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    Efficiency of silver coated urinary catheter in catheter-associated urinary tract infection in critical care unit
    (AVES, 2010) Teke T.; Yavuz Z.; Atalay H.; Maden E.; Solak Y.; Uzun K.
    Aim: Urinary tract infection (UTI) is the most prevalent cause of nosocomial infections, with an incidence of 40%. The incidence of urosepsis occurs in approximately 16% of the ICU patient populations. The purpose of this study was to determine the efficacy of a silver coated urinary catheter in prevention of catheter-associated UTI. Material and Methods: We investigated 21 patients (mean age with 71.4±9.0 year and 14 M, 7 F) foley silicon urinary catheter and 20 patients (mean age with 67.6±8.7 year and 15 M, 5 F) with silver coated urinary catheter. In all patients, foley urinary catheters were changed with silver coated catheter in critical care unit. Results: The most common cause of infection was Klebsiella (33%). The susceptibility of gram negative microorganisms against antimicrobial agents were amicacin, piperacillin-tazobactam and carbapenem. The cost of antibiotic was higher in foley catheter group than silver coated group (p<0.001). Conclusion: Silver coated urinary catheter is expensive, it is cost effect according to urinary infection and antibiotic cost.
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    Evaluation of adrenal function in chronic obstructive pulmonary disease patients receiving invasive and noninvasive mechanical ventilation
    (AVES, 2010) Atalay H.; Teke T.; Yavuz Z.; Maden E.; Kiyici A.; Solak Y.; Uzun K.
    Stress and severe disease states in the intensive care unit (ICU) cause release of adrenocorticoid hormone from the hypophysis and cortisol from the adrenal cortex by activating hypothalamo-pituitary adrenal axis. While adrenal insuffi ciency (AI) is seen in less than 0.01% of the normal population, its frequency is over 28% of cases in intensive care units (ICU). The aim of this study was to evaluate adrenal function in 36 cases with COPD, in pulmonary diseases ICU, receiving invasive mechanical ventilation (IMV) (n:23) and noninvasive mechanical ventilation (NIMV) (n:13). For this purpose, after obtaining a blood sample for baseline cortisol level, 1mg ACTH was given to patients in the fi rst day of admission to ICU. Cortisol levels were checked at the 30th and 60th minutes of ACTH test. Of all cases, mean age was 67.3±9.2, duration of hospitalization 12.9±9.3 days, APACHE II score 20.9±5.4, systolic blood pressure (bp) 103.5±28.2 mmHg, diastolic bp 64.6±19.2, mean arterial blood pressure 81.5±20.5 mmHg, sodium 138.3 ±6.3, potassium 4.3±1.2, urea 83.8±62.5 and creatinine was1.38±0.9 respectively. According to baseline cortisol levels, AI was present in 22 (45%) patients. Of these cases, 11 were in NIMV and 11 in IMV groups. When the baseline, 30th minute and 60th minute cortisol levels were compared, a statistically signifi cant difference was present (p<0.05, for all). In conclusion, we consider that adrenal insuffi ciency is encountered frequently in COPD patients with respiratory failure and further studies are needed tobetter delineate this association.