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    Fatty acid-binding proteins in the diagnosis and disease severity prediction in pneumonia
    (Bayrakol Medical Publisher, 2022) Can, Doganay; Kalafat, Utku Murat; Dorter, Melis; Erdur, Ahmet; Bildik, Busra; Guven, Ramazan; Dogan, Serkan
    Aim: Infections of the respiratory tract are important healthcare problems that are one of the main causes of referrals to the emergency department. PSI and CURB-65 are the most common scoring methods globally with proven accuracy and validity through many studies. Fatty acid-binding proteins are member of small cytoplasmic proteins that play a role in the transportation and deposition of lipids almost in all mammalian cells. They are strongly associated with metabolic and inflammatory processes. The aim of the present study was to determine the value of FABP for diagnosis and disease severity in patients diagnosed with pneumonia and to compare the correlation with PSI and CURB-65 scoring systems.Material and Methods: This prospective and single-cantered study was conducted on patients referring to the emergency department of Istanbul Kanuni Sultan Suleyman Training and Research Hospital who were diagnosed with pneumonia and on healthy volunteers. Results: FABP level was significantly higher in the patient group when compared with the control group (p: <0.01). FABP level was detected significantly higher in the severe pneumonia group of the binary groups created according to PSI and CURB-65 scoring. Discussion: As a result of the data obtained in the present study, it was concluded that FABP would be useful for the determination of the diagnosis, disease severity and the decision whether to hospitalize the patient with pneumonia. FABP is an important biomarker that guides the clinician for management of pneumonia patients who refer to the emergency department.
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    Utility of non-invasive synchronized intermittent mandatory ventilation in acute cardiogenic pulmonary edema
    (W B Saunders Co-Elsevier Inc, 2022) Cekmen, Bora; Bildik, Busra; Bozan, Oner; Atis, Seref Emre; Dogan, Serkan; Kocak, Abdullah Osman
    Backgrounds: Acute cardiogenic pulmonary edema (ACPE), one of the outcomes of acute heart failure (AHF), is a common reason in a critical condition with respiratory distress. Non-invasive synchronized intermittent manda-tory ventilation(nSIMV) mode, which includes inspiratory pressure in addition to positive end expiratory pres-sure with/without pressure support provided in the non-invasive continuous positive airway pressure plus/ pressure support(nCPAP/PS) mode can be effective in hypercarbia and the associated changes in consciousness. This study aimed to demonstrate the efficacy of nSIMV in ACPE. Methods: Patients who presented with clinical acute respiratory failure and were admitted to the critical care unit of the emergency department with the diagnosis of ACPE were included. Patients were placed on non-invasive mechanical ventilators with an oronasal mask under the nCPAP/PS and nSIMV modes. Pulse and respiratory rate, systolic and diastolic blood pressure and Glasgow Coma Scores(GCS), HACOR(heart rate, acidosis, con-sciousness, oxygenation and respiratory rate) scores, pH, PaCO2, PaO2/FiO2 and lactate at the time of admission and at 30 and 60 min were evaluated. Results: Twenty-two patients were recruited, nCPAP/PS mode was 10 and nSIMV mode was 12. Although there was no statistically significant difference between the two groups in terms of the change in the relevant param-eters from admission to 60 min, the decreases in PaCO2 and lactate levels (31.4% vs. 21.2%, p = 0.383; 68.8% vs. 47.1%, p = 0.224; respectively) and the increase in PaO2 and PaO2/FiO2 values (34% vs. 14.2%, p = 0.710 and 132.1% vs. 52.7%, p = 0.073; respectively) were higher in the nSIMV group. Conclusion: The nSIMV mode is as effective as the nCPAP/PS mode in the treatment of patients with ACPE. We be-lieve that the nSIMV mode can be preferable, particularly in patients with hypercarbia who have relatively lower GCS and oxygenation.(c) 2022 Elsevier Inc. All rights reserved.