Browsing by Author "Heppekcan D."

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    An adverse event associated with antifungal therapy: Clinic-like posterior reversible encephalopathy syndrome; [Antifungal ilaca bağlı gelişen yan etki: Posterior reversible ensefalopati sendromu benzeri klinik?]
    (AVES İbrahim KARA, 2018) Ak A.K.; Erbüyün S.; Heppekcan D.; Batum M.; Boyacı R.; Mavioğlu H.; Tok D.A.
    Posterior reversible encephalopathy syndrome (PRES) is a diagnosis characterized by headache, changes in consciousness, epileptic seizures, visual symptoms (decreased visual acuity and blurred vision), vasospasm, and perfusion abnormalities in the posterior systemic vessels of the brain. The most common clinical findings of PRES include headache, epileptic seizure, altered consciousness, motor deficits, and loss of vision. In the patient who presented with symptoms similar to those in PRES after the use of anidulafungin and had a history of trauma, other causes of PRES (like carotid and/or vertebral artery dissection, intra-abdominal trauma, and head trauma etc.) were excluded. In our case, visual disturbance was assessed as being secondary to central nervous system pathology. There are no similar cases in the literature that presented with clinical features of PRES and normal imaging findings. The primary aim of this study was to draw attention to the fact that anidulafungin may cause symptoms similar to those in PRES. © 2018 by Turkish Society of Medical and Surgical Intensive Care Medicine.
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    Impact of Secondary Insults in Brain Death After Traumatic Brain Injury
    (Elsevier USA, 2019) Heppekcan D.; Ekin S.; Çivi M.; Aydın Tok D.
    In addition to primary injury in severe head trauma, secondary systemic insults that aggravate the brain injury may result in fatal neurologic outcome. We aim to evaluate the correlation between brain death and secondary systemic insults in 100 patients with severe traumatic brain injury (TBI) admitted to the intensive care unit. We collected data on hypotension and hypoxemia at the time of admission to intensive care unit and data on hypotension, hypoxemia, hypocarbia, hypercarbia, shock, anemia, hyperglycemia, and hyperthermia within the first 24 hours. In addition, we recorded the category of TBI according to computed tomography findings. Twenty-six patients (26%) who developed brain death were significantly younger than survivors. Early hypotension (odds ratio [OR], 10.24; 95% confidence interval [CI], 3.64–28.78; P = .000) and early shock (OR, 8.31; 95% CI, 2.65–26.01; P = .000) were significantly more frequent among brain-death patients. The most featured factor that independently predicted the development of brain death in patients with severe TBI was the existence of hypotension (B–2.74; 95% CI, 0.016–0.252; P = .000). The most common type of injury among brain death patients was a surgically evacuated mass lesion. Although all critical care principles are applied to prevent secondary systemic brain insults, when brain death occurs, the prevention of hypotension will become significant in preserving organs in better condition for procurement. © 2019 Elsevier Inc.