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Objective: Preoperative fasting is a common practice aiming to reduce the risk of pulmonary aspiration during anaesthesia. It is advised to avoid fasting times longer than 6 hours in all children, whenever possible. Prolonged fasting can be uncomfortable for children and may lead to dehydration and other negative outcomes. The primary outcome of the study was the relationship between preoperative duration of fasting and cardiac index (CI) variability, used as a surrogate for intravascular volume status after the induction of anaesthesia, in paediatric patients undergoing surgery. Methods: Prospective, observational study that included patients over 5 years of age, scheduled for surgery. Passive leg-raising-induced CI variability was evaluated for fluid responsiveness and intravascular volume after anaesthesia induction. Patients were termed fluid responders (Rs) if an increase in CI of >10% was obtained after passive leg raising, and non-responders (NRs) if the CI variability was <10%. CI and aortic peak velocity (Vpeak) were measured through the suprasternal notch via an ultrasonic cardiac output monitor. Results: There were 32 Rs and 53 (NRs). The mean duration of fasting for Rs was 11.53±2.61, while NR had a mean duration of fasting of 10.6±2.93 hours, showing an insignificant difference. Aortic Vpeak change was significantly higher in Rs (0.24±0.17) compared to NRs (0.03±0.13) (P < 0.001). Duration of fasting showed no significant correlation with CI variability and peak aortic velocity. Conclusion: With this study method, it was observed that preoperative fasting time had no effect on intraoperative intravascular volume.

(1) Background: The aim of this bibliometric study is to analyze global research trends, citation impact, and scientific collaborations in the field of neuromuscular blockers (NMBAs) and their antagonists between 2000 and 2024. (2) Methods: Data were retrieved from the Web of Science Core Collection (WoSCC) using Boolean search strategies. Bibliometric analyses were conducted using R bibliometrix, VOSviewer, and CiteSpace software to visualize collaboration networks, keyword trends, and citation bursts. (3) Results: A total of 499 articles were analyzed, with the United States of America (USA), China, and South Korea leading in productivity, while France had the highest citation impact. Influential authors included Mertes PM and Fuchs-Buder T. Emerging topics such as sugammadex, sevoflurane, and neuromuscular monitoring were identified, reflecting a shift from pharmacokinetic studies to safety and monitoring strategies. (4) Conclusions: The findings indicate a marked increase in studies on neuromuscular monitoring and reversal agents, such as sugammadex, over the past two decades. The USA, France, and China emerged as the most contributory countries in NMBAs research, with their extensive international collaborations playing a pivotal role in shaping scientific progress. Highly influential studies have predominantly focused on NMBA pharmacokinetics, safety, anaphylaxis risks, and the clinical benefits of sugammadex, underscoring its critical role in reducing residual neuromuscular blockade (rNMB) and enhancing patient safety.

Introduction: Favipiravir (FVP) is an antiviral and used to treat COVID-19. We aimed to document the safety and adverse events associated with FVP on the outcome of COVID-19 treatment. Methodology: The study included 225 adult patients with moderate COVID-19 infection (World Health Organization scale-5). The adverse events (AEs) were evaluated using a grading scale supported by the Food and Drug Administration. Safety was assessed by the frequency of serious AEs. Results: The AEs associated with FVP treatment were hepatotoxicity (87/225, 38.7%), weakness (32/225, 14.2%), nephrotoxicity (26/225, 11.6%), nausea (18/225, 8.0%), diarrhea (8/225, 3.6%), vomiting (5/225, 2.2%), and insomnia (4/225, 1.8%); rash was not detected. Hepatotoxicity was observed more frequently in patients who also developed nephrotoxicity (57.7% vs 36.2%, p = 0.03). The deceased patients were significantly older and had higher prevalence of hypertension, congestive heart failure (CHF), coronary artery disease, cancer, nephrotoxicity. and angiotensin- converting enzyme inhibitors/angiotensin receptor blocker use. While male gender (OR: 5.38 CI: 1.64-17.67) and CHF (OR: 6.8 CI: 1.92-24.74) were significantly associated with nephrotoxicity, age (OR: 1.06 CI: 1.02-1.10), cancer (OR: 3.9 CI: 1.10-14.22) and nephrotoxicity (OR: 5.5 CI: 1.74-17.74) were associated with mortality. Conclusions: Serious AEs were detected at very low levels that would not require discontinuation of treatment or any AE-related death. Since SARS-CoV-2 itself and drug interactions may differ, FVP-related AEs might vary in COVID-19 patients. Our study shows that FVP can be used safely with a low AE profile. More extensive evidence is required to evaluate the long-term AEs of FVP.

