Clinical trials

Perioperative airway/respiratory complications are a major driver of morbidity and mortality. While UK audits NAP4 and NAP7 extensively examined major critical events (e.g., cardiac arrest), prospective standardized data on acute, more frequent extubation-phase complications-such as desaturation, laryngospasm, obstruction, bronchospasm, and aspiration-remain scarce. Off-hours procedures carry additional risks related to increased workload, reduced senior supervision, and clinician fatigue, though current evidence is inconclusive and requires further human-factors research using validated tools like the Karolinska Sleepiness Scale (KSS). This prospective cohort study at Kocaeli City Hospital aims to compare the incidence of acute airway/respiratory complications and intervention requirements during extubation and the first 30 minutes post-extubation between on-hours (08:00-16:00) and off-hours (\>16:00). Notably, this will be the first prospective observational study to specifically test NAP7's off-hours risk findings at the extubation stage, with the goal of strengthening patient safety and guiding institutional quality improvement.

The objective of this prospective observational cohort study is to evaluate the validity, reliability, and responsiveness of the Turkish version of the Quality of Recovery-15 (QoR-15T) scale in adult patients undergoing elective cardiac surgery. While the QoR-15T has been validated for general surgery in Turkey, its performance remains to be established in high-risk cardiac surgery populations involving cardiopulmonary bypass and intensive care stays.Approximately 150 patients at Kocaeli City Hospital will be enrolled. The study will compare the patients' QoR-15T scores-recorded preoperatively and on the 7th postoperative day-with the Global Recovery Visual Analog Scale (VAS) to determine construct validity.

Acute appendicitis is one of the most common emergency general surgical conditions worldwide and represents the leading cause of emergency abdominal surgery in children. In some cases, appendectomy may result in persistent or recurrent pain in the right iliac fossa, which may negatively affect quality of life, particularly in children. The primary aim of this study is to determine the prevalence of chronic pain at the third postoperative month in pediatric patients who underwent appendectomy. The age, sex, body mass index, and comorbidities of patients aged 8-18 years who underwent appendectomy will be recorded. Pain in children who met the inclusion criteria was assessed using the Numeric Rating Scale (NRS). To evaluate the effects of pain on quality of life, the child and parent versions of the Pediatric Quality of Life Inventory (PedsQL) were administered at the third postoperative month. In addition, the Functional Disability Inventory (FDI) was used at the third postoperative month to assess the impact of pain on the patient's functional status.

This study aims to evaluate the effectiveness of Serratus Posterior Superior Intercostal Plane (SPSIP) block compared to Intercostal Nerve (ICN) block in terms of postoperative pain control, reduction of opioid analgesic consumption, minimization of postoperative respiratory complications, and increase patient satisfaction (using a 5-point Likert scale) in patients undergoing video-assisted thoracoscopic surgery (VATS).

The aim of this study was to compare three different awake tracheal intubation technique -fiberoptic bronchoscopy (ATI:FB), videolaryngoscopy (ATI:VL), and fiberoptic bronchoscopy via a supraglottic airway device (ATI:SAD)- in terms of success rates, intubation times, and complications. Additionally, the study aims to evaluate the reliability of the SAD-assisted ATI method and its potential to contribute to the literature.

Physical restraint (restraint) is defined as the restriction of a patient's free body movements and the prevention of the patient's ability to move easily by healthcare professionals using physical or mechanical devices to prevent the patient from harming themselves or others. Physical restraints can be used by healthcare professionals for many purposes, particularly in intensive care units, such as ensuring patient safety, controlling aggressive and disruptive behavior, continuing patient care and treatment, and preventing the removal of medical equipment attached to the patient. However, when looking at the duration of physical restraint applications, it has been determined that they vary between 3-4 days. The longer the duration of physical restraint, the greater the likelihood of complications developing. In particular, long-term physical restraint can result in neurovascular and dermatological complications such as pressure injuries, edema, ecchymosis, redness, numbness, limited movement, increased temperature, discoloration, and nerve damage. The care package application is a model that improves patient care quality by simultaneously and comprehensively implementing 3-5 applications based on strong scientific evidence, prepared for the relevant area in the specified patient group. Care package applications are created to enable evidence-based practices outlined in guidelines to be used more effectively and practically in clinical settings. Within this context, the aim of this study is to develop a care package to prevent dermatological complications and edema that may occur in the restraint area in patients undergoing physical restraint in intensive care and to evaluate the effectiveness of this care package.

