INTRODUCTION: Acute Kidney Injury(AKI) after cardiac surgery is common and has serious effects on early and late postoperative outcomes. The primary objective of this retrospective study was to determine the incidence of acute renal injury after RIFLE, KDIGO and AKIN classifications in patients with normal renal function and to determine the risk factors involved in the development of acute renal injury. The secondary aim is to determine the relationship between these three classifications and risk factors with early mortality.
METHODS: Patients who underwent cardiovascular surgery under CPB between 2011 and 2015 at Manisa Celal Bayar University Medical Faculty Cardiovascular Surgery Clinic were examined retrospectively and 353 patients were included in the study. Preoperative demographic information, operation type, hemoglobin, hematocrit levels, and creatinine values of each patient were recorded. RIFLE, KDIGO and AKIN score were determined daily using serum creatinine value and urine output in the postoperative period. ROC analysis and logistic regression analysis were used in the evaluation of the data.
RESULTS: According to the KDIGO, AKIN classification and RIFLE classification of the research group respectývely were found to be 28.6%, 29.4% in any AKI stage. According to RIFLE, AKIN and KDIGO classifications in our study, there was a significant relationship between the development of renal injury with advanced age, combined CABG - valve surgeon, long pump duration, low preoperative hemoglobin level, high baseline creatinine value, high perioperative blood transfusion and long term intensive care unit. The area under the receiver operating characteristic curve for hospital mortality was similarly found to be 0.956, 0.957, 0.956 for the RIFLE, AKIN and KDIGO classifications respectively.
DISCUSSION AND CONCLUSION: In our study, there was no significant difference in mortality estimation between RIFLE, AKIN and KDIGO classifications.

INTRODUCTION: In this study, we aimed to compare fiberoptic bronchoscop (FOB) and Disposcope® endoscope (DE), one of the optical imaging methods used in Cohen flexitip bronchial blocker placement.
METHODS: In this study, a total of 40 patients in whom a bronchial blocker was inserted for one-lung ventilation were randomly assigned into two groups as FOB (n=20) and DE (n=20). Data including demographic and clinical characteristics of the patients, Cormack-Lehane grade, and duration and ease of bronchial blocker placement were recorded.
RESULTS: The mean bronchial blocker insertion time of the DE group (196±32 sec) was shorter than the mean BB insertion time of the FOB group (244±21 sec) and was found to be statistically significant (p <0.05). In both FOB and DE groups, it was found that placement to the right main bronchus was easier than the left main bronchus (p <0.05).
DISCUSSION AND CONCLUSION: Disposcope® endoscope-guided Cohen flexitip bronchial blocker placement is a suitable option for single lung ventilation in thoracic surgery practice with its short and easy placement.

INTRODUCTION: Endotracheal tube should be placed appropriate depth in the trachea to prevent endobronchial intubation, unexpected extubation, vocal cord and nerve compression during intubation. Considering that tube tip misplacement may occur more frequently in patients with short vocal cord-carina distance, prediction of these patients will prevent such complications. In this study, we investigated whether there is a correlation between vocal cord-carina distance and body surface anatomic measurements.
METHODS: 200 patients were included in the study. Various airway measurements and different body surface anatomic measurements were recorded. Following endotracheal intubation, we calculated the vocal cord-carina distances using the markers placed on the endotracheal tube with the help of Disposcope endescope.
RESULTS: The mean vocal cord carina distance both women and men were 13.1 ± 1.9 cm. The vocal cord carina distance of 9 (4.5%) patients was 10.5 cm or less. A total of 34 patients (17%) had a short vocal cord carina distance of less than 11.2 cm. Best correlated anatomic measurements with vocal cord carina distance were sternomental distance (r = 0.358), length (r = 0.270) and ulnar length (r = 0.256), respectively.
DISCUSSION AND CONCLUSION: We found poor correlation between body surface anatomic measurements and vocal cord carina distance. We think that it is still difficult to predict the body surface anatomic measurements of patients with short vocal cord carina distance. We conclude that endotracheal tubes with a distance of less than 10 cm from the end of the marker lines can be safely used in the majority of Turkish adult patients.

