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Baytaş V, Karadağ Erkoç S, Özçelik M, Gökmen D, Bermede AO, Selvi Can Ö, Uysalel A. A Randomized, Double-Blind, Graded Dose-Response Study of Norepinephrine Administration for Prevention of Post-Spinal Hypotension during Elective Cesarean Delivery. J Clin Med 2023; 12:6437. [PMID: 37892573 PMCID: PMC10607547 DOI: 10.3390/jcm12206437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Norepinephrine has been recently introduced for prophylaxis against post-spinal hypotension during cesarean delivery; however, no data are available regarding its optimum dosing scheme. The primary objective of this study is to compare three different infusion and bolus dose combinations of norepinephrine for prophylaxis against post-spinal hypotension during cesarean delivery. This randomized, double-blind study was performed between February 2021 and May 2022. The study protocol was registered at Clinicaltrials.gov with the identification number NCT04701190. A total of 192 parturients were enrolled into this study. Patients were assigned to three groups-Zero-Bolus High-Infusion (Group ZBHI, 0 µg/0.1 µg kg-1 min-1, n = 61), Moderate-Bolus Moderate-Infusion (Group MBMI, 5 µg/0.075 µg kg-1 min-1, n = 61) and High-Bolus Low-Infusion (Group HBLI, 10 µg/0.05 µg kg-1 min-1, n = 61)-according to different combinations of norepinephrine infusion and bolus doses. All patients received spinal anesthesia with 10 mg hyperbaric bupivacaine plus 12.5 µg fentanyl. Immediately after cerebrospinal fluid was obtained, patients underwent a norepinephrine protocol corresponding to the randomized group. The primary outcome was the incidence of post-spinal hypotension. Secondary outcomes were post-delivery hypotension, frequency of post-spinal hypertension and bradycardia, and neonatal outcomes. The incidence of post-spinal hypotension was 11.7% in Group HBLI, 6.7% in Group ZBHI and 1.7% in Group MBMI (p = 0.1). The overall incidence of post-delivery hypotension in parturients was 41.1% (p = 0.797). The lowest frequency of post-spinal bradycardia (8.3%) and hypertension (11.7%) was seen in Group HBLI. The neonatal APGAR scores at 1st minute were higher in Group MBMI than in Group ZBHI (8.58 vs. 8.23, p = 0.001). All three infusion and bolus dose combinations of norepinephrine effectively reduced the incidence of post-spinal hypotension. However, high-dose bolus (10 µg) followed by low-dose infusion (0.05 µg kg-1 min-1) of norepinephrine can be preferred due to the reduced frequency of bradycardia and hypertension during cesarean delivery under spinal anesthesia.
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Affiliation(s)
- Volkan Baytaş
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
| | - Süheyla Karadağ Erkoç
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
| | - Menekşe Özçelik
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
| | - Derya Gökmen
- Department of Biostatistics, School of Medicine, Ankara University, 06290 Ankara, Türkiye;
| | - Ahmet Onat Bermede
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
| | - Özlem Selvi Can
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
| | - Asuman Uysalel
- Department of Anaesthesiology and ICM, School of Medicine, Ankara University, 06230 Ankara, Türkiye; (V.B.); (A.O.B.)
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Uysal D, Çakar Turhan S, Ergün E, Can ÖS. Is Laryngeal Mask a Good Alternative in Children Undergoing Laparoscopic Inguinal Hernia Repair with Percutaneous Internal Ring Suturing Under and Over Two Years Old? Turk J Anaesthesiol Reanim 2023; 51:255-263. [PMID: 37455532 DOI: 10.4274/tjar.2023.221176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Objective This study aimed to evaluate respiratory parameters during percutaneous internal ring suturing (PIRS) for inguinal hernia repair in two different-aged pediatric patients in whom the airway is provided with a laryngeal mask or endotracheal tube for general anaesthesia. Methods After local ethics committee and parental consent, 180 ASAI-II children were randomly allocated to 4 groups; according to their age (0-24 months / 25-144 months) and airway device laryngeal mask (LMA) / endotracheal tube (ETT) used for general anaesthesia (45 children each) for laparoscopic inguinal hernia repair. Standard anaesthesia induction was done with lidocaine, propofol, and fentanyl, and 0.6 mg kg-1 rocuronium was added to the ETT groups. Sevoflurane is used for maintenance. Hemodynamic parameters, peak airway pressure, end-tidal carbon dioxide (EtCO2), and peripheric oxygen saturation (SpO2) values were recorded after induction, before, and during pneumoperitoneum. The duration of anaesthesia, surgery, recovery time, and surgical satisfaction was recorded. Airway complications (cough, laryngospasm, bronchospasm, desaturation, and aspiration) were recorded. Results Hundred and eighty patients (45 in each group) were analyzed. Duration of surgery and surgical satisfaction were similar in all groups. Duration of anaesthesia and recovery times were significantly shorter in the LMA groups. Peak airway pressure and EtCO2 levels were significantly lower in the LMA groups. Rare airway complications were observed without significance. Conclusion In laparoscopic inguinal hernia repair with the PIRS technique, LMA offered comparable operating conditions and surgical satisfaction.
