutrophil counts) were recorded. From these values, CRP/albumin, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were calculated. Length of stay and mortality were also recorded. Results: A total of 454 patients (Group I: 249 and Group II: 205) were included in the study. Blood glucose, urea, creatinine and sodium values were found to be statistically higher in Group I (p=0.027, p

Aim: The steep Trendelenburg position is frequently used in laparoscopy to improve the surgical image.However, this positioning combined with pneumoperitoneum raises concerns especially in relation to cerebral hemodynamic physiology.In this study, we aimed to evaluate the effects of pneumoperitoneum and steep Trendelenburg position, applied in laparoscopic gynecological surgeries on cerebral venous return, with changes in internal jugular vein (IJV) blood flow.Material and Methods: Twenty patients who underwent laparoscopic gynecological surgery under general anesthesia were included in the study.IJV crosssectional area (CSA) and Doppler flow velocity were measured with an ultrasonography device at the end of inspiration.IJV blood flow (ml/min) was calculated with the formula of cross-sectional area (cm²) × Doppler flow velocity (cm/sec) × 60.The first measurement was performed in the supine position immediately after endotracheal intubation.The second measurement was performed 1 hour after applying pneumoperitoneum and 25° Trendelenburg position.Results: In the steep Trendelenburg position, there was a significant increase in right and left IJV CSA (p = 0.001; p = 0.038) and blood flow (p = 0.005; p = 0.039), while no significant difference was observed in Doppler flow rate.In the supine position, the right IJV CSA and blood flow were significantly greater than the left IJV CSA and blood flow (p = 0.015 and p = 0.017).Discussion: The steep Trendelenburg position and pneumoperitoneum in laparoscopic gynecological surgeries caused an increase in bilateral IJV blood flow to raise cerebral venous drainage.

Background/Aims: The importance of pediatric palliative care centers, which we think is insufficient both in the world and in our country, is increasing. The aim of this study is to reveal the demographic, clinical and laboratory characteristics of pediatric patients followed in a palliative care center. Methods: In this retrospective study, demographic data (age, gender), laboratory findings (platelet, mean platelet volume, lymphocyte, neutrophil counts, glucose, sodium, potassium, urea) of pediatric patients followed up in an adult palliative care center between 18.10.2018 and 15.01.2023, creatinine, albumin and the C-reactive protein, CRP/albumin ratio, platelet/lymphocyte ratio and neutrophil/lymphocyte ratio) and clinical features (length of stay in PCU and survival) were evaluated. Results: It was determined that 61 pediatric patients between the ages of 2-17 were followed up in the palliative care center between 18 October 2018 and 15 January 2023. 65.6% of the patients were male and 6.6% were Syrian citizens. The duration of stay in the palliative care center was between 1-64 days. While 16.4% of the patients had tracheostomy, 14.8% needed home mechanical ventilator. Only 3 (4.9%) patients received parenteral nutrition. The diagnosis of admission to the palliative care center of 47 (77.0%) patients included in the study had neurological sequelae after head trauma. The mortality rate was 1.6%. Conclusions: It is obvious that the centers are insufficient in the face of the increasing need for pediatric palliative care. Although adult palliative care centers are compensating for this deficiency at this stage, it is clearly seen that the number of pediatric palliative care centers should be increased in the future.

PURPOSE:The effects of the 5-hydroxytryptamine (5-HT3) receptor antagonists on regional anaesthesia are complex and unclear. The present study was designed to test the hypothesis that granisetron, a selective 5-HT3 receptor antagonist, would decrease the duration of motor block, sensory block, and proprioception in a dose-dependent fashion in a rat model of bupivacaine-induced sciatic nerve blockade. MATERIALS AND METHODS:Thirty-eight male Wistar Albino rats that received unilateral sciatic nerve blocks were randomly divided into five experimental groups. Group B received a perineural of 0.3 ml of bupivacaine alone; Group BG800 received perineural 0.3 ml of bupivacaine and 800 µg of granisetron 10 min later; Group BG1200 received perineural 0.3 ml of bupivacaine and 1200 µg of granisetron 10 min later; Group BG1200IP received a perineural 0.3 ml of bupivacaine and an intraperitoneal injection of 1200 µg of granisetron 10 min later; and Group S was sham operated. A blinded investigator assessed motor, sensory and proprioception function every 10 min until the return of normal function. RESULTS:The medians for recovery times in Group B, Group BG800, Group BG1200, and Group BG1200IP were 105, 64, 85, and 120 min for motor function, respectively; 80, 64, 84, and 104 min for sensory function; 80, 63, 85, and 108 min were calculated for the proprioception function. The time to the return of normal motor, sensory, and proprioception function was not statistically significantly different between the groups (p > 0.05). Motor block did not develop in any of the rats in Group S. CONCLUSIONS:Local and systemic application of granisetron was not significantly decrease the duration of bupivacaine induced motor, sensory, and proprioception block of sciatic nerve in rat.