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Introduction: Long-term home non-invasive mechanical ventilation (NIV) is widely used in patients with hypercapnic chronic obstructive pulmonary disease (COPD). However, its efficacy is heavily dependent on patient adherence. Body mass index (BMI) can influence tolerance and ventilatory load, but its impact on adherence remains unclear. Additionally, NIV for later use at home is frequently initiated during hospitalization to facilitate early discharge, and its ongoing necessity varies. Methods: This retrospective cohort study included patients with stable hypercapnic COPD prescribed home NIV between 2017 and 2025 at a tertiary respiratory intensive care unit outpatient clinic. Demographics, arterial blood gases, spirometry, ventilator settings, and first-month NIV usage data were extracted from the patients’ medical records. We used correlation analyses and Poisson regression modeling to evaluate factors associated with daily hours of NIV use. Results: A total of 413 patients were included. The mean partial pressure of carbon dioxide was 48 ± 7 mmHg. The mean forced expiratory volume in the first second was 28%, indicating severe airflow limitation. Overall adherence was very poor, with approximately 80% of patients using NIV for < 4 hours a day, regardless of their BMI category. We found no significant linear correlation between BMI and NIV adherence. A large proportion of the low-adherence group had elevated bicarbonate (HCO₃⁻) levels (≥ 27 mmol/L), suggesting chronic compensated hypercapnia. Multivariable analysis found BMI to predict slightly higher adherence (risk ratio [RR] 1.01; p = 0.050), whereas higher HCO₃⁻ was associated with lower adherence (RR 0.96; p = 0.020). Discussion: BMI was not a major determinant of first-month NIV adherence, whereas elevated HCO₃⁻ levels may help identify patients at increased risk of poor early NIV adherence.

Background: Kyphoscoliosis is a restrictive thoracic disorder frequently associated with chronic respiratory failure. While home non-invasive ventilation (NIV) improves short-term outcomes, long-term mortality predictors remain underexplored in this context. Methods: This retrospective cohort study evaluated 88 kyphoscoliosis patients with chronic respiratory failure who were initiated on home-based NIV between 2008 and 2018 at a tertiary ICU outpatient clinic. The demographic, clinical, and laboratory data were analyzed. Survival was assessed using Kaplan–Meier analysis, and independent predictors of mortality were identified via Cox regression. Results: Among the 88 patients (52% male), 28 (32%) died during long-term follow-up. Age, BMI, pulmonary function, and arterial blood gas values were similar between survivors and non-survivors. Non-survivors had significantly higher mMRC dyspnea scores, were more likely to be active smokers, and had a higher prevalence of coronary artery disease (CAD) (p = 0.015). The Kaplan–Meier survival analysis revealed significantly lower survival in patients with CAD (p = 0.021) and active smokers (p = 0.034). Cox regression analysis indicated that the presence of CAD (HR: 5.69, 95% CI: 1.34–24.08, p = 0.018) and hospital admission after the initiation of home-based NIV therapy (HR: 1.97, 95% CI: 1.01–3.85, p = 0.040) increased the risk of mortality. Conversely, a higher pH at the last outpatient visit was associated with improved survival (HR: 0.50, 95% CI: 0.00–0.692, p = 0.003). Conclusions: CAD, pH value, and increased ICU admissions after the initiation of home-based NIV are predictors of mortality in kyphoscoliosis patients. The study results highlight reduced survival associated with the presence of coronary artery disease and smoking, emphasizing the importance of routine cardiovascular assessment and close clinical follow-up in this high-risk population.

Research is limited in describing the association between admission source and mortality in critically ill patients. Therefore, this study investigated how intensive care units (ICUs) admission source (emergency department (ED) or ward) correlates with mortality rates. This retrospective observational cross-sectional study was conducted in a tertiary pulmonology teaching hospital's ICU from January 1, 2018, to December 31, 2019. Patients were ICU patients admitted for acute respiratory failure. Demographic, comorbidities, diagnoses, APACHE II score, ICU admission (ED or ward), mechanical breathing support (invasive or noninvasive), length of stay, and mortality were recorded. Comparisons of ICU admission sources and mortality factors were established. A total of 2,173 ICU patients were studied; 1,011 (46%) were admitted from the ED and 1,162 (54%) from the ward. Their mean age was 70 years, and 66% of them were men. Pneumonia was the leading cause of ICU admission at 60% and Chronic Obstructive Pulmonary Disease (COPD) was the most common comorbidity at 54%. When both groups were evaluated in terms of respiratory support, non-invasive mechanical ventilation use was higher in patients admitted from the emergency room (ED: 50% vs. Ward: 35%), invasive mechanical ventilation was more frequently required in patients admitted from the ward compared to those admitted from the emergency department (ED: 17% vs. Ward: 25%). Length of ICU stay (2 vs. 3 days P < 0.001) and ICU mortality (odds ratio: 1.66, 95% confidence interval 1.297-2.124, P < 0.001) were higher in patients admitted from the ward than in patients admitted from the emergency department. In addition, pneumonia patients and those with malignancies, interstitial lung disease, or noninvasive mechanical ventilation (NIV) failure were associated with higher mortality. Our study suggests that ward-to-ICU patients had higher mortality rates compared to ED-to-ICU patients. Triage protocols to better identify potentially critically ill patients in the ED may improve outcomes by avoiding delays in care and better assignment of admission location.