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Affiliation(s)
- Damla Uysal
- Department of Anaesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sanem Çakar Turhan
- Department of Anaesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergun Ergün
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özlem Selvi Can
- Department of Anaesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
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Ergün E, Gurbanov A, Göllü G, Ateş U, Bingöl Koloğlu M, Murat Çakmak A, Selvi Can Ö. Effects of intraperitoneal bupivacaine injection in laparoscopic appendectomy in children on post-operative pain: A controlled randomized double-blinded study. ULUS TRAVMA ACIL CER 2022; 28:974-978. [PMID: 35775676 PMCID: PMC10493829 DOI: 10.14744/tjtes.2021.68927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of this study is to determine the effects of local anesthetics administered intraperitoneally in laparoscopic appendectomy. METHODS Patients who underwent laparoscopic appendectomy due to acute appendicitis were enrolled in the study. The children were divided into two groups. Intraperitoneal bupivacaine injection to appendectomy site and subdiaphragmatic area was performed after resection of appendix and aspirastion of intraperitoneal reactive fluid in Group 1 while Group 2 did not receive this therapy. The children were questioned by a nurse at postoperative 1st, 6th, 12th, and 24th h. Pain scores (PS) (abdominal), abdominal wall incisional pain (IP), shoulder pain (SP), and first need for analgesics were recorded. RESULTS One hundred and twenty children were enrolled to the study. There was no significant difference in PS values and IP values between the two groups (p>0.05). SP values at 12th and 24th h were significantly lower in Group 1 (p<0.05). There was a statistically significant reduce in analgesic need in Group 1 (p=0.007). CONCLUSION Intraperitoneal bupivacaine instillation to surgery site and subdiaphragmatic area seems to reduce the SP post-opera-tive and also reduce post-operative analgesic need. More meaningful results can be obtained with an increase in the number of patients.
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Affiliation(s)
- Ergun Ergün
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Anar Gurbanov
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Gülnur Göllü
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Ufuk Ateş
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Meltem Bingöl Koloğlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Ahmet Murat Çakmak
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Türkiye
| | - Özlem Selvi Can
- Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara-Türkiye
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Ergün E, Sözduyar S, Gurbanova A, Serttürk F, Çiftçi E, Özdemir H, Arga G, Konca HK, Çınar G, Akdemir Kalkan İ, Gülten E, Selvi Can Ö, Şen Akova B, Suat Fitöz Ö, Vatansever G, Tekin D, Göllü G, Bingöl-Koloğlu M, Yağmurlu A, Çakmak M, Ateş U. An indirect effect of COVID-19 pandemic: Increased pediatric perforated appendicitis rate due to delayed admission. Turk J Surg 2021; 37:318-323. [PMID: 35677491 PMCID: PMC9130943 DOI: 10.47717/turkjsurg.2021.5277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022]
Abstract
Objectives Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years. Material and Methods Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes. Results This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p <0.001), total hospitalization time (p <0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years. Conclusion Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.
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Affiliation(s)
- Ergun Ergün
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sümeyye Sözduyar
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aynur Gurbanova
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fırat Serttürk
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gül Arga
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hatice Kübra Konca
- Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Güle Çınar
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - İrem Akdemir Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ezgi Gülten
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özlem Selvi Can
- Department of Anesthesia and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Birsel Şen Akova
- Division of Pediatric Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömer Suat Fitöz
- Division of Pediatric Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Göksel Vatansever
- Division of Pediatric Emergency, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Tekin
- Division of Pediatric Emergency, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülnur Göllü
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Bingöl-Koloğlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydın Yağmurlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Murat Çakmak
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ufuk Ateş
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
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Kendirli T, Özcan S, Havan M, Baran Ç, Çakıcı M, Arıcı B, Selvi Can Ö, Eyileten Z, Uçar T, Tutar E, Akar AR. Pediatric extracorporeal cardiopulmonary resuscitation: single-center study. Turk J Med Sci 2021; 51:1733-1737. [PMID: 33350296 PMCID: PMC8569742 DOI: 10.3906/sag-2002-10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 12/21/2020] [Indexed: 11/05/2022] Open
Abstract
Background/aim Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to evaluate the clinical outcomes of our ECPR experience in a pediatric patient population. Materials and methods Between September 2014 and November 2017, 15 children were supported with ECPR following in-hospital cardiac arrest (IHCA) in our hospitals. VA-ECMO setting was established for all patients. Pediatric cerebral performance category (PCPC) scales and long-term neurological prognosis of the survivors were assessed. Results The median age of the study population was 60 (4–156) months. The median weight was 18 (4.8–145) kg, height was 115 (63–172) cm, and body surface area was 0.73 (0.27–2.49) m2. The cause of cardiac arrest was a cardiac and circulatory failure in 12 patients (80%) and noncardiac causes in 20%. Dysrhythmia was present in 46%, septic shock in 13%, bleeding in 6%, low cardiac output syndrome in 13%, and airway disease in 6% of the study population. Median low-flow time was 95 (range 20–320) min. Central VA-ECMO cannulation was placed in only 2 (13.3%) cases. However, the return of spontaneous circulation (ROSC) was obtained in 10 (66.6%) patients, and 5 (50%) of them survived. Overall, 5 patients were discharged from the hospital. Finally, survival following ECPR was 33.3%, and all survivors were neurologically intact at hospital-discharge. Conclusion ECPR can be a life-saving therapeutic strategy using a promising technology in the pediatric IHCA population. Early initiation and a well-coordinated, skilled, and dedicated ECMO team are the mainstay for better survival rates.
