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    A view on pediatric airway management: a cross sectional survey study
    (Edizioni Minerva Medica, 2022) Saracoğlu, Ayten; Saraçoğlu, Kemal Tolga; Sorbello, Massimiliano; Kurdi, Raghad; Greif, Robert; Abitağaoğlu, Süheyla; Akın, Mine
    BACKGROUND: This survey aimed to investigate routine practices and approaches of clinicians on pediatric airway in anesthesia and intensive care medicine. METHODS: A 20-question multiple-choice questionnaire with the possibility to provide open text answers was developed and sent. The survey was sent to the members of European Airway Management Society via a web-based platform. Responses were analyzed thematically. Only the answers from one representative of the pediatric service of each hospital was included into the analysis. RESULTS: Among the members, 143 physicians responded the survey, being anesthesiologists (83.2%), intensivists (11.9%), emergency medicine physicians (2.1%), and (2.8%) pain medicine practitioners. Astraight blade was preferred by 115 participants (80.4%) in newborns, whereas in infants 86 (60.1%) indicated a curved blade and 55 (38.5%) a straight blade. Uncuffed tracheal tube were preferred by 115 participants (80.4%) in newborns, whereas 24 (16.8%) used cuffed tubes. Approximately 2/3 of the participants (89, 62.2%) reported not to use routinely a cuff manometer in their clinical practice, whereas 54 participants (37.8%) use it routinely in pediatric patients. Direct laryngoscopy for routine pediatric tracheal intubation was reported by 127 participants (88.8%), while 16 (11.2%) reported using videolaryngoscopes routinely. Interestingly, 39 (27.3%) had never performed neither videolaryngoscopy nor flexible bronchoscopy in children. These results were significantly less in hospitals with a dedicated pediatric anesthesiologist. CONCLUSIONS: This survey on airway management in pediatric anesthesia revealed that the use of cuffed tubes and the routine monitoring of cuff pressure are rare. In addition, the rate of videolaryngoscopy or flexible optical intubation was low for expected difficult intubation. Our survey highlights the need for properly trained pediatric anesthesiologists working in-line with updated scientific evidence. © 2022 Edizioni Minerva Medica. All rights reserved.
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    Comparison of piperacillin-tazobactam and vancomycin (TZP-VAN) with piperacillin-tazobactam and teicoplanin (TZP-TEI) for the risk of acute kidney injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study
    (Elsevier, 2025) Aslan, Abdullah Tarik; Kara, Emre; Köksal, Gamze; Bilir, Yeliz; Saraçoğlu, Kemal Tolga; Eser, Fatma; Güner, Rahmet; Alkan, Sevil
    Objective: Both vancomycin (VAN) and teicoplanin (TEI) augment the risk of acute kidney injury (AKI) when combined with piperacillin-tazobactam (TZP). We aimed to compare the risk of AKI among patients receiving TZP-VAN vs. TZP-TEI. Methods: This was a prospective, multinational, multicentre cohort study conducted in 12 centres from Turkiye, Italy, and Spain between 1 June 2022, and 31 December 2023. The primary outcome was the occurrence of AKI between the first day of antibiotic treatment and the third day after completing therapy, according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression and propensity-score match analyses were employed to adjust for confounding variables. Stratified Kaplan- Meier analysis was used to assess the time-to-AKI between the comparison groups. Results: Of 187 patients (TZP-TEI, n = 102; TZP-VAN, n = 85), the AKI occurred in 21 patients (24.7%) who received TZP-VAN and in 15 patients (14.7%) with TZP-TEI (unadjusted odds ratio [OR], 1.90; 95% CI: 0.91-3.97; P = 0.087). After adjusting for confounding variables with multivariable analysis, TZP-VAN was not associated with increased odds of AKI compared with TZP-TEI; with an adjusted OR of 2.24 (95% CI: 0.78-6.42; P = 0.133). In propensity-score matched analysis ( n = 49 pairs), the AKI risk was similar between the two groups (OR, 2.10; 95% CI: 0.67-6.50; P = 0.199). The stratified Kaplan-Meier analysis indicated no difference between the treatment groups in terms of time-to-AKI (log-rank test, P = 0.107). Conclusions: The risk of AKI in TZP-VAN was similar to that in TZP-TEI. These results should be confirmed in randomized controlled trials.
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    Does hemoglobine level play a role in metabolism of succinylcholine?
    (Çanakkale Onsekiz Mart Üniversitesi, 2013-05) Saraçoğlu, Kemal Tolga; Saraçoğlu, Ayten; Özden, Özben; Deniz, Seda
    [No Abstract Available]
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    Spinal travmanın eşlik ettiği Wolff-Parkinson-White Sendrom’lu hastanın anestezi yönetimi
    (Çanakkale Onsekiz Mart Üniversitesi, 2014) Saraçoğlu, Kemal Tolga; Baygın, Ömer; Soral, Merve
    Wolff-Parkinson-White sendromu nadir görülen, patolojik aksesuar yolak olan Kent demetinden kaynaklanan iletinin ventriküle ulaştığı preeksitasyon sendromudur. Çoğu preeksitasyon sendromlu hastalar olumsuz bir klinik sunuma sahip olmasalar da hafif ve orta derecede göğüs ağrısından ciddi kardiyopulmoner rahatsızlıklara kadar değişen hatta ani kardiyak ölümle sonuçlanan bulgulara sahip olabilirler. Anestezik ilaçlar ve anestezi uygulama yöntemleri atriyoventriküler (AV) nodun iletiminde değişikliklere neden olarak taşiaritmi riskinde artışa neden olabilir. Wolff-Parkinson-White sendromlu hastaların anestezi yönetimleriyle ilgili olarak literatürde olgu sunumları yer almasına rağmen genel anestezi verilen hastalarda sugammadeks kullanımıyla ilgili bir olgu sunumu literatürde yer almamaktadır. Wolff-Parkinson-White tanısı almış, elektrokardiyografisinde delta dalgası ve kısa PR intervali bulunan, 28 yaşında, 75 kg erkek hasta 3 yıl önce geçirdiği araç içi trafik kazası sonrası spinal travmaya bağlı gelişen bilateral bacaklarda spastisite nedeniyle baklofen pompası takılması amacıyla ameliyathaneye kabul edildi. Sorunsuz bir cerrahi sonrasında hastaya nöromüsküler bloker olarak verdiğimiz rokuronyumun etkisinin geri döndürülmesinde bu hastalar için fatal aritmi potansiyeli bulunan neostigmin ve atropin kombinasyonu yerine sugammadeks verildi. Anestezi yönetiminin başarılı olduğu bu hasta komplikasyon gelişmeden servise devredildi. Genel anestezi altında cerrahi uygulanacak olan Wolff-Parkinson-White sendromlu hastaların anestezi yönetiminde sugamadeks kullanımının daha güvenli olacağı kanısına varılmıştır.