Filiz Coskun | Istanbul University (original) (raw)
Papers by Filiz Coskun
Cardiology in the Young, 2021
Objective: The aim of this study is to report on the short-term and mid-term outcomes of preterm ... more Objective: The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy. Methods: Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery. Results: During the operation, the median weight of the patients was 900 g (IQR 800–1125 g), the median age was 21 days (IQR 14.5–29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus t...
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2017
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2016
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Journal of Cardiac Surgery, 2013
This study evaluated the outcomes of patients undergoing surgical repair of isolated ventricular ... more This study evaluated the outcomes of patients undergoing surgical repair of isolated ventricular septal defect (VSD) in the first year of life with particular attention to age and severity of pulmonary hypertension (PH). Between July 1, 2002 and May 31, 2012, 282 patients aged less than one year underwent isolated VSD closure at a median age of five months (range, 21 days to 1 year) and a median weight of 5.3 kg (range, 2.9 to 12.5 kg). Patients were divided into three groups according to the age at surgery (0-3, 3-6, and 6-12 months), and groups were compared in regard to severity of PH associated with morbidity and mortality. Four (1.4%) early and four (1.4%) late deaths occurred postoperatively. All mortalities were patients with severe PH, aged between 3 and 12 months. Although hemodynamic studies revealed a higher incidence of persistent postoperative PH in patients above three months of age, there was no statistically significant difference in morbidity associated with prolonged mechanical ventilation, and long intensive care unit and hospital stays between age-related groups. In this study, the incidence of mortality was higher in patients over three months of age undergoing repair of isolated VSD; the data suggest that the mortality may be decreased in patients with severe PH who were operated on earlier in life. We conclude that in infants with severe PH, early surgical repair (less than three months) of isolated VSDs is strongly advised to achieve more favorable results.
Journal of Hospital Infection, 2001
Cases of ventilator-associated pneumonia (VAP) were investigated in a cardiothoracic surgery post... more Cases of ventilator-associated pneumonia (VAP) were investigated in a cardiothoracic surgery postoperative intensive care unit between 1 January 1999 and 31 December 1999. A total of 1716 patients who had undergone cardiothoracic operations and admitted to the intensive care unit (ICU) were included in the study. Patient- and laboratory-based prospective surveillance of VAP was done along with other hospital-acquired infections. During the study period a total of 26 585 patient-days with 2708 ventilator-days were recorded. Forty-six cases of VAP occurred in 36 of 1716 patients who had undergone cardiothoracic operations (2.09%, 1.3 episodes of pneumonia per patient). The ventilator utilization rate at our institution was 0.10. There were 16.4 VAPs per 1000 ventilation days. Thirty-eight percent of VAP were caused by Gram-negative enteric rods, 34% by Pseudomonas aeruginosa, and 17% by Staphylococcus aureus. VAP was polymicrobial in 9% of cases. No causative micro-organism was identified in 2% of cases. The same bacteria were isolated in both blood and endotracheal aspirate cultures in 10 of 46 pneumonia cases (22%). The crude mortality rate of VAP was calculated as 30%
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazol... more Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazolam/deksketoprofen trometamolün postoperatif ağrı, sedasyon, ekstübasyon süresi ve hemodinami üzerine etkilerinin karşılaştırılarak erken postoperatif dönemde en etkin analjezi ve sedasyon yönteminin belirlenmesi hedeflenmiştir.
