Araştırma Makalesi
Yıl 2019,
Cilt: 7 Sayı: 2, 55 - 67, 30.12.2019
Öz
Öz: Çalışmanın amacı sepsisli
neonatal buzağılarda hematolojik ve biyokimyasal değişimlerin araştırılmasıdır.
Çalışmada, 20 adet sepsisli ve klinik olarak sağlıklı 10 adet neonatal buzağı
kullanıldı. Bütün buzağıların rutin klinik muayenesi yapıldı ve monitörize
edilerek sistolik kan basıncı (SKB), diyastolik kan basıncı (DKB) ve ortalama
arteriyel kan basıncı (MAP) belirlendi. Ayrıca tüm hayvanların pulse oksimetre
ile oksijen satürasyonları (SpO2) ölçüldü. Çalışmada yer alan tüm
buzağıların hematolojik ve biyokimyasal analizleri yapıldı. Çalışmada sepsisli buzağıların
vücut ısısı (p<0.001) ve SpO2 (p<0.01) değerleri düşük,
solunum sayılarının (p<0.01) ise kontrol grubuna göre yüksek olduğu
belirlendi. Hematolojik analizlerde sepsisli buzağıların total lökosit (WBC,
p<0.001), monosit (MID, p<0.001), granülosit (GRA, p<0.01), ortalama
korpuskuler volüm (MCV, p<0.01), ortalama korpuskuler hemoglobin (MCH,
p<0.001) ve ortalama korpuskuler hemoglobin konsantrasyonu (MCHC, p<0.01)
düzeyleri kontrol grubu değerlerine göre yüksek bulundu. Çalışmada yapılan
biyokimyasal analizlerde ise sepsisli buzağıların total bilirubin (T.BİL,
p<0.01), direkt bilirubin (D.BİL, p<0.001), üre (ÜRE, p<0.001),
kreatinin (KREA, p<0.001), aspartat aminotrasferaz (AST, p<0.01) ve
laktat dehidrojenaz, p<0.001) değerlerinde kontrol grubuna göre anlamlı
artışlar saptanırken total protein (TP, p<0.01), albümin (ALB, p<0.001)
ve immunoglobulin (Ig, p<0.001) düzeylerinde ise önemli düzeyde düşüşler
belirlendi. Yatar pozisyonda olan sepsisli (şiddetli) grupta ayakta olan (orta
derecede) sepsisli buzağılara göre daha çok sayıda buzağıda hematolojik ve
biyokimyasal parametrelerde değişimler belirlendi. Elde edilen TP ve Ig
sonuçları sepsisli buzağılarda yetersiz kolostrum alındığını ve pasif immun
transfer yetmezliğinin geliştiğini göstermektedir. Sonuç olarak sepsis neonatal
buzağılarda önemli hematolojik ve biyokimyasal değişimlere neden olmakta ve kalp,
karaciğer ve böbrekler gibi organların fonksiyonlarını negatif yönde etkilemektedir.
Elde edilen bu sonuçların sepsisli buzağıların tanısı, tedavisinin
yönlendirilmesi ve prognozunun belirlenmesinde yararlı olacağı kanısındayız.
Anahtar Kelimeler: Biyokimya,
Buzağı, Hematoloji, Monitörizasyon, Sepsis.
