Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleAçık Erişim2026Preferences for mechanical ventilation modes among intensivists in Türkiye: a nationwide point-prevalence study
Yildirim, Suleyman; Kilinçözgün, Nurhayat; Alpdogan, Ozcan; Uçar, Huseyin; Taskiran, Imren; Ata, Adnan; Özcan, Ozhan; Öncü, Kivanc; Acarbay, Saba Mukaddes; Güner, Temel
Background/aim: Invasive mechanical ventilation (IMV) is a fundamental intervention for patients with respiratory failure in intensive care units (ICUs). This nationwide, multicenter point-prevalence study aimed to describe current mechanical ventilation mode preferences (conventional, adaptive, and biphasic) in Turkish ICUs and to report associated clinical outcomes descriptively, without assessing causal relationships. Materials and methods: A nationwide, multicenter point-prevalence study was conducted on 17 April 2024 and included adult patients (>= 18 years) who had been receiving IMV for more than 24 h. Data on patient demographics, ventilation mode distribution, ventilatory parameters, and descriptive clinical outcomes on day 28 (weaning status, tracheostomy, and mortality) were recorded without comparative outcome analysis. Results: A total of 426 patients were included. Conventional modes were used in 84.5% of patients, adaptive modes in 10.6%, and biphasic modes in 4.9%. Synchronized intermittent mandatory ventilation (SIMV) was the most commonly used conventional mode. The primary indication for IMV was acute respiratory failure (61%), with pneumonia being the leading cause. Among the 350 orotracheally intubated patients, 25.6% were in the weaning phase on the study day. A total of 59 (16.9%) patients were extubated, 150 (42.9%) underwent tracheostomy, and 64 (18.2%) remained intubated on day 28. Overall, 185 (43.4%) patients died during their ICU stay, 152 (35.7%) remained in the ICU, and 89 (20.9%) were successfully discharged from the ICU. Conclusion: Conventional ventilation modes, particularly SIMV, were more commonly used in Turkish intensive care units (ICUs), whereas adaptive modes were less frequently applied. These patterns may reflect factors such as clinician familiarity, institutional practices, and equipment availability rather than definitive preferences. Although the impact of ventilation modes on clinical outcomes was not comparatively evaluated in this study, the choice of ventilation mode may still influence patient outcomes. Therefore, further prospective and comparative studies are warranted to better elucidate this relationship.
- MakaleAçık Erişim2024The Association Between Glycemic Variability and Mortality in Critically Ill Patients: A Multicenter Prospective Observational Study
Emgin, Omer; Yavuz, Mehmet; Sahin, Adem; Günes, Murat; Eser, Mustafa; Yavuz, Tunzala; Kökalan, Damla; Ergün, Bisar; Rollas, Kazim; Çakirgöz, Mensure Yilmaz
Background: Glycemic variability (GV) is a prevalent and significant condition observed in critically ill patients. This study aimed to investigate the relationship between early glycemic variability parameters and 28-day mortality in critically ill patients. Methods: A multicenter, prospective, and observational study was performed at five tertiary intensive care units (ICUs) in Turkey. All patients who had more than six blood glucose level (BGL) measures per 24 h were included. The parameters of GV including the SD, MGL, MGD (the difference between the maximal and minimal glucose level), and the CV (the percentage of SD to the MGL) in the first 24 h were recorded. Results: A total of 578 eligible patients were enrolled in the study, of whom 43.6% were women. The mean age of the patients was 68.09 +/- 16.62 years. Overall mortality was 31.5% (n = 182). The glycemic parameters of the CV, SD, and MGD were significantly higher in the non-survivor group than in the survivor group (p = 0.040, 0.006, and 0.002, respectively). The multivariate logistic regression analysis revealed that the CV (OR 1.023; 95% CI 1.004-1.042; p = 0.017) was an independent factor that increased mortality. Spearman's rho correlation analysis revealed a strong (r:0.871) and statistically significant correlation (p < 0.001) between the CV and MGD. Conclusions: The CV calculated within the first 24 h of ICU admission is independently associated with 28-day mortality. The MGD is correlated with the CV and is maybe a practical tool to predict increased risk of mortality at the bedside. However, further studies are needed to establish the independent association of the MGD with mortality.