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Amaç: Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve m... more Amaç: Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazolam/deksketoprofen trometamolün postoperatif ağrı, sedasyon, ekstübasyon süresi ve hemodinami üzerine etkilerinin karşılaştırılarak erken postoperatif dönemde en etkin analjezi ve sedasyon yönteminin belirlenmesi hedeflenmiştir. Gereç ve Yöntem: Çalışmamıza kalp cerrahisi uygulanmış toplam 75 hasta alındı. Grup I: Deksketoprofen trometamol +Midazolam (n: 25), Grup II: Fentanil+ Midazolam (n: 25) ve Grup III: Deksmedetomidin (n: 25) olarak ayrıldı. Grup I'e midazolam 0.03 mg/kg/sa ve deksketoprofen trometamol 25-50 mg, Grup II'ye midazolam 0.03 mg/kg/sa ve fentanil 2 mcgr/kg/sa, Grup III'e deksmedetomidin HCL 0,3-0,5 mcg/kg/sa infüzyonu verildi. Hastaların kalp atım hızı (KAH), ortalama arteriyel kan basıncı (OAB), arteriyel kan gazı değerleri kaydedildi. Postoperatif ağrı değerlendirilmesi görsel (Visuel Analog Skalası-VAS), postoperatif sedasyon değerlendirilmesi Ramsay Sedasyon Skalası (RSS) ile yapıldı. Hastaların ekstübasyon ve postoperatif yoğun bakımda ve hastanede kalış süreleri kaydedildi. Bulgular: Grupların ekstübasyon süreleri, yoğun bakımda kalış ve hastanede yatış süreleri arasında anlamlı farklılık görülmedi. VAS değerlendirilmesinde ekstübasyondan 30 dk. sonra (T4) ve 4 saat sonra (T5) anlamlı farklılık bulunmadı. Postoperatif yoğun bakıma geliş döneminde (T0) değerlendirilen RSS skorları anlamlı farklılık gösterdi (p<0.01). Grup I ve Grup II T2 ve T3 RSS skorlarının Grup III'den anlamlı yüksek olduğu saptandı (p=0.001; p=0.001). Sonuç: Deksmedetomidinin kalp cerrahisi sonrası RSS skorundaki anlamlı fark ile postoperatif solunumu deprese edici etkisi olmadan sedasyon sağlaması, analjezik etkisi ile postoperatif sedasyon ve analjezide midazolam/fentanil ve midazolam/ deksketoprofen trometamole göre daha uygun bir ajan olduğu düşünmekteyiz. Anahtar kelimeler: kalp cerrahisi, postoperatif sedasyon, analjezi, deksmedetomidin fentanil, deksketoprofen trometamol, midazolam SUMMARY Sedation and Analgesia After Cardiac Surgery: Comparison of Dexmedetomidine, Midazolam/Fentanyl and Midazolam/ Dexketoprofen Trometamol Objective: In our study we aimed to determine most effective analgesic and sedative method in the early postoperative period by comparing dexmedetomidine,midazolam/fentanyl and midazolam/dexketoprofen trometamol as for their effects on postoperative pain, sedation, extubation time and hemodynamic parameters. Material and Methods: A total of 75 patients who had cardiac surgery included in our study. Patients were grouped as Group I: midazolam/dexketoprofen trometamol (n: 25) Group II: midazolam /fentanyl (n: 25) and Group III: dexmedetomidine (n: 25).Infusions of midazolam 0.03 mcg/kg/h and dexketoprofen 25-50 mg for Group I, midazolam 0.03 mcg/kg/h and fentanyl 2 mcg/kg/h for Group II and dexmedetomidine 0.3-0.5 mcg/ kg/h for group III were applied. Heart rate, mean arterial blood pressure, arterial blood gas values were recorded, and evaluation of postoperative pain was performed using visual analog scale (VAS) and postoperative sedation was evaluated by Ramsay sedation scale (RSS). In addition, periods of extubation, postoperative intensive care unit and hospitalization were recorded. Results: There was no significant difference between groups as for their periods of extubation, postoperative intensive care unit, and hospitalization (p>0,05). Also there was no significant difference between VAS scores at 30 minutes (T4) and 4 hours (T5) after extubation (p>0,05). Significantly different RSS scores were detected between groups at their first admission into intensive care unit (T0) (p<0,01).We also found that in Groups I and II, T2 and T3 RSS scores were significantly higher than Group III series (p= 0,001, p= 0,001 respectively). Conclusion: After cardiac surgery thanks to its significantly different RSS scores, sedative and analgesic effect without postoperative respiratory depression dexmedetomidine is more appropriate agent than midazolam/ fentanyl and midazolam/ dexketoprofen trometamol for postoperative sedation and analgesia.