Anahtar Kelimeler
Proje Numarası
0467-YL-17
Kaynakça
- KaynaklarAl-Khafaji, A.H., Pinsky, M.R., 2017. Multiple Organ Dysfunction Syndrome in Sepsis, http://emedicine.medscape.com/article/169640-overview.(10.03.2016).Angus, D.C., Van der Poll, T., 2013. Severe sepsis and septic shock. N Engl J Med. 369(9):840-851.Asati, C.K., Roy, S. and Roy, M., 2008. Haemato-biochemical study and diagnosis in calves. Intas-Polivet., 2, 245-248.Aydoğdu, U., Güzelbekteş, H., 2018. Effect of colostrum composition on passive calf immunity in primiparous and multiparous dairy cows. Veterinarni Medicina, 63,1–11Basoglu., A., Baspinar, N., Tenori, L., Hu, X., Yildiz, R., 2014. NMR Based Metabolomics Evaluation in Neonatal Calves with Acute Diarrhea and Suspected Sepsis: A New Approach for Biomarker/S Metabolomics, 4, 1-6.Başer, D.F., Civelek, T., 2013. Correlations between venous acid-base status and renal function in neonatal calves with acute diarrhea. Kocatepe Vet J., 6, 25-31Bedenice, D., Whitehead, C., 2016. A systematic approach to the neurological examination of llamas and alpacas. Livestock, 21, Camelids.Bedenice, D.C., 2016. Overview of Management Of the neonate in Large Animals. Merck Veterinary Manual 11th edition, http://www.merckvetmanual.com/management-and-nutrition.(16.5.2017).Bednarski, M., Kupczynski, R., Sobiech, P., 2015. Acid-base disorders in calves with chronic diarrhea. Pol J Vet., 18, 207–215.Bozukluhan, K., Merhan, O., Gökçe, H.İ., Deveci, H.A., Gökçe, G., Ongun, M., Maraşlı, Ş., 2017. Alterations in lipid profile in neonatal calves affected by diorrhea. Veterinary World, 10, 786–789.Brar, A.P.S., Sood, N.K., Ahuja, C.S., Sandhu, B.S., Gupta, K., Singh, C.K., 2014. Serum biochemical changes in neonatal diarrhoeic calves of different age groups. Indian J Vet Pathol., 38, 14-17.Brar, T.K., Singh, K.D., Kumar, A., 2015. Effect of different phases of menstrual cycle on heart rate variability (HRV). J Clin Diagn Res., 9, 1-4. Cho Y-il, Yoon K-jin 2014. An overview of calf diarrhea-infectious etiology, diagnosis, and intervention. J Vet Sci., 15 (1), 1–17. Civelek, T., Kav, K., Camkerten, İ., Çelik, H.A., Acar, A., 2007. Bacterial pneumonia in neonatal calves on serum lipids. Bull Vet Inst Pulawy., 51, 503-507.Constable, P.D., Hinchcliff, K.W., Done, S.H., Grünberg, W., 2016. Veterinary Medicine, 11th ed, Saunders Ltd. China, p: 57-67.Egli, C.P., Blum, J.W., 1998. Clinical, haematological, metabolic and endocrine traits during the first three months of life of suckling simmentaler calves held in a cow-calf operation. Zentralbl Veterinar med A., 45, 99-118.Fecteau, G., Pare, J., Van Metre, D.C., Smith, B.P., Holmberg, C.A., Guterbock, W., Jang S., 1997. Use of a clinical sepsis score for predicting bacteremia in neonatal dairy calves on a calf rearing farm. Can Vet J., 38, 101-104.Fecteau, G., Smith, B.P., George, L.W., 2009. Septicemia and meningitis in the newborn calves. Vet Clin North Am Food Anim Pract., 25, 195-208.Gasparavic, V., Dakovic, K., Gornik, I., Radonic, R., 2014. Severe Acute Pancreatitis as a Part of Multiple Dysfunction Syndrome. Coll Antropol., 38, 125–128.Himanshu, 2010. Clinico-pathologic and therapeutic studies on enteritis in neonatal calves. Department of Veterinary Medicine, CSK Himachal Pradesli Krislii Vishvavidyalaya PaIampur-176 062 (H.P.) India.House, A.M., Irsik, M., Shearer, J.K., 2008. Sepsis, Failure of Passive Transfer, and Fluid Therapy in Calves.1 Veterinary Medicine-Large Animal Clinical Sciences Department publications, http://www.calfology.com, p: 1-5.Jezek, J., 2007. The dynamics of serum immunoglobulin concentrations and hematological and biochemical parameters in the period to the age of 24 weeks in diferently reared calves, p: 172, Univerza v Ljubljani, Veterinarska fakulteta, Ljubljana, Slovenija.Jezek, J., Klocic, M., Klinkon, M., 2006. Influence of age on biochemical parameters in calves. Bull Vet Inst Pulawy., 50, 211–214.Kaneko, J..J, Harvey, J.W., Bruss, M.L., 2008. Clinical Biochemistry of Domestic Animals. p: 364-390.6th ed. Academic Press, New York. ABD.Kaneko, J.K., 1997. Clinical biochemistry of domestic animals, 5th ed, Academic pres, San Diego, p: 413.Kaur, K., Randhawa, S.S., Chhabra, S., 2006. Haemato-biochemical profile of diarrhoeic dairy calves affected with colibacillosis. Indian Journal of Veterinary Medicine., 26, 9-11.King, E.G., Bauza, G.J., Mella, J.R., Remick, D.G ., 2014. Pathophysiologic mechanisms in septic shock. Lab Invest., 94, 4–12.Klinkon, M., Jezek, J., 2012. Volues of blood variables in calves. 302-320. https://www.researchgate.net/publication/290488632_Values_of_blood_variables_in_calves.( 20.10.2018).Knowles, T.G., Edwards, J.E., Bazeley, K.J., Brown, S.N., Butterworth, A., Warriss, R.D., 2000. Changes in the blood biochemical and haematological profile of neonatal calves with age. Veterinary Record., 147, 593-598.
