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Öğe A Retrospective Evaluation of the Cardiometabolic Profile of Patients with COPD-Related Type 2 Respiratory Failure in the Intensive Care Unit(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Ensarioglu, Kerem; Cirik, Mustafa Ozgur; Peker, Tulay Tuncer; Canbay, FatmaBackground and Objectives: Chronic obstructive pulmonary disease (COPD) is a notable cause of morbidity and mortality worldwide and can become complicated by Type 2 respiratory failure. This study aimed to analyze the cardiological and metabolic comorbidities of patients admitted to the intensive care unit (ICU) due to COPD-related Type 2 respiratory failure and evaluate their effects on clinical outcomes. Materials and Methods: A retrospective analysis was conducted on 258 patients admitted to the secondary-level pulmonary disease intensive care unit between January 2022 and January 2024. Patients' demographic data, cardiological and metabolic comorbidities, laboratory parameters, and ICU-related variables were evaluated using statistical analysis methods. Results: The most common comorbidities were hypertension (57.0%), congestive heart failure (48.1%), diabetes mellitus (31.4%), and obesity (37.6%). Female patients had significantly higher rates of hypothyroidism, hypertension, obesity, and congestive heart failure compared to males. Patients diagnosed with chronic kidney disease (CKD) had markedly higher cardiothoracic ratios and proBNP levels. ICU length of stay was considerably longer in patients with acute kidney injury (AKI) and coronary artery disease (CAD). Cardiomegaly and obstructive sleep apnea syndrome (OSAS) were more frequently observed in obese patients. Additionally, in COPD patients, a body mass index (BMI) threshold of 25.5 was determined as a cutoff value for radiological cardiomegaly findings with a sensitivity of 69.9% and a specificity of 59.5%. Elevated pCO2 and bicarbonate levels in patients receiving long-term oxygen therapy (LTOT) were associated with advanced-stage COPD. Conclusions: Metabolic and cardiological comorbidities notably impact the clinical prognosis and ICU management of patients diagnosed with COPD and Type 2 respiratory failure. This study, which aims to provide a snapshot of the comorbidities in patients requiring ICU admission due to COPD exacerbation-related Type 2 respiratory failure but without a fatal course, seeks to highlight the key areas where preventive and protective healthcare services should be focused in this patient group. Special attention should be given to monitoring female and obese patients. Future studies should explore how individualized and preventive follow-ups and treatment approaches can improve patient outcomes, with a particular emphasis on these identified areas.Öğe Culture Positivity and Antibiotic Resistance in Respiratory Intensive Care Patients: Evaluation of Readmission and Clinical Outcomes(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Ensarioglu, Kerem; Ari, Maside; Cirik, Mustafa Ozgur; Kahraman, AbdullahBackground: Multidrug-resistant bacteria (MDRB) represent a significant challenge in intensive care units (ICUs), as they limit treatment options, prolong hospital stays, and escalate healthcare costs. Respiratory ICUs are particularly affected due to the high prevalence of chronically ill patients with recurrent infections. Understanding the impact of culture positivity and MDRB on clinical outcomes and readmission rates is essential for enhancing patient care and addressing the growing burden of antimicrobial resistance. Methods: This retrospective study was conducted in a specialized respiratory ICU at a tertiary care hospital between 1 January 2019, and 1 January 2020. A total of 695 ICU admissions were analyzed, with patients grouped based on readmission status and culture results. Demographic, clinical, and laboratory data were reviewed. Statistical analyses were performed using appropriate tests, with p-values <= 0.05 considered statistically significant. Results: Among the 519 unique patients, 65 experienced ICU readmissions. Male patients were significantly more likely to be readmitted (p = 0.008). Culture positivity was predominantly observed in respiratory samples, with Klebsiella spp. identified as the most common pathogen. MDRB prevalence exceeded 60% in both groups, significantly prolonging ICU stays (p = 0.013). However, no significant differences in survival rates were observed between MDRB-positive and MDRB-negative groups. Notably, patients with readmissions had lower C-reactive protein (CRP) levels both during admission and at discharge compared to non-readmitted patients (p = 0.004). This paradox may reflect a subclinical inflammatory response associated with bacterial colonization rather than active infection, particularly in patients with chronic respiratory diseases. Conclusions: MDRB infections and culture positivity are key contributors to prolonged ICU stays, resulting in increased healthcare costs. Implementing effective strategies to manage MDRB infections is critical for improving outcomes in respiratory ICUs and reducing associated risks. This study underscores the growing burden of MDRB and highlights the importance of enhanced antimicrobial stewardship in respiratory ICUs.