Introduction: Healthcare-associated infection is an important cause of mortality and morbidity worldwide. Well-regulated infection control and hand hygiene are the most effective methods for preventing healthcare-associated infections. This study evaluated and compared conventional hand hygiene observation and an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections. Methodology: This pre- and post-intervention study, employed an electronic hand-hygiene recording and reminder system for preventing healthcare-associated infections at a tertiary referral center. Healthcare-associated infection surveillance was recorded in an anesthesia and reanimation intensive care unit from April 2016 to August 2016. Hand-hygiene compliance was observed by conventional observation and an electronic recording and reminder system in two consecutive 2-month periods. healthcare-associated infections were calculated as incidence rate ratios. Results: The rate of healthcare-associated infections in the electronic hand- hygiene recording and reminder system period was significantly decreased compared with that in the conventional hand-hygiene observation period (incidence rate ratio = 0.58; 95% confident interval = 0.33-0.98). Additionally, the rate of central line-associated bloodstream infections and the rate of ventilator-associated pneumonia were lower during the electronic hand hygiene recording and reminder system period (incidence rate ratio= 0.41; 95% confident interval = 0.11-1.30 and incidence rate ratio = 0.67; 95% confident interval = 0.30-1.45, respectively). Conclusions: After implementing the electronic hand hygiene recording and reminder system, we observed a significant decrease in healthcare-associated infections and invasive device-associated infections. These results were encouraging and suggested that electronic hand hygiene reminder and recording systems may reduce some types of healthcare-associated infections in healthcare settings.

Objective: Modified thoracoabdominal nerve block with a perichondrial approach (M-TAPA) provides effective analgesia in the anterior and lateral thoracoabdominal regions. Previous studies have shown the efficacy of M-TAPA in laparoscopic surgery. The primary aim of this study was to investigate the efficacy of M-TAPA block in patients undergoing open major abdominal surgery. Methods: This study was designed as a prospective, randomized, single-blind, controlled study. A total of 43 patients were included in the study. In group M-TAPA, the block was performed bilaterally at the end of the surgery. Local wound infiltration was performed on the control group. Postoperative analgesia was provided with patient-controlled intravenous morphine. When numeric rating scale (NRS) pain scores exceeded 4, rescue analgesia with tramadol was administered. The primary outcome of this study was to compare the 24-hour total morphine consumption. The secondary outcomes included comparing pain scores, rescue analgesia requirements, and patient satisfaction. Results: Regarding our primary outcome, median morphine consumption during the first 24 hours was lower in the M-TAPA group [16 (14-18)] than in the control group [24.5 (19.5-27)] (P < 0.01, 95% confidence interval: -9, 42 and -3.01). Additionally, NRS scores were significantly lower and patient satisfaction was significantly higher in the M-TAPA group. The need for rescue analgesics in the first 24 hours was comparable among the study groups. Conclusion: The M-TAPA block is an effective abdominal wall block that can be considered part of multimodal analgesia in open major abdominal surgery.

Amaç: Bu çalışmada yoğun bakım ünitesinde (YBÜ) kritik koronavirüs hastalığı-2019 (COVİD- 19) hastalarında standart tedaviye eklenen konvelesan plazma (CP) uygulamasının mortaliteye olan etkisi araştırıldı. Gereç ve Yöntem: Retrospektif kohort şeklinde planlanan bu çalışma 1 Nisan 2020-1 Kasım 2020 tarihleri arasında Marmara Üniversitesi Tıp Fakültesi Hastanesi, Pandemi YBÜ’de, 255 kritik COVİD- 19 hastasının verileri değerlendirilerek gerçekleştirildi. Bulgular: Hastalar standart tedavi alan hastalar (153; %60,0) ve CP alan hastalar (102; %40,0) olarak 2 gruba ayrıldılar. YBÜ mortalite oranı CP alan hastalarda (38; %37,3), almayanlara göre (79; %51,6) daha düşük bulundu (p Objective: This study investigates the effect of convalescent plasma (CP) addition to the standard treatment on mortality in critical coronavirus disease-2019 (COVID-19) patients. Materials and Methods: This retrospective cohort study was conducted by evaluating the data of 255 critical COVID-19 patients in Marmara University Medical Faculty Hospital, Pandemic Intensive Care Unit (ICU), between April and November 2020. Results: The patients were divided into two groups, a control group that received standard treatment (153; 60.0%) versus a second group that received CP in addition to standard treatment (102; 40.0%). The ICU mortality rate was found to be lower (p

Background and AimsThe aim of this study is to compare the postoperative analgesic efficacy of Suprainguinal Fascia Iliaca Block(FIB) and Lumbar Erector Spinae Plane Block(L-ESPB) in patients undergoing proximal femur fractures surgery.MethodsPatients with ASA(American Society of Anesthesiology)II-III were included and randomized into: FIB, L-ESPB, and control groups. Surgery was performed under spinal anesthesia in each group and preoperative block was performed in the related groups. Postoperative intravenous morphine via PCA(patient controlled analgesia) was administered and pain intensity was evaluated using NRS(Numeric Rating Scale).ResultsA total of 63 patients were included. NRS scores at 12, 24 and 36th hours postoperatively were significantly lower in the FIB (1.18+-0.13, 0.82+-0.14, 1.0+-0.17) compared to the control group (2.05+-0.25, 2.14+-0.27, 1.81+-0.25) (p=0.006, p=<0.001, p=0.011, respectively). While the 12th and 36th hour NRS in the FIB were similar to those in the L-ESPB group, the 24th hour NRS in the FIB was significantly lower than in the L- ESPB group(1.60+-0.23) (p=0.01). NRS was similar between groups at 0, 2, 6 and 48th hours. Morphine consumption in the first 2hours and 2-6- hour period were significantly higher in the control group compared to other groups(p=0.018, p=0.021 respectively) and after 6th hour was similar among the three groups. The cumulative opioid use was higher in the control group at 6h,12h,24h,36h,48h hours where as it was similar between the FIB and L-ESPB groups in each time period.ConclusionsCombining FIB or L-ESPB with spinal anesthesia effectively reduced postoperative opioid consumption and provided better pain control. FIB demonstrated longer-lasting pain relief compared to L-ESPB.Ethical Committee Approval