- Kumar, S., Jakhar, K.K., Nehra, V., Singh, S., 2018. Alterations of haemato-biochemical and oxidative stress parameter in diarrhoeic buffalo calves. The Pharma Innovation Journal., 7, 195-197.Kurz, M.M., Willett, L.B., 1991. Carbonhydrate, enzyme, and hematology Dynamics in newborn calves. J Dairy Sci., 74, 2109-2118.Lassen, E.D., 2004. Laboratory evaluation of plasma and serum proteins. In: Thrall MA, editor. Veterinary hematology and clinicalchemistry. Philadelphia (PA): Lippincott Williams &Wilkins, p: 401–415.Lofstedt, J., Dohoo, I.R., Duizer, G., 1999. Model to predict septicemia in diarrheic calves. J Vet Intern Med., 13,81-8.Maach, L., Grunder, H.D., Boujya, A., 1992. Clinical and haematological investigations in new born Holstein Friesian calves with diarrhea in Morocco. Deutsche Tierarztliche Wochenschrfi, 99, 133-140.Maden, M., Birdane, F.M., Altunok, V., Dere, S., 2004. Serum and colostrum/milk alkaline phosphatase activities in the determination of passive transfer status in healty lambs. Revue Méd Vét., 155, 565-569.Martin, G.S., Mannino, D.M., Eaton, S., Moss M., 2003. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med., 348, 1546-1554.McGuirk, S.M., 2011. Management of Dairy Calves from Birth to Weaning. Ed (s): Risco, CA, Retemal PM, Dairy Production Medicine, Wiley –Blackwell, West Sussex, p: 175-182.Merx, M.W., Weber, M.D., 2007. Sepsis and the Heart. Circulation, 116, 793-802.Mohri, M., Sharifi, K., Eidi, S., 2007. Hematology and serum biochemistry of Holstein dairy calves: Age related changes and comparison with blood composition in adults. Res Vet Sci., 83, 30–39.Muri, C., Schottstadt ,T., Hammon, H.M., Meyer, E., Blum, J.W., 2005. Hematological. Metabolic and endocrine effects of feedning vitamin A and lactoferin in neonatal calves. Journal of dairy science, 88,1062-1077.Osterbur, K., Mann, F.A., Kuroki, K., DeClue, A., 2014. Multiple Organ Dysfunction Syndrome in Humans and Animals. J Vet Intern Med., 28, 1141–1151.Pardon, B., Deprez, P., 2018. Rational antimicrobial therapy for sepsis in cattle in face of the new lagislation on critically important antimicrobials. Vlaams Diergeneeskundig Tijdschrift, 87, 37-46.Pekcan, M., Fidancı, U.R., Yüceer, B., Özbeyaz, C., 2013. Estimation of passive immunity in newborn calves with routine. Ankara Üniv Vet Fak Derg., 60, 85-88.Poulsen, K.P., Foley, A.L., Collins, M.T., McGuirk, S.M., 2010. Comparison of passive transfer of immunity in neonatal dairy calves fed colostrum or bovine serum-based colostrum replacement and colostrum supplement products. J Am Vet Med Assoc., 237, 949–954. Rastawicki, W., Paradowska-Stankiewicz, I., Stefanoff, P., Zasada, A.A., 2011. Reliability of the cut-off value in the routine serodiagnosis of pertussis performed by the commercial ELISA assays. Med Dosw Mikrobiol.,63, 73-80.Santos, R.L., Renee, M., Baumler, J. and Adams, L., 2002. Hematologicand serum biochemical changes in Salmonella ser Typhimurium-infectedcalves. 