Multidisipliner Kardiyoloji Yoğun Bakım Tanımı ve Teknik Özellikleri Servet Altay Kardiyoloji Yoğun Bakımda Fizik Muayene Esasları Sena Sert Şekerci Kardiyoloji Yoğun Bakımında İnvaziv Hemodinamik Ölçümler Songül Usalp Arter Kan Gazı Değerlendirme Ethem Yıldız Yoğun Bakımda Beslenme Esasları Hande Özportakal Hipo/Hiperglisemi ve Diyabetik Komalara Yaklaşım Seydahmet Akın Songül Aktaş Koroner Yoğun Bakımda Akut Koroner Sendrom Hastalarının Yönetimi Efe Yılmaz Muhammet Gürdoğan Akut Koroner Sendrom Mekanik Komplikasyonları Mustafa Ferhat Keten Akut Kalp Yetersizliği ve Kardiyojenik Şok Yusuf Bilen Akut Fulminan Miyokardit Ertan Ekici Havva Tuğba Gürsoy Takotsubo Kardiyomiyopatisi Melik Demir Yoğun Bakım Ünitesinde Ventriküler Taşikardilere Yaklaşım Gökay Taylan Supraventriküler Taşiaritmilere Yaklaşım Çağan Yıldırım Alper Kepez Digoksin İntoksikasyonu Tuğba Kayhan Altuner Akut Doğal Kapak Yetersizlikleri Semih Kalkan Akut Protez Kapak Patolojileri Mustafa Ozan Gürsoy Hipertansif Aciller Mehmet Murat Yiğitbaşı Hülya Çiçekçioğlu Akut Aortik Sendromlar Hasan Ali Sinoplu Ersan Oflar Pulmoner Emboli ve Kateter Bazlı Tedavi Yöntemleri Ümit Öztürk Halil Ataş İnotrop ve Vazopressör Ajanlar Mehmet Ali Astarcıoğlu Yoğun Bakımda Diürez ve Aldığı Çıkardığı Takibi Esasları Flora Özkalaycı Kaçar Burcu Candan Renal Replasman Tedavisi Serap Yadigar Elif Arı Bakır Kardiyorenal Sendrom Ferdi Karagöz İlhan Kurultak Yoğun Bakımda Terapötik Hipotermi Mustafa Ebik Kardiyak Travma Safa Özçelik Elektriksel Fırtınaya Yaklaşım Abdulkadir Uslu Perikardiyal Efüzyon ve Kardiyak Tamponad Kadriye Memiç Sancar Gamze Babur Güler Yoğun Bakımda Geçici Kalp Pili Uygulamaları Sedat Sakallı Veysel Özgür Barış Geçici Mekanik Destek Cihazları Ahmet Can Topçu Şeyhmus Külahçıoğlu Ventriküler Destek Cihazları Hakan Hançer Mehmet Kaan Kırali Kalp Nakli Sonrası Takip, Tedavi ve Hasta Yönetimi Mustafa Mert Özgür Antikoagülan ve Antiplatelet Tedavi Altında Kanamaya Yaklaşım Tuba Unkun Vasküler Giriş Yeri Komplikasyonları Doğancan Çeneli Kadir Bıyıklı TAVI Sonrası Komplikasyonlar Mehmet Aytürk Münevver Sarı Yoğun Bakımda Deliryum Yönetimi Mengühan Araz Altay Akut İskemik İnmeye Yaklaşım Ayşenur Önalan Erdem Gürkaş Akut Solunum Yetmezliğine Yaklaşım Nezihe Çiftaslan Gökşenoğlu Nalan Adıgüzel Yoğun Bakımda Enfeksiyonun Kontrol ve Önlenmesi İnşa Gül Ekiz İşcanlı Acil Bronkoskopi Barış Yılmaz Gökay Güngör Akut Respiratuar Distres Sendromu Temel Güner Esra Adıyeke Kardiyoloji Yoğun Bakımda Sedasyon ve Analjezi Münire Deniz Mustafa Emre Gürcü

COVID-19,lymphocyte,eosinophil,intensive care unit,hospitalization

While C-reactive protein (CRP) is a well-studied marker for predicting treatment response and mortality in sepsis, it was aimed to assess the efficacy of the neutrophil lymphocyte ratio (NLR) as a predictor of mortality and treatment response in sepsis patients in the intensive care unit (ICU). In this retrospective cross-sectional study, sepsis patients were divided according to the presence of septic shock on the 1st day of ICU stay, and then subgrouped according to mortality. Patient demographics, acute physiologic and chronic health evaluation II and sequential organ failure assessment scores, NLR and CRP (on the 1st, 3rd, and last day in the ICU), microbiology data, antibiotic responses, ICU data, and mortality were recorded. Receiver operating characteristic (ROC) curves for the area under curve (AUC) were calculated for the inflammatory markers and ICU severity scores for mortality. Of the 591 (65% male) enrolled patients, 111 (18.8%) were nonsurvivors with shock, 117 (19.8%) were survivors with shock, 330 (55.8%) were survivors without shock, and 33 (5.6%) were nonsurvivors without shock. On the 1st day of ICU stay, the NLR and CRP were similar in all of the groups. On the 3rd day of antibiotic response, the NLR was increased (11.8) in the nonresponsive patients when compared with the partially responsive (11.0) and responsive (8.5) patients. If the NLR was ≥15 on the 3rd day, the mortality odds ratio was 6.96 (CI: 1.4–34.1, P < 0.017). The NLR and CRP on the 1st, 3rd, and last day of ICU stay (0.52, 0.58, 0.78 and 0.56, 0.70, 0.78, respectively) showed a similar increasing trend for mortality. The NLR can predict mortality and antibiotic responsiveness in ICU patients with sepsis and septic shock. If the NLR is >15 on the 3rd day of postantibiotic initiation, the risk of mortality is high and treatment should be reviewed carefully.

Nosocomial pneumonia (NP) and ventilator associated pneumonia (VAP) have been associated with financially significant economic burden and increased case fatality rate in adult intensive care units (ICUs). This study was designed to evaluate case fatality rate among patients with NP and VAP in a respiratory ICU.

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