Intensive Care and Anesthesiology

MPGCARE coordinates specialist assessment at suitable Medical Park and Liv Hospital partner centers in Türkiye. The receiving hospital, clinician and available services are confirmed individually. A clinical examination and review of previous records guide the plan; photographs or a remote inquiry do not establish a diagnosis or guarantee a procedure.
Intensive care provides close monitoring and organ support for critically ill patients. Anesthesiology includes assessment and safe delivery of anesthesia, sedation and perioperative care. These are related but different services. This page describes adult care; pediatric and neonatal critical care require the appropriate specialist unit.
An ICU admission or international transfer is not a routine travel booking. The current and receiving physicians must review the patient, medical transport, hospital capability and an available bed. If someone is acutely deteriorating, seek local emergency care immediately rather than waiting for MPGCARE or planning an overseas journey.

Conditions and clinical needs that may require specialist care

The examples below describe possible assessment pathways. The clinician chooses investigations and care according to findings, alternatives, medical history and informed consent.

Condition or concern	Assessment and treatment options	Planning and follow-up
Sepsis and septic shock	Urgent infection assessment, treatment of the source and organ support.	Immediate local stabilization; elective travel must not delay care.
Acute respiratory failure and severe pneumonia	Oxygenation assessment and selected non-invasive/invasive ventilation.	Support is adapted to cause and response.
Acute respiratory distress syndrome	Critical-care evaluation and lung-support strategy.	Advanced rescue options depend on indication and center capability.
Circulatory shock	Assess infection, bleeding, heart or other causes; fluids/drugs as appropriate.	Close organ and circulation monitoring.
After cardiac arrest	Critical-care and cardiac/neurological evaluation.	Outcome cannot be predicted from a single early observation.
Severe trauma and bleeding	Emergency surgical/critical-care coordination.	Stabilize locally and assess transfer safety.
Major postoperative complications or high-risk recovery	Monitoring and selected organ support following surgery.	ICU need depends on procedure and patient, not every operation.
Acute kidney injury in critical illness	Fluid/electrolyte and cause assessment; renal support if indicated.	Dialysis modality and duration are individualized.
Severe neurological illness or reduced consciousness	Urgent airway, neurological and systemic evaluation.	Appropriate neurocritical capability must be confirmed.
Severe poisoning or metabolic crisis	Emergency assessment and specific medical treatment.	Urgent local care; do not wait for international arrangements.
Multiple-organ dysfunction	Coordinated support and treatment of the underlying cause.	Daily review of response, prognosis and goals.
Prolonged ventilation and selected tracheostomy needs	Assess weaning, airway and ongoing support requirements.	Procedure, timing and recovery vary; transfer needs specialist approval.
Anesthesia for surgery and selected procedures	Pre-anesthetic assessment and choice of general/regional/local techniques or sedation.	Individual consent, fasting and recovery instructions.
Pain and postoperative recovery needs	Multimodal pain review, nausea management and suitable monitoring.	Coordinate with surgery and anesthesia teams.

Who decides on admission and transfer?
The treating doctors assess severity, organ support, infection-control needs, receiving-unit capability and bed availability. ICU admission can be planned after major surgery or urgent during critical illness. A transfer requires an agreed clinical handover and a risk-benefit review; commercial flying or ordinary road transport may be unsafe. No bed, acceptance date or transfer suitability can be guaranteed from an inquiry alone.

Monitors, lines and organ support
The team tracks circulation, breathing, consciousness, fluid balance and tests, using equipment according to need. Patients may have venous/arterial lines, urinary catheters, drains or feeding tubes, each with benefits and risks. Medicines may support blood pressure; selected patients need dialysis or other organ support. ECMO or other advanced therapy is not routine and requires a specific indication and an appropriately equipped accepting center.

Why is a ventilator used, and can it be removed?
A ventilator supports breathing while the underlying problem is treated; it does not by itself cure the disease. A breathing tube, non-invasive mask or selected tracheostomy may be used depending on the situation. Sedation and pain relief are adjusted, and readiness to reduce support is reviewed. Weaning depends on lung function, strength, consciousness and overall stability; there is no universal removal date.

