Objectives: Magnesium plays an essential role in numerous cellular functions, including energy metabolism and enzyme regulation. We evaluated the impact of preoperative oral magnesium supplementation on the development of intraoperative ventricular fibrillation (VF) after aortic cross-clamp removal, postoperative atrial fibrillation (POAF), and renal function parameters in patients undergoing coronary artery bypass grafting (CABG).
Methods: Ninety patients who underwent isolated CABG were included and divided into magnesium and non-magnesium groups. Demographic, perioperative, and postoperative variables were compared. Multivariate logistic regression analysis was performed to identify independent predictors of POAF.
Results: The incidence rates of POAF and VF after cross-clamp removal did not differ between the groups. In multivariate analysis, preoperative magnesium supplementation was not an independent predictor of POAF (OR: 1.35, 95% CI: 0.42–4.36, p=0.615), whereas age was an independent risk factor (OR: 1.10, 95% CI: 1.02–1.19, p=0.016). Magnesium supplementation had no significant impact on postoperative urea or creatinine levels.
Conclusion: Preoperative oral magnesium administration did not reduce the incidence of POAF or VF after CABG surgery. Further large-scale, prospective, randomized studies are needed to clarify the potential benefits of magnesium supplementation in this patient population.

Objectives: Point-of-care blood gas analyzers are essential in acute care settings because of their rapid turnaround time and integrated quality control. However, analytical variability between platforms may influence clinical interpretation. This study aimed to evaluate the analytical agreement between the ABL90 FLEX and GEM Premier 5000 blood gas analyzers in arterial whole blood samples.
Methods: A total of 433 arterial samples were collected at Zonguldak Bulent Ecevit University Hospital; 406 samples met the inclusion criteria and were analyzed consecutively on the ABL90 FLEX and GEM Premier 5000 within 2 minutes. Parameters included blood gases, electrolytes, co-oximetry fractions, metabolic analytes, and calculated values. Statistical analysis was performed using Pearson correlation, Passing–Bablok regression, and Bland–Altman analysis.
Results: pH and pCO₂ showed strong agreement (r=0.880 and 0.957, respectively), with minimal bias (−0.003 and −1.34, respectively) and no significant difference (p>0.05). No significant differences were observed for ionized calcium, chloride, methemoglobin, total bilirubin, or lactate (p>0.05). Significant differences were detected for pO₂, SO₂, sodium, potassium, glucose, bicarbonate, osmolality, and co-oximetry parameters (p<0.05). Bland–Altman analysis showed narrow limits of agreement for acid–base parameters but wider bias for pO₂ (1.63) and SO₂ (1.24). Passing–Bablok regression demonstrated proportional bias for oxygenation indices, sodium, and O₂Hb, with significant deviation from linearity in several parameters, indicating limited interchangeability between analyzers for oxygenation and derived measurements. Conclusion: The ABL90 FLEX and GEM Premier 5000 provide comparable results for key acid–base and selected metabolic parameters, whereas oxygenation indices, sodium, and some co-oximetry fractions require cautious interpretation and consistent platform use for serial monitoring.

Objectives: Major adverse events (MAEs) following coronary artery bypass grafting (CABG) represent important clinical outcomes affecting early postoperative morbidity and mortality. This study aimed to evaluate the association of preoperative glycated hemoglobin (HbA1c) and the triglyceride–glucose (TyG) index with the development of postoperative MAEs in patients undergoing elective CABG.
Methods: In this retrospective cohort study, data from 500 patients who underwent elective on-pump CABG between January 1, 2022, and December 31, 2023, were analyzed. Demographic characteristics, comorbidities, EuroSCORE II, and preoperative laboratory parameters were recorded. The TyG index was calculated using fasting triglyceride and glucose levels. The primary outcome was MAE, defined as the occurrence of at least one of the following: mortality, stroke, sepsis, or acute kidney injury. Logistic regression analyses were performed to identify predictors associated with MAE.
Results: MAE occurred in 110 patients (22%). Patients who developed MAE were older and had a higher prevalence of hypertension (p<0.001). However, no significant differences were observed between the groups in terms of HbA1c, fasting glucose, triglyceride levels, or the TyG index (p>0.05). In the multivariable analysis, age (OR: 1.03, 95% CI: 1.00–1.06; p=0.034) and hypertension (OR: 2.63, 95% CI: 1.58–4.36; p<0.001) were identified as independent predictors of MAE.
Conclusion: Preoperative HbA1c and the TyG index were not independent predictors of early postoperative MAE in patients undergoing elective CABG. In contrast, advanced age and the presence of hypertension were independently associated with an increased risk of MAE.