110 Am. J. Vet. Res. 63, 1145-115.Singh, M., Gupta, V.K., Mondal, D.B., Bansal, S.K., Sharma, D.K., Shakya, M., Gopinath, D., 2014. A study on alteration in haemato-biochemical parameters in Colibacillosis affected calves. International Journal of Advanced Research. 2, 746-750.Smith, B.P., 2015. Large Animal Internal Medicine, 5th edition, Elsevier Press, Missouri, p 221-339.Sobiech, P., Kuleta, Z., 2006. Activity of LDH isoenzymes in diarrhoeic calves. Bull Vet Inst Pulawy., 50, 401-404.Thomas H.S., 2014., Septicemia and Toxemia in Calves, Angus Beef Bulletin, 7, 1. Tothova, C., Nagy, O., Kovac, G., Nagyova, V., 2016., Changes in the concentratios of serum proteins in calves during the first month of life. Journal of Applied Animal Research.44, 338-346.Tyler, J.W., Hancock, D.D, Wiksie, S.E., Holler, S.L., Gay, J.M., Gay, CC., 1998. Use of serum protein concentration to predict mortality in mixed-source dairy replacement heifers. Journal of veterinary internal medicine, 12, 79-83.Vincent, J.L., Sakr, Y., Sprung, C.L., 2006. Sepsis in Europeanintensivecareunits: results of the SOAP study. Crit Care Med., 34, 344–353.
Yıl 2019,
Cilt: 7 Sayı: 2, 55 - 67, 30.12.2019
Öz
Destekleyen Kurum
Mehmet Akif Ersoy Üniversitesi
Proje Numarası
0467-YL-17
Teşekkür
Mehmet Akif Ersoy Üniversitesi Bilimsel Araştırma Projeleri Koordinatörlüğüne maddi katkılarından dolayı teşekkür ederiz.
Kaynakça
- KaynaklarAl-Khafaji, A.H., Pinsky, M.R., 2017. Multiple Organ Dysfunction Syndrome in Sepsis, http://emedicine.medscape.com/article/169640-overview.(10.03.2016).Angus, D.C., Van der Poll, T., 2013. Severe sepsis and septic shock. N Engl J Med. 369(9):840-851.Asati, C.K., Roy, S. and Roy, M., 2008. Haemato-biochemical study and diagnosis in calves. Intas-Polivet., 2, 245-248.Aydoğdu, U., Güzelbekteş, H., 2018. Effect of colostrum composition on passive calf immunity in primiparous and multiparous dairy cows. Veterinarni Medicina, 63,1–11Basoglu., A., Baspinar, N., Tenori, L., Hu, X., Yildiz, R., 2014. NMR Based Metabolomics Evaluation in Neonatal Calves with Acute Diarrhea and Suspected Sepsis: A New Approach for Biomarker/S Metabolomics, 4, 1-6.Başer, D.F., Civelek, T., 2013. Correlations between venous acid-base status and renal function in neonatal calves with acute diarrhea. Kocatepe Vet J., 6, 25-31Bedenice, D., Whitehead, C., 2016. A systematic approach to the neurological examination of llamas and alpacas. Livestock, 21, Camelids.Bedenice, D.C., 2016. Overview of Management Of the neonate in Large Animals. Merck Veterinary Manual 11th edition, http://www.merckvetmanual.com/management-and-nutrition.(16.5.2017).Bednarski, M., Kupczynski, R., Sobiech, P., 2015. Acid-base disorders in calves with chronic diarrhea. Pol J Vet., 18, 207–215.Bozukluhan, K., Merhan, O., Gökçe, H.