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  1. Article ; Online: Double-edge sword in airway management for morbid obese patients outside the OR: time to intubate all?

    Saracoglu, Ayten / Abdallah, Bushra M / Saracoglu, Kemal T

    Minerva anestesiologica

    2024  

    Language English
    Publishing date 2024-03-20
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123584-9
    ISSN 1827-1596 ; 0026-4717 ; 0375-9393
    ISSN (online) 1827-1596
    ISSN 0026-4717 ; 0375-9393
    DOI 10.23736/S0375-9393.24.18080-7
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  2. Article: The Reliability of Carotid Artery Doppler Ultrasonography Indices in Predicting Fluid Responsiveness during Surgery for Geriatric Patients: A Prospective, Observational Study.

    Bilgili, Beliz / Saracoglu, Ayten / Saracoglu, Kemal T / Ratajczyk, Pawel / Kararmaz, Alper

    Healthcare (Basel, Switzerland)

    2024  Volume 12, Issue 7

    Abstract: Background: The reliability of determining fluid responsiveness during surgery in geriatric patients is challenging. Our primary outcome was to determine the reliability of Corrected Flow Time (FTc) in predicting fluid responsiveness.: Methods: ... ...

    Abstract Background: The reliability of determining fluid responsiveness during surgery in geriatric patients is challenging. Our primary outcome was to determine the reliability of Corrected Flow Time (FTc) in predicting fluid responsiveness.
    Methods: Elderly patients undergoing major surgery under general anesthesia were included. Measurements of common carotid artery diameter, velocity time integral, and systolic flow time (FT) were performed before and after a fluid challenge. FTc and carotid blood flow (CBF) were subsequently calculated.
    Results: The median change in carotid diameter was significantly higher in the fluid-responder (R) compared to the non-responder (NR) (6.51% vs. 0.65%,
    Conclusions: In geriatric patients, potential endothelial changes in the carotid artery may influence the dynamic markers of fluid responsiveness. Despite the demonstrated effectiveness of FTc in predicting fluid responsiveness in the general population, this study underscores the limited reliability of carotid Doppler ultrasonography indices for prediction in a geriatric patient population.
    Language English
    Publishing date 2024-04-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare12070783
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  3. Article ; Online: Efficiency of laryngeal mask airway ProtectorTM and i-gel® as a conduit in Aintree catheter-guided fibreoptic tracheal intubation: a randomised clinical trial.

    Saracoglu, Kemal T / Turan, Ayse / Aydas, Asli / Yilmaz, Mehmet

    Anaesthesiology intensive therapy

    2022  Volume 54, Issue 2, Page(s) 120–126

    Abstract: Background: Fibreoptic intubation through a supraglottic airway device (SAD) is recom-mended in difficult airway management algorithms. The Difficult Airway Society published a guideline describing the details of this technique in 2011. This study was ... ...

    Abstract Background: Fibreoptic intubation through a supraglottic airway device (SAD) is recom-mended in difficult airway management algorithms. The Difficult Airway Society published a guideline describing the details of this technique in 2011. This study was designed to compare the efficiency of two different 2nd generation SADs as a conduit for Aintree catheter-guided fibreoptic tracheal intubation.
    Methods: 80 adult patients with an ASA score of 1-3 undergoing elective surgical procedures were included in the study. The patients were intubated after randomization to two groups: the i-gel group and the laryngeal mask airway (LMA) Protector group. SAD insertion time and tracheal intubation time were recorded separately. Demographic data, changes in haemodynamic parameters during the procedure, and complications were noted.
    Results: In the LMA Protector and i-gel groups, the number of attempts (1.14 ± 0.35 vs. 1.24 ± 0.49 times, P = 0.394), device insertion time (14.89 ± 8.11 vs. 17.84 ± 16.59 seconds, P = 0.896), and the need for an optimization manoeuvre (43.2% vs. 37.8%, P = 0.813) were similar (P > 0.05). The fibreoptic laryngeal appearance scale and haemodynamic parameters were similar (P > 0.05). However, the airway complication rate was significantly higher in the LMA Protector group than in the i-gel group (21.6% vs. 2.7%, P = 0.013). The most common complications were bronchospasm and bloody secretion on SAD.
    Conclusions: With the stable haemodynamic parameters, acceptable insertion time and lower complication rate, we concluded that the i-gel may be preferable in fibre-optic tracheal intubation. The rigid structure of the LMA Protector compared to the i-gel might contribute to this result.
    MeSH term(s) Adult ; Airway Management ; Catheters ; Fiber Optic Technology ; Humans ; Intubation, Intratracheal/methods ; Laryngeal Masks
    Language English
    Publishing date 2022-04-12
    Publishing country Poland
    Document type Journal Article ; Randomized Controlled Trial
    ISSN 1731-2531
    ISSN (online) 1731-2531
    DOI 10.5114/ait.2022.115366
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  4. Article: Coagulopathy during liver transplantation.