Introduction: Vitamin D plays a role in host defense and is known to be associated with mortality in patients in the intensive care unit (ICU). We aimed to evaluate the relationships between vitamin D levels and predictors of mortality in patients with ventilator-associated pneumonia (VAP) caused by extensively drug-resistant Acinetobacter baumanii (XDR A. baumanii). Methodology: A retrospective single-center study was conducted in an 18-bed adult ICU of a teaching hospital, including all patients with VAP due to XDR A. baumanii. Levels of 25(OH)D, procalcitonin (PCT), C-reactive protein (CRP), n-terminal pro-BNP (NT-proBNP), as well as clinical scores (Sequential Organ Failure Assessment [SOFA], Acute Physiology And Chronic Health Evaluation [APACHE II], Clinical Pulmonary Infection Score [CPIS) were recorded. Results: Forty-for patients were studied over six months. All patients had vitamin D deficiency. The 28-day mortality in patients with 25(OH)D levels ≤ 10 ng/mL was higher than in patients with 25(OH)D > 10ng/mL (p = 0.001). The fourth- and seventh-day SOFA scores (p= 0.04 and p= 0.001) and first- and fourth-day procalcitonin levels (p = 0.03 and p = 0.004) were higher in patients with 25(OH)D levels ≤ 10 ng/mL. The clinical scores (SOFA, CPIS, and CEPPIS) and biomarkers (NT-proBNP, PCT) were negatively correlated with 25(OH)D levels in all study groups. Conclusions: Severe vitamin D deficiency was associated with adverse outcome in VAP due to XDR A. baumanii. Vitamin D levels may be a prognostic predictor of VAP. It is also important to evaluate the effect of rapid vitamin D replacement on mortality.

Amaç: Kritik hastalarda beslenme risk durumunun 28 günlük mortalite üzerine etkisini araştırmayı amaçladık. Gereç ve Yöntem: Çalışmamız, 48 saatten fazla invaziv mekanik ventilasyon gereksinimi olan erişkin kritik hastalarda retrospektif yapıldı. Hastaların demografik verileri ve yatış günü, mNUTRIC (modified Nutritional Risk in Critically Ill) skoru kaydedildi. Enerji alımı ölüm, taburculuk veya 12. güne kadar günlük olarak kaydedildi. Hastalar a) günlük kalori ihtiyacının Objective: This study investigates the relationship of nutritional risk status with 28-day mortality in critically ill. Materials and Methods: This retrospective study included critically ill adult patients receiving >48 hours receiving mechanical ventilation. Data on baseline characteristics and the modified Nutritional Risk in Critically ill (mNUTRIC) score were collected on day 1. Energy intake was recorded daily until death, discharge or until twelfth evaluable days. Patients were divided into 2 groups: a) received

Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)Background and Aims In our study, our aim is to examine the effects of modified thoracoabdominal nerve (M-TAPA) applied for postoperative analgesia in patients who had major intraabdominal surgery on the postoperative pain score, the change in the postoperative total opioid requirement and the side effects.MethodsWe separated the patients into two groups as M-TAPA applied group and control group. In group M-TAPA, M-TAPA block was performed bilaterally with 20 mL of 0.2% bupivacaine under ultrasound guidance at the end of surgery. No block was performed in the control group. Patients were administered morphine through patient controlled analgesia (PCA) pump with a bolus dose of 1 mg, 15 min lockout interval. The postoperative pain scores (the numeric rating scores (NRS)), total opioid consumption in the first 48 h, antiemetic consumption and opioid related side effects were recorded.Abstract EP090 Table 1Evaluation of outgoing volume measurements by groupsAbstract EP090 Table 2Evaluation of NRS measurements by groupsResultsA total of 43 patients were included in the study. Pain scores (at 2.,6.,12.,24.,36. hours) were significantly lower in group M-TAPA than in the group control (p<0.001). The total amount of morphine consumption in the first 48 h was lower in group M-TAPA than in the group control (M-TAPA 21,13± 6,56; IV PCA 61,70 ± 11,42) (P<0.001). There were no significant differences between the groups in terms of side effects and rescue treatment (p>0,05).ConclusionsBilateral ultrasound-guided M-TAPA block provides reduced postoperative pain scores, effective analgesia and decreased opioid consumption in patients undergoing major abdominal surgery.