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    Effects of selective NOS inhibition in sepsis: Evaluation of lung tissue damage and blood gases
    (INT COLLEGE OF SURGEONS, 2008) Ceran, Sami; Erikoglu, Mehmet; Sahin, Mustafa; Sunarn, Gueven Sadi; Golcuk, Murat; Pasaoglu, Hatice; Avsar, Fatih
    NO is an important mediator in the generalized inflammatory response of the body during sepsis and septic shock. We investigated the possible effects Of L-arginine and aminoguanidine on plasma NO levels and the interaction between NO levels and lung tissue damage and blood gases in sepsis. Fifty Wistar male rats were used in this study and divided into five groups: group 1, sham group; group 2, CLP (sepsis); group 3, CLP + 10 mg/kg L-arginine administration; group 4, CLP +15 mg/kg aminoguanidine administration; group 5: CLP + L-arginine + aminoguanidine given in similar doses. Sepsis was induced by cecal ligation and puncture (CLP) method. Drugs were administered at postoperative hours 4 and 12. The levels in the aminoguanidine and aminoguanidine + L-arginine groups were similar to the sham group. Lung tissue damage in the sepsis and L-arginine groups was more severe than the other groups.
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    Risk factors for postoperative pulmonary complications in upper abdominal surgery
    (WILEY, 2007) Kanat, Fikret; Golcuk, Ayse; Teke, Turgut; Golcuk, Murat
    Background: Pulmonary complications are the most frequent cause of postoperative morbidity and mortality in upper abdominal surgery (UAS). We aimed to examine the influence of possible preoperative, operative and postoperative risk factors on the development of early postoperative pulmonary complications (POPC) after UAS. Methods: A prospective study of 60 consecutive patients was conducted who underwent elective UAS in general surgical unit. Each patient's preoperative respiratory status was assessed by an experienced chest physician using clinical examination, chest radiographs, spirometry and blood gas analysis . Anaesthetical risks, surgical indications, operation time, incision type, duration of nasogastric catheter and mobilization time were noted. Forty-eight hours after the operation, pulmonary examinations of the patients were repeated. Results: Postoperative pulmonary complications were observed in 35 patients (58.3%). The most common complication was pneumonia, followed by pneumonitis, atelectasis, bronchitis, pulmonary emboli and acute respiratory failure. The presence of preoperative respiratory symptoms and the spirometric parameter of forced expiratory volume in 1 s/forced vital capacity were the most valuable risk factors for early prediction of POPC. The sensitivity, specificity and diagnostic efficiency of the presence of preoperative respiratory symptoms in the POPC prediction were 70, 61 and 66%, respectively. Conclusion: We recommend a detailed pulmonary examination and spirometry in patients who will undergo UAS by chest physicians to identify the patients at high risk for POPC, to manage respiratory problems of the patients before surgery and also to help surgeons to take early measures in such patients before a most likely POPC occurrence. Improvement of lung function in those patients at risk for POPC before operation may decrease morbidity in surgical patients.