    Saracoglu, Ayten / Saracoglu, Kemal T

    Journal of anaesthesiology, clinical pharmacology

    2018  Volume 34, Issue 3, Page(s) 289–295

    Abstract: In this review article, we aimed to mainly review the principles for the management of hemostasis, changes that occur in the hemostatic system, and the techniques to reduce hemorrhage during liver transplantation. Hemostasis is a defense mechanism that ... ...

    Abstract In this review article, we aimed to mainly review the principles for the management of hemostasis, changes that occur in the hemostatic system, and the techniques to reduce hemorrhage during liver transplantation. Hemostasis is a defense mechanism that may ensue from vascular damage and hemorrhage and consists of multiple phases which involve cellular and humoral elements of coagulation. In the presence of a cause, such as trauma-induced liver injury or hepatic failure that may trigger coagulopathy, the process becomes more problematic, and moreover, severe coagulation disorders may arise in daily practice unless the situation is intervened correctly and on time. During liver transplantation, the implementation of transfusion and coagulation management algorithms based on the point of care tests may reduce blood loss and transfusion requirement. Moreover, antifibrinolytic therapy and a low central venous pressure with restrictive fluid administration reduce bleeding.
    Language English
    Publishing date 2018-10-29
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 1401760-x
    ISSN 0970-9185
    ISSN 0970-9185
    DOI 10.4103/joacp.JOACP_390_16
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  5. Article ; Online: Airway management strategies for the Covid 19 patients: A brief narrative review.

    Saracoglu, Kemal T / Saracoglu, Ayten / Demirhan, Recep

    Journal of clinical anesthesia

    2020  Volume 66, Page(s) 109954

    MeSH term(s) Airway Management/methods ; COVID-19 ; Coronavirus Infections/physiopathology ; Coronavirus Infections/therapy ; Humans ; Intubation, Intratracheal/methods ; Pandemics ; Pneumonia, Viral/physiopathology ; Pneumonia, Viral/therapy
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Letter ; Review
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2020.109954
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    Zs.A 2622: Show issues Location:
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  6. Article ; Online: Changes in the cuff pressure in neonates in the absence of nitrous oxide.

    Saracoglu, Ayten / Saracoglu, Kemal T / Canaz, Huseyin / Kafali, Haluk / Lerman, Jerrold

    Anaesthesiology intensive therapy

    2022  Volume 54, Issue 2, Page(s) 127–131

    Abstract: Background: Changes in the pressure of cuffed neonatal size tracheal tubes (TT) during anaesthesia without nitrous oxide are not well described. We determined whether the cuff pressure changes over time in neonates under general anaesthesia without ... ...