Objectives: Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable form of pulmonary hypertension caused by organized thromboembolic obstruction of the pulmonary arteries. Advances in surgical and anesthetic techniques have improved outcomes, highlighting the importance of evaluating institutional experience. This study presents our anesthetic management and short-term outcomes in the first 29 patients who underwent pulmonary endarterectomy (PEA) for CTEPH.
Methods: This retrospective, single-center study included 29 patients with CTEPH who underwent PEA between November 2018 and July 2024 at Baskent University Ankara Hospital, Türkiye. Demographic, preoperative, and intraoperative anesthetic data and postoperative outcomes were analyzed. Outcomes included duration of mechanical ventilation, intensive care unit (ICU) and hospital lengths of stay, early and 6-month echocardiographic findings, and mortality. Preoperative and follow-up data were compared, and univariate logistic regression was performed to assess risk factors for in-hospital mortality.
Results: The mean patient age was 55.1±18 years, and 44.8% were male. Preoperative echocardiography revealed a mean EF of 53±12%, mPAP of 85±29.2 mmHg, and TAPSE of 17±4.7 mm. Mean CPB, aortic cross-clamp, and total circulatory arrest durations were 232±64.8, 84±29.7, and 34±15.5 minutes, respectively. Early postoperative echocardiography showed a substantial reduction in mPAP to 45.6±22.9 mmHg, which remained stable at 6 months (44.4±27.9 mmHg). The 6-month mortality rate was 21.5%, with no perioperative variables inde-pendently associated with mortality.
Conclusion: PEA resulted in significant early improvement in pulmonary hemodynamics. Although mortality was higher than that reported by high-volume centers, this likely reflects advanced disease and early institutional experience, consistent with the learning-curve effect described in the literature.

Objectives: Genetic anomalies are frequently associated with congenital heart disease and may influence postoperative outcomes after pediatric cardiac surgery. However, their relationship with postoperative hemodynamic severity remains incompletely characterized. This study aimed to evaluate postoperative clinical burden and hemodynamic severity in pediatric patients with congenital heart disease and genetic anomalies who underwent cardiac surgery.
Methods: This retrospective, single-center cohort study included pediatric patients who underwent surgery for congenital heart disease during a two-year study period. Patients were classified according to the presence or absence of documented genetic anomalies. Demographic, operative, and postoperative variables, including the vasoactive–inotropic score (VIS), cross-clamp duration, mechanical ventilation duration, intensive care unit (ICU) length of stay, hospital length of stay, extracorporeal membrane oxygenation (ECMO) requirement, dialysis requirement, delayed sternal closure, reintubation, and in-hospital mortality, were analyzed.
Results: A total of 1,456 pediatric patients were included, including 86 patients with documented genetic anomalies. Patients with genetic anomalies demonstrated significantly greater postoperative hemodynamic severity and resource utilization. Median VIS values were sig-nificantly higher in the genetic anomaly group (17.0 [12.0–22.0] vs. 13.0 [8.0–17.0], p=0.003). Cross-clamp duration (p=0.027), mechanical ventilation duration (p=0.007), ICU length of stay (p=0.007), and hospital length of stay (p=0.002) were significantly prolonged. Mortality was numerically higher among patients with genetic anomalies, although statistical significance was not reached.
Conclusions: Pediatric patients with congenital heart disease and genetic anomalies who undergo cardiac surgery represent a clinically vul-nerable subgroup characterized by greater postoperative hemodynamic severity and increased healthcare resource utilization. Recognition of this phenotype may facilitate intensified perioperative monitoring and earlier supportive interventions.

Objectives: To compare perioperative lung aeration loss after elective lower extremity orthopaedic surgery under regional versus general anaesthesia using a standardised 12-zone lung ultrasound (LUS) score and to evaluate its relationship with spirometry and arterial blood gas (ABG) outcomes.
Methods: In this prospective, single-centre observational study conducted at a tertiary care university hospital, 60 adults (ASA I–III) without pulmonary disease undergoing elective lower extremity orthopaedic surgery were allocated by clinical decision to receive combined spinal–epidural anaesthesia (n=30) or general anaesthesia (n=30). LUS, spirometry, and ABG on room air were performed preoperatively and within 2 hours postoperatively.
Results: Baseline characteristics and preoperative LUS scores were comparable between the groups (13.03±3.60 vs. 12.70±3.29). Postoperative aeration loss was significantly greater after general anaesthesia (ΔLUS 6.53±2.90) than after regional anaesthesia (ΔLUS 1.90±3.26), with a mean difference of 4.63 (95% CI 3.03–6.24; p<0.001; Cohen’s d=1.50). Clinically significant atelectasis (ΔLUS≥4) occurred more frequently in the general anaesthesia group (76.7% vs. 36.7%; absolute risk reduction, 40.0%; NNT, 2.5). Adjusted analysis confirmed an independent group effect (β=4.79; p<0.001; R²=0.513). Oxygenation did not differ between the groups and showed no correlation with ΔLUS. Small airway function declined more after general anaesthesia.
Conclusions: These findings suggest that regional anaesthesia may be associated with reduced perioperative lung aeration loss and support the potential role of LUS in perioperative monitoring. Further randomised controlled trials are warranted.

Tracheal stenosis most commonly occurs following prolonged endotracheal intubation or tracheostomy after intensive care treatment. Airway management during tracheal resection is challenging due to changes in airway anatomy and the need to maintain adequate oxygenation and ventilation while preserving the anastomotic line. This case report presents the anesthetic management of a 29-year-old male patient who developed upper tracheal stenosis following prolonged intubation. During tracheal resection surgery, cross-field ventilation via the tracheostomy site was initially used. Since head and neck extension could not be safely performed due to the risk of anastomotic injury, retrograde intubation was performed intraoperatively using a tube-changing catheter. The procedure was successfully completed with a short apnea period and without complications. The patient was safely extubated and discharged on the eighth postoperative day. This case highlights that retrograde intubation can be an effective and safe alternative airway management technique during tracheal resection when conventional intubation methods cannot be applied.