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Indian Heart Journal, 2014
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Cardiology in the Young, 2021
Objective: The aim of this study is to report on the short-term and mid-term outcomes of preterm ... more Objective: The aim of this study is to report on the short-term and mid-term outcomes of preterm infants who underwent patent ductus arteriosus ligation through anterior mini-thoracotomy. Methods: Data for 103 preterm infants who underwent patent ductus arteriosus clipping through an anterior mini-thoracotomy at the 2nd intercostal space between 2009 and 2019 were retrospectively reviewed. The patients were divided into two groups according to their weight at the time of surgery. The complications, morbidity, and mortality rates of each group were compared at postoperative day 30 and at the end of 1 year after surgery. Results: During the operation, the median weight of the patients was 900 g (IQR 800–1125 g), the median age was 21 days (IQR 14.5–29 days). The lowest body weight was 460 g. In three patients (3%), there was intraoperative bleeding from the patent ductus arteriosus that required transition to median sternotomy. In one patient (1%) a residual patent ductus arteriosus t...
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2017
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2016
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Journal of Cardiac Surgery, 2013
This study evaluated the outcomes of patients undergoing surgical repair of isolated ventricular ... more This study evaluated the outcomes of patients undergoing surgical repair of isolated ventricular septal defect (VSD) in the first year of life with particular attention to age and severity of pulmonary hypertension (PH). Between July 1, 2002 and May 31, 2012, 282 patients aged less than one year underwent isolated VSD closure at a median age of five months (range, 21 days to 1 year) and a median weight of 5.3 kg (range, 2.9 to 12.5 kg). Patients were divided into three groups according to the age at surgery (0-3, 3-6, and 6-12 months), and groups were compared in regard to severity of PH associated with morbidity and mortality. Four (1.4%) early and four (1.4%) late deaths occurred postoperatively. All mortalities were patients with severe PH, aged between 3 and 12 months. Although hemodynamic studies revealed a higher incidence of persistent postoperative PH in patients above three months of age, there was no statistically significant difference in morbidity associated with prolonged mechanical ventilation, and long intensive care unit and hospital stays between age-related groups. In this study, the incidence of mortality was higher in patients over three months of age undergoing repair of isolated VSD; the data suggest that the mortality may be decreased in patients with severe PH who were operated on earlier in life. We conclude that in infants with severe PH, early surgical repair (less than three months) of isolated VSDs is strongly advised to achieve more favorable results.
Journal of Hospital Infection, 2001
Cases of ventilator-associated pneumonia (VAP) were investigated in a cardiothoracic surgery post... more Cases of ventilator-associated pneumonia (VAP) were investigated in a cardiothoracic surgery postoperative intensive care unit between 1 January 1999 and 31 December 1999. A total of 1716 patients who had undergone cardiothoracic operations and admitted to the intensive care unit (ICU) were included in the study. Patient- and laboratory-based prospective surveillance of VAP was done along with other hospital-acquired infections. During the study period a total of 26 585 patient-days with 2708 ventilator-days were recorded. Forty-six cases of VAP occurred in 36 of 1716 patients who had undergone cardiothoracic operations (2.09%, 1.3 episodes of pneumonia per patient). The ventilator utilization rate at our institution was 0.10. There were 16.4 VAPs per 1000 ventilation days. Thirty-eight percent of VAP were caused by Gram-negative enteric rods, 34% by Pseudomonas aeruginosa, and 17% by Staphylococcus aureus. VAP was polymicrobial in 9% of cases. No causative micro-organism was identified in 2% of cases. The same bacteria were isolated in both blood and endotracheal aspirate cultures in 10 of 46 pneumonia cases (22%). The crude mortality rate of VAP was calculated as 30%
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazol... more Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazolam/deksketoprofen trometamolün postoperatif ağrı, sedasyon, ekstübasyon süresi ve hemodinami üzerine etkilerinin karşılaştırılarak erken postoperatif dönemde en etkin analjezi ve sedasyon yönteminin belirlenmesi hedeflenmiştir.
