Researcher:
Yurdakul, Fatma

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Doctor

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Fatma

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Yurdakul

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Yurdakul, Fatma

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2021 - 20223

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    Physical rehabilitation in intensive care unit in acute respiratory distress syndrome patients with COVID-19
    (Edizioni Minerva Medica, 2021) N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; Taşkıran, Özden Özyemişçi; Turan, Zeynep; Tekin, Süda; Şentürk, Evren; Topaloğlu, Mahir; Yurdakul, Fatma; Ergönül, Önder; Çakar, Nahit; Faculty Member; Doctor; Faculty Member; Faculty Member; Doctor; Doctor; Faculty Member; Faculty Member; School of Medicine; N/A; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; School of Medicine; KUH Hospital; 133091; N/A; 42146; 48359; N/A; N/A; 110398; 198906
    Background: The risk of muscle weakness is high in the survivors of acute respiratory distress syndrome with COVID-19 following discharge from intensive care unit. AIM: To evaluate the effects of early rehabilitation program in intensive care unit in patients with acute respiratory distress syndrome secondary to COVID-19. Design: The design of the study is observational. SETTING: The setting of the study is inpatient Population: Thirty-five patients with acute respiratory distress syndrome secondary to COVID-19 were enrolled. Methods: This study was performed in an intensive care unit of a university hospital. Early rehabilitation program consisting of passive or active range of motion exercises and neuromuscular electrical stimulation in addition to standard intensive care (N.=18) compared to standard intensive care (N.=17). Primary outcome was hand grip strength following discharge. RESULTS : Rehab group had higher prevalence of chronic pulmonary diseases and neurologic diseases. There was no difference in hand grip or manual muscle strength following discharge between rehab and non-rehab groups. No adverse event was noted. Conclusions: The results did not support the beneficial effects of early rehabilitation in intensive care unit on improving muscle strength. More patients with pulmonary and neurologic diseases in rehab group might impede the impact of rehabilitation on outcomes. On the other hand, these comorbidities underline the role and need of rehabilitation. It is safe both for the patients and the health care workers when necessary precautions are taken. Clinical Rehabilitation Impact: This study guide how to rehabilitate patients with acute respiratory distress syndrome with COVID-19 during intensive care unit in a safe way.
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    The association between Acinetobacter baumannii infections and the COVID-19 pandemic in an intensive care unit
    (Nature Publishing Group (NPG), 2022) N/A; Boral, Jale; Pınarlık, Fatihan; Can, Füsun; Ekinci, Güz; Kuşkucu, Mert Ahmet; Ergönül, Önder; Genç, Zeliha; İrkören, Pelin; Kapmaz, Mahir; Çakar, Nahit; Şentürk, Evren; Yurdakul, Fatma; Dikenelli, Bilge; Tekin, Süda; PhD Student; PhD Student; Faculty Member; Master Student; Faculty Member; Faculty Member; Nurse; Doctor; Doctor; Faculty Member; Faculty Member; Doctor; Doctor; Faculty Member; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); Graduate School of Health Sciences; Graduate School of Health Sciences; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; N/A; N/A; N/A; School of Medicine; School of Medicine; N/A; N/A; School of Medicine; Koç University Hospital; N/A; N/A; 103165; N/A; N/A; 110398; N/A; N/A; N/A; 198906; 48359; N/A; N/A; 42146
    We aimed to describe the increased rate of Acinetobacter baumannii infections during the COVID-19 pandemic and define its significance within the last five years. This study was performed in a tertiary hospital with 280 beds and included all patients infected with A. baumannii in the intensive care unit between January 1, 2018, and June 30, 2022. A. baumannii-infected patients in the intensive care unit 27 months before the pandemic and 27 months during the pandemic were included. Pulsed-field gel electrophoresis was performed to assess clonal relatedness. The infection control measures were specified based on the findings and targeted elimination. In total, 5718 patients were admitted to the intensive care unit from January 1st, 2018, to June 30th, 2022. A. baumannii infection was detected in 81 patients. Compared to the pre-pandemic era, the rate of A. baumannii infection during the pandemic was 1.90 times higher (OR: 1.90, 95% CI: [1.197, 3.033]). Clonality assessment of multidrug-resistant A. baumannii samples revealed eight clusters with one main cluster comprising 14/27 isolates between 2021 and 2022. The case fatality rate of the pre-pandemic and pandemic era was not different statistically (83.33% vs. 81.48%, p=0.835). Univariate analysis revealed the association of mechanical ventilation (p=0.002) and bacterial growth in tracheal aspirate (p=0.001) with fatality. During the COVID-19 pandemic, potential deficits in infection control measures may lead to persistent nosocomial outbreaks. In this study, the introduction of enhanced and customized infection control measures has resulted in the containment of an A. baumannii outbreak.
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    PublicationOpen Access
    Is obesity paradox valid for critically-ill COVID-19 patients with respiratory failure?
    (Aves, 2022) Canbaz, Hande Bulut; Sezer, Havva; Yurdakul, Fatma; Özserezli, Boğaç; Dereli, Dilek Yazıcı; Teaching Faculty; Faculty Member; School of Medicine; School of Nursing; Koç University Hospital; N/A; N/A; N/A; N/A; 179659
    Objective: we aimed to analyze the association between body mass index and mortality in patients with coronavirus disease 2019 induced acute respiratory distress syndrome. Materials and methods: in this retrospective cohort study, we analyzed 108 consecutive patients admitted in the intensive care unit for coronavirus disease 2019-induced lung disease in a single center between March 2020 and February 2021. Coronavirus disease 2019 infection was confirmed by real-time reverse transcription-polymerase chain reaction assay of nasal swabs or lower respiratory tract samples. Acute respiratory distress syndrome was defined using Berlin criteria. Acute respiratory distress syndrome severity was assessed with partial pressure of arterial oxygen/fraction of inspired oxygen ratio. We categorized patients according to the body mass index as underweight, <18.5 kg/m2; normal weight, from 18.5 kg/m2 to <25 kg/m2; overweight, from 25 kg/m2 to <30 kg/m2; obese, ?30 kg/m2. Clinical characteristics and mortality were compared among groups. Demographic and clinical data were collected from electronic medical records of the hospital system. Results: the mean age was 67.3 ± 13.3 years. Study participants were predominantly males (66.7%). The mean BMI was 28.2 ± 5.6 kg/m2. There were 2 patients (2%), 28 (26%), 42 (39%), and 36 patients (33%) in the underweight, normal-weight, overweight, and obese groups, respectively. The hospital mortality was 40.7%. There was no association between body mass index and mortality (P =.09). In multivariate analysis, mortality was associated with the presence of cancer [odds ratio = 7.338 (1.636-32.914), P =.009], and time between diagnosis and intubation [odds ratio = 1.318 (1.150-1.509), P ?.001]. Conclusion: neither acute respiratory distress syndrome severity nor mortality was higher in patients with higher body mass index compared to the ones with normal body mass index.