İ., Deveci, H.A., Gökçe, G., Ongun, M., Maraşlı, Ş., 2017. Alterations in lipid profile in neonatal calves affected by diorrhea. Veterinary World, 10, 786–789.Brar, A.P.S., Sood, N.K., Ahuja, C.S., Sandhu, B.S., Gupta, K., Singh, C.K., 2014. Serum biochemical changes in neonatal diarrhoeic calves of different age groups. Indian J Vet Pathol., 38, 14-17.Brar, T.K., Singh, K.D., Kumar, A., 2015. Effect of different phases of menstrual cycle on heart rate variability (HRV). J Clin Diagn Res., 9, 1-4. Cho Y-il, Yoon K-jin 2014. An overview of calf diarrhea-infectious etiology, diagnosis, and intervention. J Vet Sci., 15 (1), 1–17. Civelek, T., Kav, K., Camkerten, İ., Çelik, H.A., Acar, A., 2007. Bacterial pneumonia in neonatal calves on serum lipids. Bull Vet Inst Pulawy., 51, 503-507.Constable, P.D., Hinchcliff, K.W., Done, S.H., Grünberg, W., 2016. Veterinary Medicine, 11th ed, Saunders Ltd. China, p: 57-67.Egli, C.P., Blum, J.W., 1998. Clinical, haematological, metabolic and endocrine traits during the first three months of life of suckling simmentaler calves held in a cow-calf operation. Zentralbl Veterinar med A., 45, 99-118.Fecteau, G., Pare, J., Van Metre, D.C., Smith, B.P., Holmberg, C.A., Guterbock, W., Jang S., 1997. Use of a clinical sepsis score for predicting bacteremia in neonatal dairy calves on a calf rearing farm. Can Vet J., 38, 101-104.Fecteau, G., Smith, B.P., George, L.W., 2009. Septicemia and meningitis in the newborn calves. Vet Clin North Am Food Anim Pract., 25, 195-208.Gasparavic, V., Dakovic, K., Gornik, I., Radonic, R., 2014. Severe Acute Pancreatitis as a Part of Multiple Dysfunction Syndrome. Coll Antropol., 38, 125–128.Himanshu, 2010. Clinico-pathologic and therapeutic studies on enteritis in neonatal calves. Department of Veterinary Medicine, CSK Himachal Pradesli Krislii Vishvavidyalaya PaIampur-176 062 (H.P.) India.House, A.M., Irsik, M., Shearer, J.K., 2008. Sepsis, Failure of Passive Transfer, and Fluid Therapy in Calves.1 Veterinary Medicine-Large Animal Clinical Sciences Department publications, http://www.calfology.com, p: 1-5.Jezek, J., 2007. The dynamics of serum immunoglobulin concentrations and hematological and biochemical parameters in the period to the age of 24 weeks in diferently reared calves, p: 172, Univerza v Ljubljani, Veterinarska fakulteta, Ljubljana, Slovenija.Jezek, J., Klocic, M., Klinkon, M., 2006. Influence of age on biochemical parameters in calves. Bull Vet Inst Pulawy., 50, 211–214.Kaneko, J..J, Harvey, J.W., Bruss, M.L., 2008. Clinical Biochemistry of Domestic Animals. p: 364-390.6th ed. Academic Press, New York. ABD.Kaneko, J.K., 1997. Clinical biochemistry of domestic animals, 5th ed, Academic pres, San Diego, p: 413.Kaur, K., Randhawa, S.S., Chhabra, S., 2006. Haemato-biochemical profile of diarrhoeic dairy calves affected with colibacillosis. Indian Journal of Veterinary Medicine., 26, 9-11.King, E.G., Bauza, G.J., Mella, J.R., Remick, D.G ., 2014. Pathophysiologic mechanisms in septic shock. Lab Invest., 94, 4–12.Klinkon, M., Jezek, J., 2012. Volues of blood variables in calves. 302-320. https://www.researchgate.net/publication/290488632_Values_of_blood_variables_in_calves.( 20.10.2018).Knowles, T.G., Edwards, J.E., Bazeley, K.J., Brown, S.N., Butterworth, A., Warriss, R.D., 2000. Changes in the blood biochemical and haematological profile of neonatal calves with age. Veterinary Record., 147, 593-598.
