Maintaining volume status and optimising the hemodynamic parameters plays paramount importance on postoperative morbidity and mortality. In the management of fluid therapy it is required to guarantee blood flow to maintain sufficient and safe tissue oxygenation and determine if cardiac output is sufficient in maintaining the metabolic demand. In critically ill patients, intravascular volume status must be correctly assessed and hemodynamic response (ie if the patient is capable of increasing in stroke volume or cardiac output by fluid loading) following fluid overload could be foreseen. Nowadays, certain hemodynamic monitors, provide dynamic parameters like stroke volume variation (SVV) and pulse pressure variation by continuously calculating stoke volume. To infuse optimum amount of fluid and to avoid the negative effects of fluid overloading appropriate hemodynamic monitoring which predicts fluid response should be applied and by applying rational fluid strategy, fluid therapy should be individualized for the patient.

INTRODUCTION: The aim of this study was to compare the hemodynamic effects of the endotracheal intubation performed with Airtaq® (Prodol Meditec, Vizcaya, Spain) and Macintosh laryngoscopes.
METHODS: After approval by the Institutional Ethics Committe and obtaining patients’ written consents, 60 patients aged between 18 – 65 years, ASA group I, with Mallampati scores I - II undergoing elective surgery were included in the study. Patients were randomized into two groups (n=30). All patients had their heart rate (HR), non-invasive systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), end-tidal carbondioksite pressure (ETCO2) and peripheral oxygen saturation (SpO2) monitored. Patients in the first and second groups were intubated using Macintosh and Airtraq laryngoscopes respectively. Hemodynamic parameters of all patients were recorded before induction (preop), after induction (0 min), and every 5 minutes after intubation. The recorded data were compared statistically.
RESULTS: There were no significant differences between two groups regarding demographic characteristics and Mallampati scores. Systolic, diastolic and mean arterial pressures and heart rate values in preoperative period and at 0., 1., 2., 3., 4., and 5. min did not show statistically significant differences between groups (p>0,05). In both of groups, systolic, diastolic and mean arterial pressure and heart rate values ​ increased significantly at 1.min (p<0,05).
DISCUSSION AND CONCLUSION: Airtraq laryngoscope was found comparable to Macintosh laryngoscope concerning ease of use and hemodynamic response to intubation.

INTRODUCTION: The preoperative evaluation of patients undergoing noncardiac surgery with cardiovascular disease is crucial. The aim of our study was to investigate the relationship between the American Society of Anesthesiologists (ASA) classification, Goldman scoring system, cardiac risk determined by the cardiologist, and the perioperative mortality and morbidity.
METHODS: 500 patients undergoing noncardiac surgery who were referred to a cardiologist were studied prospectively. The relationship between the patients’ ASA classes, Goldman scores, cardiac risks, comorbidities, operation types, preoperative cardiac symptoms, and perioperative morbidity and mortality was assessed.
RESULTS: The mean age in the group with morbidity (69.3 ± 10.6 years) was significantly higher than that in the group without morbidity (64.0 ± 12.1 years) (p < 0.001). There was no perioperative mortality, and of the 500 patients, 354 (70.8%) had cardiovascular complications. While the operation type of both groups was significantly different (p = 0.001), preoperative hypertension was more prevalent in the morbidity group (p = 0.007). The preoperative ASA classes (p = 0.016), Goldman scores (p < 0.001), and cardiac risks of patients (p = 0.039) were significantly different between the groups. Logistic regression analysis was applied, and only age, hypertension, and operation type were found to be risk factors for perioperative morbidity.
DISCUSSION AND CONCLUSION: We believe that ASA classification, Goldman Cardiac Risk Index, and cardiac risk determined can affect the patients’ perioperative management and the use of risk indices and algorithms can reduce the consultation requirement and unnecessary laboratory or imaging tests and can prevent the unnecessary cancellation or delaying of the surgery.

INTRODUCTION: The aim of this study was to compare the effects of paracetamol, diclofenac sodium, and tramadol administration in the postoperative period for the patients who underwent coronary artery bypass grafting (CABG) on postoperative pain.

METHODS: After the approval of ethics committee and informed consent 200 patients who undergoing CABG with normal renal and liver functions and an ejection fraction value of 40 % were included. The patients were randomly divided into four groups: group I (n=50) patients received paracetamol (IV), group II (n=50) patients received diclofenac sodium(IM), group III (n=50) patients received tramadol(IV), and group IV (n=50) patients received placebo. Group IV was given only 2 µg/kg/h of fentanyl for 2 hours. Hemodynamic values and biochemical parameters were recorded. Postoperative pain was assessed using visuel analog scale(VAS).
RESULTS: In the placebo group, PaCO2 levels were higher, mean arterial pressure was higher and extubation time was longer than the other groups. There was no statistically significant difference between the three analgesia groups.
DISCUSSION AND CONCLUSION: Based on our study results, analgesic effect of IV paracetamol appears to be similar to diclofenac and tramadol.

INTRODUCTION: The difficulty of accessing recurrent intravenous (IV) routes in intensive care unit (ICU) patients is a frequently encountered problem. Central venous catheterization has been increasingly used. The aim of this study was to evaluate retrospectively the successfull catheterization incidence and complications of juguler and subclavian central venous catheterization.
METHODS: We retrospectively reviewed the files of 211 ICU patients who underwent central venous catherisation between January 2010-March 2013. Patients demographic data, primary diagnoses, number of interventions, the frequency of complications, were recorded. Patients were evaluated as right internal jugular vein (Group J) and right subclavian vein (Group S) groups according to their entrance.
RESULTS: 72 patients (%34.1) were female and 139 (%65.9) were male. The ages ranged from 28-96 years and the mean age was 70.89 +11.32 years. %55.9 internal juguler catheterisations were performed and %44.1 subclavian catheterisations were performed. The complication seen in %13.7 (29) due to the infection %31 (n: 9), %24.2 (n: 7) pneumothorax, %44.8 (n: 13) haematoma.
DISCUSSION AND CONCLUSION: Central venous catheterization is an important issue both in follow-up and management period of the patients, but have some complications. Close observation of patients after catheterization is considerable for determining and management of complications.

Extracorporeal membrane oxygenation (ECMO) is a machine that undertakes the role of these organs in life-threatening conditions of the heart and lung. Many complications can be seen during ECMO treatment. We will discuss the development and management of leg cramps due to peripheral catheters.

Saphenous vein is used as a graft in coronary artery bypass graft surgery. The graft must be of appropriate length and inclination between the distal and proximal anastomoses. Thus, myocardium is fed well by providing sufficient blood flow. We present a case of ST elevation resulting in folding of a long safen ven graft after coronary artery bypass surgery. In this case report, we aimed to emphasize the importance of close follow-up and monitoring in patients who underwent coronary artery bypass graft surgery.