Noninvasive mechanical ventilation, referring to the provision of mechanical ventilatory assistance without the need for an invasive airway. Noninvasive mechanical ventilation has been used increasingly to treat acute and chronic respiratory failure. The best candidates for noninvasive ventilation are the medically stable and cooperative patients with intact airway reflexes. Understanding of the aims of noninvasive mechanical ventilation is important for determining the patients who can take benefit from device. In this review, the clinical use of mechanism and efficiency of noninvasive mechanical ventilation is summarized by literatures.

INTRODUCTION: Comparison of general anesthesia and regional anesthesia (cervical block) in terms of their postoperative and intraoperative outcomes in carotis endarterectomy (CEA) surgical operations
METHODS: The results of 64 patients performed elective CEA surgery under general and regional anesthesia between January, 2010 and July, 2012 were retrospectively evaulated.
RESULTS: Of all the 64 patients involved in the study, 43.75 % (n=28) of them were operated under general enesthesia and 56.25% (n=36) under regional anesthesia.
Mean arterial pressure values after carotis declamping and arterial pressure values after the operation were higher in the regional anesthesia group compared to the patients having underone general anesthesia.
There was also a significant increase in the serebral oxymetry values (bilateral) after declamping in both groups. After declamping and the end of the operation left serebral oxymetry values were also higher in the regional anesthesia group.
There was no significant difference between these two groups with respect to the operative complication rates, operation durations and cross-clamp durations
However postoperative complication rates were higher in the general anesthesia group (p=0.04). There was also no difference between these two groups in terms of their postoperative hospitalization durations, but ICU follow up durations were lower in regional anesthesia patients.

DISCUSSION AND CONCLUSION: Our study shows that the regional anesthesia method is preferable in CEA surgery because it has less ICU durations less mortality and complication rates. In addition, regional anesthesia method can also be prefered for a better neurologic assesment because of patients’ being awake during CEA surgery.

INTRODUCTION: Thoracic sympathectomy is a simple and reliable method in the treatment of primary hyperhidrosis and some vascular diseases. Sympathectomy applications performed before thoracotomy are done with thoracoscopic procedure with video-assisted minimally invasive surgical techniques. In this retrospective study, we aimed to present the anesthetic management of thoracic sympathectomy performed on 84 patients.
METHODS: It was included 84 patients in the study perfomed thoracic sympathectomy in between 1999-2014 after obtaining ethical approval. Information about the patient were obtained from patient files and anesthesia records.
RESULTS: The average age of patients treated thoracic sympathectomy were 23.65 ± 6.93, 51(60.7%) were female and 33(39.3%) male. The average operative time was recorded as 86.01±42.31 minutes. Surgery was scheduled because of 64(76.2%) of the patients for hyperhidrosis, 13 (15.5%) of the patinets for Raynaud's syndrome and 7(8.3%) of the patinets for reflex sympathetic dystrophy. Surgical techniques were applied in 11 patients(13.2%) with open thoracotomy, 17(20.2%) patients with uniport VATS and 56(66.6%) patients with 3-port VATS. No complication was observed in 73(86.9%) patient, pneumothorax in the early postoperative period was seen in 8(9.5%) patients, prolonged air leak in 2(2.4%) patients, and transient paresthesia on foot in 1(1.2%) patient. The average discharge time was recorded as 3: 02 ± 2: 42 day.
DISCUSSION AND CONCLUSION: In Conclusion, in this group of considered low risk patients should also be careful in terms for postoperative complications and intraoperative management declined complications, mortality and morbidity rates, analgesic drug requirement and duration of the operation depending on the developments in surgical procedures in thoracic sympathectomy application.

INTRODUCTION: Endoscopic saphenous vein harvesting (EVH) has been a routine technique in some cardiovascular surgery clinics, especially in U.S.A, and decreases the postoperative morbidity resulting in increased patient satisfaction. We aimed to evaluate the impact of experience of the surgeon/harvester on duration, pain and incidence of complications regarding EVH.


METHODS: 100 patients that had undergone EVH procedure by 2 separate harvesters with closed, carbondioxide insufflated endoscopic system (The VasoViewTM System, Maquet) during first time isolated or combined coronary artery bypass grafting surgery, in Acıbadem Maslak and Kadikoy Hospitals between October 2012 and December 2013 were divided into two groups in chronological order; group I: the first 50 patients, group 2: the last 50 patients. Safenous vein grafts’ (SVG) length, total harvesting times, postoperative pain scores, complications as hematoma and surgical site infections were recorded and compared.
RESULTS: 74 male, 26 female patients were aged between 46-79 (61±9,1). Mean number of coronary arteries bypassed was 3,4±0,9 and 40,6±13,7 cm.s long safen vein were harvested in 61,2±30,7 min.s. EVH duration decreased with time; for the first ten case 0,5 cm. of safen vein were harvested per minute while pace was 0,99 cm/min for the last ten patients. Complication frequency about harvested safen vein is statistically significantly higher in group I than in group II (p; 0,006).
DISCUSSION AND CONCLUSION: We suggest that experience in endoscopic vein harvesting results in decreased incidence of complications.

INTRODUCTION: Implantable chest ports (ICP) are implanted for central venous access to infuse mostly chemotherapy drugs and other medications. Here, we describe a new modification for single incision technique that facilitates the catheter–reservoir connection despite limited manipulation area. Additionally this modification decreases the possibility of catheter kinking rates.
METHODS: In this retrospective study we investigated patients who underwent ICP implantation for chemotherapy. Two pockets were made over and under a single incision. Catheter was cut into appropriate length and connected with reservoir at outside. Intravenous catheter placement was accomplished via peel away sheath when reservoir was at the upper pocket. Then reservoir was moved to lower pocket and fixated with the sutures that were inserted previously. This report describes the facilitation of catheter-port connection and reservoir implantation with the upper pocket that was adopted to the single incision technique.
RESULTS: Two hundred and fifty six patients who underwent ICP placement were evaluated. All procedures were uneventful and no procedure related complications like hematoma, pneumothorax, or primary malposition were observed. We didn’t observe kinking or port migration with this modification including ICP’s with at least 6 months or longer follow up except a ‘pinch-off’ and a port dysfunction due to incorrect use. Seven of our patients were suffered from port infection and ICP’s were removed.
DISCUSSION AND CONCLUSION: This double pocket technique facilitates manipulations and has no kinking at the puncture and reservoir connection sites during implantation and minimal port dysfunction rates in long term follow up. Further studies needed to evaluate the advantages of this technique.