INTRODUCTION: In cardiac surgery, low serum albumin level is an important risk factor that increases mortality and morbidity in the postoperative period. Diabetes mellitus may affect this clinical condition by causing albumin loss with proetinuria. In this study, the effects of preoperative albumin values and the presence of diabetes mellitus (DM) on postoperative renal failure were investigated.
METHODS: Patients who underwent coronary artery bypass grafting between 01.01.2015-31.12.2019 in our clinic were retrospectively analyzed. Patients who received dialysis treatment in the preoperative period, whose ejection fraction was below 50%, and who underwent emergency surgery were excluded from the study. The patients were divided into 3 groups according to the serum albumin levels before surgery. Patients with serum albumin level ≥3.5 mgr / dl Group 1; those between 2.5-3.5 mg / dl Group 2; patients with ≤ 2.5 were named as Group 3. Later, these 3 groups were divided into 2 subgroups according to the presence of DM.
RESULTS: 308 patients who underwent coronary artery bypass surgery were included in the study. The demographic characteristics, peroperative data and operative data of the patients were similar. The need for renal replacement therapy was higher in Group 2 and Group 3 than in Group 1 in the postoperative period.
DISCUSSION AND CONCLUSION: Preoperative low serum albumin is a risk factor for the development of acute renal failure in the postoperative period, and the presence of DM adversely affects this condition. Close follow-up of these patients positively contributes to reducing mortality and morbidity.

INTRODUCTION: Phosphate is an essential mineral involved in regulatory multiple metabolic events involving signal transduction, energy production and mineral metabolism. In this study, we aimed to investigate the effect of deviation of serum phosphate levels from the upper and lower limits of 2.5-4.5 mg / dL given as the phosphate reference value on 28-day mortality.
METHODS: After obtaining written permission from the head physician of our hospital, 53 patients over 18 years of age who underwent continuous renal replacement therapy due to septic shock related acute kidney injury in our intensive care unit were included in the study retrospectively. Since the serum phosphate level reference range in our hospital's biochemistry laboratory was 2.5-4.5 mg / dL, the mean serum phosphate levels of the patients were statistically lower than the lower limit reference range of 2.5 mg / dL and the upper limit reference range of 4.5 mg / dL. changes were calculated.
RESULTS: The mean serum phosphate levels of the patients were significantly higher than the phosphate lower limit of 2.5 mg / dL 4.14 ± 1.72, p <0.001. When the phosphate values of the groups were compared, it was statistically higher in Group 1 than Group 2 p = 0.047.
DISCUSSION AND CONCLUSION: Phosphate level was significantly higher in mortal patients than non-mortal patients.

Tracheal stenosis after intubation is an important clinical condition. It is occured approximately 5% -20% in patients with intubation and tracheostomy. In patients undergoing heart transplantation, tracheal stenosis may develop due to prolonged intubation in the pre and post-transplant period. In this study, the patient who had a history of intubation for 2 weeks before heart transplantation, had tracheal resection and anastomosis due to the development of tracheal stenosis, and the patient's anesthesia experience is presented.

One of the most common causes of poisoning due to chlorine gas is after
the mixture of cleaning agents. After chlorine gas inhalation, eye and
throat irritation, wheezing, coughing, shortness of breath, hypoxemia,
wheezing, abnormal lung graphs are frequently reported and lung
complaints are generally seen. Although the cardiac effects of chlorine
gas are not fully known, chest pain and palpitations have been reported
rarely. We discussed our 26-year-old male patient who developed atrial
fibrillation due to chlorine gas toxicity after mixing the cleaning materials
with literature. Written consent was obtained from the patient to publish
this case.

Carbon monoxide (CO) intoxication can have serious effects on tissues requiring high oxygen flow such as brain and myocardium. Neurological findings are prominent and cardiotoxic effects are common. Case reports have shown a significant relationship between CO intoxication and myocardial ischemia. In the literature, the number of cases requiring CABG surgery after CO intoxication-induced myocardial infarction (MI) is limited. In the light of literature, we reported a male patient admitting to the emergency department with the complaint of chest pain without frequent neurological and respiratory system findings, having elevated troponin and increased carboxyhemoglobulin levels. He was considered to have developed MI after CO intoxication and the case underwent CABG surgery following an emergency angiography and stenting afterwards.