    Abstract Background: Changes in the pressure of cuffed neonatal size tracheal tubes (TT) during anaesthesia without nitrous oxide are not well described. We determined whether the cuff pressure changes over time in neonates under general anaesthesia without nitrous oxide.
    Methods: The airways of thirty neonates were secured with a high volume low pressure cuffed TT for meningocele surgery. The cuff was manually inflated until there was no audible leak and maintained at 10-15 cm H2O throughout by monitoring the pressure continuously with both a manometer and a pressure transducer. At baseline, the cuff pressure was assessed in the supine and then prone positions. During surgery, if the pressure exceeded 15 cm H2O, the cuff was deflated to < 15 cm H2O and if it was < 10 cm H2O, the cuff was inflated to 10-15 cm H2O. The time interval between corrections and the number of corrections were recorded.
    Results: The cuff pressures in 18 neonates (60%) required correction during surgery. The cuff pressure exceeded 15 cm H2O in nine neonates (30%) and was corrected. The cuff pressures in 13 neonates were less than 10 cm H2O and required correction. The gender, weight, height, and duration of anaesthesia did not differ significantly between neonates who required correction of the cuff pressure and those who did not. Mean cuff pressures were similar at 15, 45, and 75 minutes of anaesthesia.
    Conclusions: In 60% of neonates undergoing surgery in the prone position under general anaesthesia without nitrous oxide, the cuff pressure exceeded 15 cm H2O. In such cases, cuff pressure should be monitored continuously throughout the surgery.
    MeSH term(s) Anesthesia, General ; Humans ; Infant, Newborn ; Intubation, Intratracheal ; Nitrous Oxide ; Pressure ; Respiration, Artificial
    Chemical Substances Nitrous Oxide (K50XQU1029)
    Language English
    Publishing date 2022-02-04
    Publishing country Poland
    Document type Journal Article
    ISSN 1731-2531
    ISSN (online) 1731-2531
    DOI 10.5114/ait.2022.114485
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  7. Article ; Online: A view on pediatric airway management: a cross sectional survey study.

    Saracoglu, Ayten / Saracoglu, Kemal T / Sorbello, Massimiliano / Kurdi, Raghad / Greif, Robert

    Minerva anestesiologica

    2022  Volume 88, Issue 12, Page(s) 982–993

    Abstract: Background: This survey aimed to investigate routine practices and approaches of clinicians on pediatric airway in anesthesia and intensive care medicine.: Methods: A 20-question multiple-choice questionnaire with the possibility to provide open text ...

    Abstract Background: This survey aimed to investigate routine practices and approaches of clinicians on pediatric airway in anesthesia and intensive care medicine.
    Methods: A 20-question multiple-choice questionnaire with the possibility to provide open text answers was developed and sent. The survey was sent to the members of European Airway Management Society via a web-based platform. Responses were analyzed thematically. Only the answers from one representative of the pediatric service of each hospital was included into the analysis.
    Results: Among the members, 143 physicians responded the survey, being anesthesiologists (83.2%), intensivists (11.9%), emergency medicine physicians (2.1%), and (2.8%) pain medicine practitioners. A straight blade was preferred by 115 participants (80.4%) in newborns, whereas in infants 86 (60.1%) indicated a curved blade and 55 (38.5%) a straight blade. Uncuffed tracheal tube were preferred by 115 participants (80.4%) in newborns, whereas 24 (16.8%) used cuffed tubes. Approximately 2/3 of the participants (89, 62.2%) reported not to use routinely a cuff manometer in their clinical practice, whereas 54 participants (37.8%) use it routinely in pediatric patients. Direct laryngoscopy for routine pediatric tracheal intubation was reported by 127 participants (88.8%), while 16 (11.2%) reported using videolaryngoscopes routinely. Interestingly, 39 (27.3%) had never performed neither videolaryngoscopy nor flexible bronchoscopy in children. These results were significantly less in hospitals with a dedicated pediatric anesthesiologist.
    Conclusions: This survey on airway management in pediatric anesthesia revealed that the use of cuffed tubes and the routine monitoring of cuff pressure are rare. In addition, the rate of videolaryngoscopy or flexible optical intubation was low for expected difficult intubation. Our survey highlights the need for properly trained pediatric anesthesiologists working in-line with updated scientific evidence.
    MeSH term(s) Infant ; Child ; Infant, Newborn ; Humans ; Cross-Sectional Studies ; Intubation, Intratracheal/methods ; Laryngoscopes ; Laryngoscopy ; Airway Management/methods ; Surveys and Questionnaires
    Language English
    Publishing date 2022-07-14
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123584-9
    ISSN 1827-1596 ; 0026-4717 ; 0375-9393
    ISSN (online) 1827-1596
    ISSN 0026-4717 ; 0375-9393
    DOI 10.23736/S0375-9393.22.16445-X
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    Zs.A 516: Show issues Location:
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  8. Article ; Online: Comparison of postoperative pain in children after maintenance anaesthesia with propofol or sevoflurane: a systematic review and meta-analysis.