This prospective observational study aims to evaluate the effect of antegrade pump blood reinfusion using the crystalloid "chase" technique on postoperative transfusion requirements in adult patients undergoing cardiac surgery with cardiopulmonary bypass. At the end of cardiopulmonary bypass, blood remaining within the cardiopulmonary bypass circuit is reinfused antegradely through the arterial line using a crystalloid chase, without collection or storage. Blood remaining within the bypass circuit after surgery represents a valuable source of autologous blood, and its reinfusion may contribute to perioperative blood conservation strategies. Patients receiving antegrade pump blood reinfusion via the chase technique will be compared with those managed without reinfusion, without any intervention by the investigators. The primary outcome is postoperative blood transfusion requirement.

This prospective observational study evaluates the impact of propofol and ketamine on the risk of cardiovascular collapse during induction for endotracheal intubation in critically ill patients. Induction agents play a crucial role in managing hemodynamic stability, particularly in this vulnerable population. Propofol, known for its vasodilatory and myocardial depressant effects, has been associated with significant hypotension during induction. Conversely, ketamine, with its sympathomimetic properties, is often considered a safer alternative for hemodynamic stability. In addition to comparing the incidence of cardiovascular collapse-defined as severe hypotension or cardiac arrest-this study examines the relationship between these induction agents and shock indices, including systolic shock index, diastolic shock index, age-adjusted shock index, and modified shock index. These parameters will provide a more detailed understanding of the hemodynamic effects of each agent and their clinical implications. The findings aim to guide induction agent selection to optimize outcomes in critically ill patients.

Obesity is a disease caused by many factors, such as lifestyle, eating habits, lack of physical activity, hormonal and genetic influences. These different factors make treatment planning difficult. Common treatments include changes in diet and lifestyle, medications, endoscopic methods (like balloon or botox), and surgery. No matter which method is used, the main goal is to help patients lose weight by creating a negative energy balance. To keep the weight off, patients need to maintain a balanced lifestyle in the long term. However, many treatments are not successful over time. One important part of long-term success is helping patients change their lifestyle and eating habits. A person's cognitive function may affect how they understand and follow these changes. Some studies show that a high body mass index (BMI) is linked to problems with thinking and memory. While weight loss may help improve brain function, the investigators don't yet know how early cognitive differences affect treatment results. At the obesity center in our hospital, morbidly obese patients receive support from a team of doctors, dietitians, psychologists, and physiotherapists. For at least three months, they attend individual and group sessions to help change their lifestyle and eating habits. This study aims to see how patients' cognitive function affects how much weight they lose by the end of the program.

Radiofrequency ablation (RFA) for atrial fibrillation (AF) is performed under general anesthesia. The success of the procedure depends on the safe contact of the catheter electrode with the myocardium. Movement of the catheter tip due to respiratory changes can result in inadequate lesion formation and AF recurrence. The success of AF ablation depends on the adequacy of energy delivered to the myocardium and the durability of pulmonary vein isolation (PVI). Poor energy delivery and tissue heating during ablation are a major cause of procedural failure in RFA. To improve the success of the PVI procedure, efforts are underway to optimize catheter stability and contact force. However, catheter force and stability are influenced by respiration-induced thoracic motion, highlighting the importance of controlled breathing for further optimization. Fluoroscopy and ablation times during electroanatomic mapping-guided AF ablations improved with controlled mechanical ventilation. General anesthesia improved catheter contact. Low tidal volume, high respiratory rate (FCV), pressure controlled mechanical ventilation (PCV), volume controlled mechanical ventilation (VCV), pressure controlled volume assured mechanical ventilation (PRVC) can be used in investigators' hospital. The literature offers no definitive proof that one ablation procedure is superior to another.

The main aim of our study was to investigate the relationship between perioperative hypothermia and postoperative emergence agitation.

Emergency front of neck access (eFONA) in a non-ventilated, non-oxygenated (CVCO) patient scenario is a life-saving and important competency for anesthesiologists to learn and even repeat intermittently. The Difficult Airway Society (DAS) guideline does not elaborate on how to conduct eFONA training, while the Canadian guideline states that successful performance of such rarely used skills requires regular practice in a simulation environment that focuses on technique and provides expert feedback. In this guideline, it was also mentioned that during training, procedures can be repeatedly performed in a simulate environment and interrupted for immediate feedback. In line with these recommendations, the investigators will create an easy, inexpensive, feasible and repeatable simulation-based learning environment in the operating room of the hospital. In this model study, it is aimed to teach the cricothyrotomy technique to anesthesiologists who have no experience in eFONA with an easy set up and to increase the confidence of the participants in this subject.

This study investigates the changes in difficult airway markers at 6 months post operatively in patients undergoing obstructive sleep apnoea surgery