Sedation, confusion and communication
Pain relief and sedation may be needed for comfort and safe treatment. The depth is reviewed individually; an ICU patient is not necessarily kept continuously unconscious. Delirium can cause fluctuating confusion or distress and has several contributors. Families can provide familiar information, hearing/vision aids and calm contact according to unit rules. Reduced responsiveness needs medical interpretation and is not equivalent to a definitive prognosis.

What can relatives ask the medical team?
Ask about the main diagnosis, organ support, changes since the previous day, current goals, uncertainty and the next review. Agree a nominated contact, interpreter needs and suitable times for updates. Visiting, infection precautions and access to reports follow the hospital’s policy and the patient’s consent or applicable representation arrangements. MPGCARE may help communication, but the clinical team explains treatment decisions and prognosis.

Infection prevention, nutrition and rehabilitation
The team evaluates infection sources and device needs, nutrition, pressure-injury prevention and appropriate movement. Antibiotics, feeding route and rehabilitation are selected for the patient’s condition. Prolonged critical illness may lead to weakness and ongoing physical, cognitive or emotional difficulties. Recovery can continue after ICU and hospital discharge, requiring rehabilitation and local follow-up rather than a short guaranteed course.

Anesthesia assessment: which method is right?
The anesthesiologist reviews the procedure, health, previous anesthesia, allergies, medicines, airway, heart/lung function and any necessary tests. General anesthesia, regional techniques, local anesthesia and sedation serve different needs; none is universally best. Possible effects include nausea, sore throat, pain or confusion, with serious complications varying by patient and procedure. Benefits, alternatives and personal risks are discussed before consent.

Fasting, medicines and the day of a procedure
Follow the receiving hospital’s precise instructions for food, fluids and medicines; do not use a single fasting rule for all ages and procedures. Anticoagulants, diabetes medicines and other prescriptions require specific advice and must not be changed independently. Disclose pregnancy, sleep apnea and previous reactions. Sedation/anesthesia may require an escort and restrictions on driving or activities; discharge depends on clinical review, not a booked flight.

Prognosis, goals and step-down care
Prognosis is reassessed using cause, severity, trends and response; no guaranteed survival, awakening or independent recovery can be promised. Families should be involved in appropriate discussion of goals, patient preferences and uncertainty. Step-down to a ward depends on stability and the support still needed. The discharge plan covers medicines, nutrition, mobility, devices, follow-up and warning signs, with named responsible clinicians.

Records, scope and costs for an ICU review
The sending doctor should provide a current summary, diagnoses, support requirements, recent tests/cultures, medication/infusion list and relevant imaging, with consent or appropriate authorization. Costs can change with acuity, interventions and length of stay; a fixed short package is not a clinical prediction. Confirm the receiving team’s acceptance, scope and financial arrangements before any transport. Routine travel services do not include critical-care ambulance or air ambulance unless separately confirmed.

Preparing records, appointments and a written plan
Share current symptoms, their timeline, existing reports, a medicine list, allergies and relevant previous treatment. The specialist determines which tests and appointments are needed. Ask for a written scope distinguishing consultation, investigations, procedures, medicines and follow-up, with report timing and arrangements for complications. No universal duration or guaranteed outcome applies to every patient.

MPGCARE coordination and medically supervised transport
MPGCARE helps coordinate records and communication with the confirmed Medical Park or Liv Hospital team. Critical-care transfer requires physician-to-physician acceptance, a suitable available bed and a separately assessed medical transport plan. Free Sarp–Trabzon or airport–hospital transfers apply only to suitable ordinary travel arrangements confirmed in advance; they do not replace or imply free ICU ambulance or air ambulance. The treating and receiving teams decide whether and how travel is safe.

Patient information sources: NHS: intensive care · RCoA: anaesthesia explained · RCoA: anaesthesia risks · ICUsteps: patients and families · NHS: sepsis

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