    Abdallah, Bushra M / Elshoeibi, Amgad M / ElTantawi, Nouran / Arif, Mariah / Hourani, Razan F / Akomolafe, Aishat F / Hamwi, Mahmoud N / Mahmood, Fathima R / Saracoglu, Kemal T / Saracoglu, Ayten / Chivese, Tawanda

    British journal of anaesthesia

    2024  

    Abstract: Background: Propofol and sevoflurane are two of the most commonly used anaesthetics for paediatric surgery. Data from some clinical trials suggest that postoperative pain incidence is lower when propofol is used for maintenance of anaesthesia compared ... ...

    Abstract Background: Propofol and sevoflurane are two of the most commonly used anaesthetics for paediatric surgery. Data from some clinical trials suggest that postoperative pain incidence is lower when propofol is used for maintenance of anaesthesia compared with sevoflurane, although this is not clear.
    Methods: This meta-analysis compared postoperative pain following maintenance of anaesthesia with propofol or sevoflurane in paediatric surgeries. PubMed Medline, Embase, Scopus, Web of Science and Cochrane Library were searched for randomised controlled trials (RCTs) that compared postoperative pain between sevoflurane and propofol anaesthesia in children. After quality assessment, a meta-analysis was carried out using bias-adjusted inverse heterogeneity methods, heterogeneity using I
    Results: In total, 13 RCTs with 1174 children were included. The overall synthesis suggested nearly two-fold higher odds of overall postoperative pain in the sevoflurane group compared with the propofol group (odds ratio [OR] 1.88, 95% confidence interval [CI] 1.12-3.15, I
    Conclusions: Children maintained on inhalational sevoflurane had higher odds of postoperative pain compared with those maintained on propofol. The results also suggest that sevoflurane is associated with higher odds of needing postoperative rescue analgesia compared with propofol.
    Registration: The protocol for this systematic review and meta-analysis was registered on the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42023445913.
    Language English
    Publishing date 2024-04-26
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2024.03.022
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    Uk I Zs.80: Show issues Location:
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  9. Article ; Online: VivaSight: a new era in the evolution of tracheal tubes.

    Saracoglu, Ayten / Saracoglu, Kemal T

    Journal of clinical anesthesia

    2016  Volume 33, Page(s) 442–449

    Abstract: Study objective: To evaluate the available data describing the use of single and double lumen VivaSight tubes.: Design: Systematic review.: Setting: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and ... ...

    Abstract Study objective: To evaluate the available data describing the use of single and double lumen VivaSight tubes.
    Design: Systematic review.
    Setting: The use of VivaSight tubes for elective surgeries including advantages, disadvantages, and possible complications.
    Patients: Systematic review of randomized controlled trials from databases including Medline, Web of Knowledge, Google Scholar, and Cochrane Central Register of Controlled Trials.
    Interventions: Comparison of VivaSight single and double-lumen tubes with conventional tubes during normal airway and expected difficult airway management. The effectiveness of the devices was also evaluated during 1-lung ventilation for patients undergoing thoracic surgery.
    Measurements: Intubation time, success rate, the requirement for fiberoptic bronchoscope, and the rate of complications.
    Main results: Following a VivaSight double-lumen tube, a flexible bronchoscope is still needed. It is difficult to agree that VivaSight tube reduces the need or use of a bronchoscope. According to the current literature, it is unclear if there is any advantage of the VivaSight compared with using flexible bronchoscopy to direct a blocker into the correct lung. The cost may be another issue. Studies comparing VivaSight tubes with standard double lumen tubes reported faster tracheal intubation rate and higher success rate at first attempt for VivaSight. However, VivaSight tubes may cause soft tissue trauma such as bleeding, hematoma, edema, and erythema. Sore throat and dysphonia are other reported complications. Due to the outer thickness, smaller-sized double-lumen tube may be necessary. It has been reported to have the disadvantages, such as melting due to the heat of light source before insertion and sudden shutdown without warning.
    Conclusions: Problems such as overheating and melting on the distal end of the tube due to the light source and potential breakdowns of the cable should be solved by the manufacturer. This will probably require a redesign and necessitate further studies.
    MeSH term(s) Airway Management/instrumentation ; Airway Management/trends ; Bronchoscopy ; Equipment Design ; Humans ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/trends ; Randomized Controlled Trials as Topic ; Respiration, Artificial
    Language English
    Publishing date 2016-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2016.04.034
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