Öğe Electrolyte Imbalance and Its Prognostic Impact on All-Cause Mortality in ICU Patients with Respiratory Failure(Mdpi, 2025) Mentes, Oral; Celik, Deniz; Yildiz, Murat; Kahraman, Abdullah; Cirik, Mustafa Ozgur; Doganay, Guler Eraslan; Ensarioglu, KeremBackground and Objectives: Chronic obstructive pulmonary disease (COPD) and acute respiratory failure are critical clinical conditions associated with high mortality rates in intensive care units (ICUs). Electrolyte imbalances are significant variables that may influence all-cause ICU mortality in this patient group. In this retrospective study, we aimed to investigate the relationships between the serum levels of sodium (Na+), chloride (Cl-), potassium (K+), calcium (Ca-2(+)), and magnesium (Mg-2(+)) and all-cause ICU mortality in patients admitted with respiratory failure. Additionally, we conducted a detailed mortality analysis on the basis of sodium quartiles and pathological absolute sodium thresholds to reveal their associations with ICU mortality from all causes. Materials and Methods: A total of 1109 patients were analyzed between January 2022 and January 2024. The electrolyte levels measured at ICU admission, demographic data, APACHE II and SOFA scores, arterial blood gas results, BUN and creatinine levels, need for noninvasive mechanical ventilation, length of ICU stay, and survival outcomes were assessed. Statistical analyses were performed via Kaplan-Meier survival analysis and the Cox regression method. Results: Our findings revealed that patients with low potassium and calcium levels had significantly higher mortality rates (p < 0.05). When sodium levels were divided into quartiles, mortality risk markedly increased in both the lowest (Q1) and highest (Q4) quartiles. Cox regression analysis revealed that the mortality risk in hyponatremic patients was 2.2 times greater than that in normonatremic patients (p = 0.005). In the hyponatremic group, the increased mortality risk was statistically borderline significant (p = 0.06). In the logistic regression analysis conducted to evaluate ICU mortality, which included all electrolyte levels and clinical scoring systems, higher APACHE II and SOFA scores were identified as significant risk factors for ICU mortality. Conversely, the presence of COPD was found to be relatively protective compared with other underlying causes of respiratory failure in terms of mortality. Conclusions: Electrolyte imbalances are important predictors of mortality in patients with respiratory failure. Sodium levels exhibit a U-shaped relationship with mortality, with hyponatremia emerging as a prominent risk factor. Careful assessment of electrolyte imbalances is crucial in the clinical management of these patients.Öğe Evaluation of Respiratory Intensive Care Experiences and Relationships with Nutritional Status Among Patients Admitted to the Intensive Care Unit(Mdpi, 2025) Yildiz, Murat; Celik, Deniz; Ozdemir, Tarkan; Ensarioglu, Kerem; Cakir, Melek; Savur, Tugce Dondu; Mentes, OralBackground and Objectives: This study aimed to evaluate patients' experiences in the intensive care unit (ICU) setting and investigate whether there was a correlation between these experiences and their nutritional status. Materials and Methods: This study included patients admitted to the respiratory ICU between 1 January 2023 and 31 December 2023. Only patients aged 18 years or older were eligible for inclusion. Written and verbal consent was obtained from all participants, while those unable to provide nonverbal communication were excluded from the study. The Intensive Care Experience Questionnaire (ICEQ), developed by Rattray et al. in 2004, was utilized to assess the overall experiences of ICU patients. Results: The ICEQ results were analyzed across four categories: awareness of surroundings, recall of experiences, frightening experiences, and satisfaction with care. A total score was generated by summing the scores of these four categories. While the initial parameters were analyzed as ordinal data, the results for the four subcategories and the total score followed a parametric distribution and were thus analyzed accordingly. Conclusions: These findings reinforce the hypothesis that nutritional support requirements play a critical role in shaping patients' experiences in the ICU, regardless of their preadmission status. Adequate nutritional support was shown to have a positive effect on ICU experience.