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Amaç: Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve m... more Amaç: Çalışmamızda kalp cerrahisi uygulanan hastalarda deksmedetomidin, midazolam / fentanil ve midazolam/deksketoprofen trometamolün postoperatif ağrı, sedasyon, ekstübasyon süresi ve hemodinami üzerine etkilerinin karşılaştırılarak erken postoperatif dönemde en etkin analjezi ve sedasyon yönteminin belirlenmesi hedeflenmiştir. Gereç ve Yöntem: Çalışmamıza kalp cerrahisi uygulanmış toplam 75 hasta alındı. Grup I: Deksketoprofen trometamol +Midazolam (n: 25), Grup II: Fentanil+ Midazolam (n: 25) ve Grup III: Deksmedetomidin (n: 25) olarak ayrıldı. Grup I'e midazolam 0.03 mg/kg/sa ve deksketoprofen trometamol 25-50 mg, Grup II'ye midazolam 0.03 mg/kg/sa ve fentanil 2 mcgr/kg/sa, Grup III'e deksmedetomidin HCL 0,3-0,5 mcg/kg/sa infüzyonu verildi. Hastaların kalp atım hızı (KAH), ortalama arteriyel kan basıncı (OAB), arteriyel kan gazı değerleri kaydedildi. Postoperatif ağrı değerlendirilmesi görsel (Visuel Analog Skalası-VAS), postoperatif sedasyon değerlendirilmesi Ramsay Sedasyon Skalası (RSS) ile yapıldı. Hastaların ekstübasyon ve postoperatif yoğun bakımda ve hastanede kalış süreleri kaydedildi. Bulgular: Grupların ekstübasyon süreleri, yoğun bakımda kalış ve hastanede yatış süreleri arasında anlamlı farklılık görülmedi. VAS değerlendirilmesinde ekstübasyondan 30 dk. sonra (T4) ve 4 saat sonra (T5) anlamlı farklılık bulunmadı. Postoperatif yoğun bakıma geliş döneminde (T0) değerlendirilen RSS skorları anlamlı farklılık gösterdi (p<0.01). Grup I ve Grup II T2 ve T3 RSS skorlarının Grup III'den anlamlı yüksek olduğu saptandı (p=0.001; p=0.001). Sonuç: Deksmedetomidinin kalp cerrahisi sonrası RSS skorundaki anlamlı fark ile postoperatif solunumu deprese edici etkisi olmadan sedasyon sağlaması, analjezik etkisi ile postoperatif sedasyon ve analjezide midazolam/fentanil ve midazolam/ deksketoprofen trometamole göre daha uygun bir ajan olduğu düşünmekteyiz. Anahtar kelimeler: kalp cerrahisi, postoperatif sedasyon, analjezi, deksmedetomidin fentanil, deksketoprofen trometamol, midazolam SUMMARY Sedation and Analgesia After Cardiac Surgery: Comparison of Dexmedetomidine, Midazolam/Fentanyl and Midazolam/ Dexketoprofen Trometamol Objective: In our study we aimed to determine most effective analgesic and sedative method in the early postoperative period by comparing dexmedetomidine,midazolam/fentanyl and midazolam/dexketoprofen trometamol as for their effects on postoperative pain, sedation, extubation time and hemodynamic parameters. Material and Methods: A total of 75 patients who had cardiac surgery included in our study. Patients were grouped as Group I: midazolam/dexketoprofen trometamol (n: 25) Group II: midazolam /fentanyl (n: 25) and Group III: dexmedetomidine (n: 25).Infusions of midazolam 0.03 mcg/kg/h and dexketoprofen 25-50 mg for Group I, midazolam 0.03 mcg/kg/h and fentanyl 2 mcg/kg/h for Group II and dexmedetomidine 0.3-0.5 mcg/ kg/h for group III were applied. Heart rate, mean arterial blood pressure, arterial blood gas values were recorded, and evaluation of postoperative pain was performed using visual analog scale (VAS) and postoperative sedation was evaluated by Ramsay sedation scale (RSS). In addition, periods of extubation, postoperative intensive care unit and hospitalization were recorded. Results: There was no significant difference between groups as for their periods of extubation, postoperative intensive care unit, and hospitalization (p>0,05). Also there was no significant difference between VAS scores at 30 minutes (T4) and 4 hours (T5) after extubation (p>0,05). Significantly different RSS scores were detected between groups at their first admission into intensive care unit (T0) (p<0,01).We also found that in Groups I and II, T2 and T3 RSS scores were significantly higher than Group III series (p= 0,001, p= 0,001 respectively). Conclusion: After cardiac surgery thanks to its significantly different RSS scores, sedative and analgesic effect without postoperative respiratory depression dexmedetomidine is more appropriate agent than midazolam/ fentanyl and midazolam/ dexketoprofen trometamol for postoperative sedation and analgesia.
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014
Indian Heart Journal, 2014
Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society, 2014