- Kumar, S., Jakhar, K.K., Nehra, V., Singh, S., 2018. Alterations of haemato-biochemical and oxidative stress parameter in diarrhoeic buffalo calves. The Pharma Innovation Journal., 7, 195-197.Kurz, M.M., Willett, L.B., 1991. Carbonhydrate, enzyme, and hematology Dynamics in newborn calves. J Dairy Sci., 74, 2109-2118.Lassen, E.D., 2004. Laboratory evaluation of plasma and serum proteins. In: Thrall MA, editor. Veterinary hematology and clinicalchemistry. Philadelphia (PA): Lippincott Williams &Wilkins, p: 401–415.Lofstedt, J., Dohoo, I.R., Duizer, G., 1999. Model to predict septicemia in diarrheic calves. J Vet Intern Med., 13,81-8.Maach, L., Grunder, H.D., Boujya, A., 1992. Clinical and haematological investigations in new born Holstein Friesian calves with diarrhea in Morocco. Deutsche Tierarztliche Wochenschrfi, 99, 133-140.Maden, M., Birdane, F.M., Altunok, V., Dere, S., 2004. Serum and colostrum/milk alkaline phosphatase activities in the determination of passive transfer status in healty lambs. Revue Méd Vét., 155, 565-569.Martin, G.S., Mannino, D.M., Eaton, S., Moss M., 2003. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med., 348, 1546-1554.McGuirk, S.M., 2011. Management of Dairy Calves from Birth to Weaning. Ed (s): Risco, CA, Retemal PM, Dairy Production Medicine, Wiley –Blackwell, West Sussex, p: 175-182.Merx, M.W., Weber, M.D., 2007. Sepsis and the Heart. Circulation, 116, 793-802.Mohri, M., Sharifi, K., Eidi, S., 2007. Hematology and serum biochemistry of Holstein dairy calves: Age related changes and comparison with blood composition in adults. Res Vet Sci., 83, 30–39.Muri, C., Schottstadt ,T., Hammon, H.M., Meyer, E., Blum, J.W., 2005. Hematological. Metabolic and endocrine effects of feedning vitamin A and lactoferin in neonatal calves. Journal of dairy science, 88,1062-1077.Osterbur, K., Mann, F.A., Kuroki, K., DeClue, A., 2014. Multiple Organ Dysfunction Syndrome in Humans and Animals. J Vet Intern Med., 28, 1141–1151.Pardon, B., Deprez, P., 2018. Rational antimicrobial therapy for sepsis in cattle in face of the new lagislation on critically important antimicrobials. Vlaams Diergeneeskundig Tijdschrift, 87, 37-46.Pekcan, M., Fidancı, U.R., Yüceer, B., Özbeyaz, C., 2013. Estimation of passive immunity in newborn calves with routine. Ankara Üniv Vet Fak Derg., 60, 85-88.Poulsen, K.P., Foley, A.L., Collins, M.T., McGuirk, S.M., 2010. Comparison of passive transfer of immunity in neonatal dairy calves fed colostrum or bovine serum-based colostrum replacement and colostrum supplement products. J Am Vet Med Assoc., 237, 949–954. Rastawicki, W., Paradowska-Stankiewicz, I., Stefanoff, P., Zasada, A.A., 2011. Reliability of the cut-off value in the routine serodiagnosis of pertussis performed by the commercial ELISA assays. Med Dosw Mikrobiol.,63, 73-80.Santos, R.L., Renee, M., Baumler, J. and Adams, L., 2002. Hematologicand serum biochemical changes in Salmonella ser Typhimurium-infectedcalves. 110 Am. J. Vet. Res. 63, 1145-115.Singh, M., Gupta, V.K., Mondal, D.B., Bansal, S.K., Sharma, D.K., Shakya, M., Gopinath, D., 2014. A study on alteration in haemato-biochemical parameters in Colibacillosis affected calves. International Journal of Advanced Research. 2, 746-750.Smith, B.P., 2015. Large Animal Internal Medicine, 5th edition, Elsevier Press, Missouri, p 221-339.Sobiech, P., Kuleta, Z., 2006. Activity of LDH isoenzymes in diarrhoeic calves. Bull Vet Inst Pulawy., 50, 401-404.Thomas H.S., 2014., Septicemia and Toxemia in Calves, Angus Beef Bulletin, 7, 1. Tothova, C., Nagy, O., Kovac, G., Nagyova, V., 2016., Changes in the concentratios of serum proteins in calves during the first month of life. Journal of Applied Animal Research.44, 338-346.Tyler, J.W., Hancock, D.D, Wiksie, S.E., Holler, S.L., Gay, J.M., Gay, CC., 1998. Use of serum protein concentration to predict mortality in mixed-source dairy replacement heifers. Journal of veterinary internal medicine, 12, 79-83.Vincent, J.L., Sakr, Y., Sprung, C.L., 2006. Sepsis in Europeanintensivecareunits: results of the SOAP study. Crit Care Med., 34, 344–353.
Toplam 2 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Proje Numarası | 0467-YL-17 |
| Yayımlanma Tarihi | 30 Aralık 2019 |
| Gönderilme Tarihi | 9 Eylül 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 7 Sayı: 2 |