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Affiliation(s)
- Tanıl Kendirli
- Department of Pediatric Critical care Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Serhan Özcan
- Department of Pediatric Critical care Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Merve Havan
- Department of Pediatric Critical care Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Çağdaş Baran
- Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Mehmet Çakıcı
- Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Burcu Arıcı
- Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Özlem Selvi Can
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Zeynep Eyileten
- Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Tayfun Uçar
- Department of Pediatric Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ercan Tutar
- Department of Pediatric Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ahmet Rüçhan Akar
- Department of Cardiovascular Surgery, Faculty of Medicine, Ankara University, Ankara, Turkey
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Büyükatalay ZÇ, Agha Oghali AMN, Kendirli T, Can ÖS, Uçar T, Akar AR, Meço C. First Reported Cochlear Implantation in a Child with Total Artificial Heart. EXP CLIN TRANSPLANT 2020; 19:1352-1355. [PMID: 32281525 DOI: 10.6002/ect.2019.0304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report a case of 15-year-old boy with postlingual bilateral total hearing loss following ototoxic medication during his pediatric intensive care unit stay. The patient received the SynCardia total artificial heart implant (50 mL; SynCardia Systems, Inc., Tucson, AZ, USA) for end-stage biventricular heart failure as a bridge to heart transplant. During his time on the urgent heart transplant wait list, he underwent successful cochlear implantation following optimized coagulation and hemostasis status and appropriate anesthetic preparation. Our case represents the world's first successful cochlear implant in a pediatric patient who received an artificial heart. Despite complexities in this patient population, elective surgical procedures can be performed safely with acceptable morbidity using a collaborative approach with the heart transplant team, including input from cardiovascular surgery, pediatric cardiology, anes thesiology, consultation-liaison psychiatry, physical therapy and rehabilitation, infectious diseases and clinical microbiology, and intensive care unit staff.
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Affiliation(s)
- Zahide Çiler Büyükatalay
- From the Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey
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Kuloglu Z, Balcı D, Haskoloğlu ZŞ, Kendirli T, Bingöl-Koloğlu M, Tuna-Kırsaçlıoğlu C, Bal S, Selbuz S, Kırımker O, Savaş B, Altuntaş C, Güner ŞN, Can ÖS, Karayalçın K, Doğu F, Kansu Tanca A, İkincioğulları A. Allogeneic hematopoietic stem cell and liver transplantation in a young girl with dedicator of cytokinesis 8 protein deficiency. Pediatr Transplant 2019; 23:e13545. [PMID: 31297914 DOI: 10.1111/petr.13545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/14/2019] [Accepted: 06/08/2019] [Indexed: 11/28/2022]
Abstract
DOCK8 deficiency is a rare inherited combined immunodeficiency, caused by mutations in the DOCK8 gene. We describe a case with DOCK8 deficiency associated with severe CLD in whom orthotopic LT was performed successfully after allogeneic HSCT. A 5 year-old girl with DOCK8 deficiency presented with mild direct hyperbilirubinemia and abnormal GGT level and without a previous history of jaundice. She had severe growth retardation, hepatosplenomegaly and generalized eczema. Progressive worsening of CLD was observed within 4 months. Investigations for etiology of liver disease were negative. Liver biopsy showed bridging necrosis, cholestasis and, cirrhosis. Recurrent immune hemolytic crisis and several viral infections developed in follow-up. She underwent whole cadaveric LT for end-stage liver disease (ESLD) 1 year after allogenic HSCT from a full matched related donor. The postoperative course was uneventful. The patient is alive with normal liver function and moderate skin graft versus host disease for 36 months after LT. In conclusion DOCK8 deficiency can be associated with severe CLD. Successful LT following HSCT is possible in patients with ESLD in DOCK8 deficiency. The timing of LT is challenging in patients requiring both HSCT and LT since conditioning regimens for HSCT can be highly hepatotoxic and the patients with suboptimal liver function can become decompensated during HSCT.
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Affiliation(s)
- Zarife Kuloglu
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara University School of Medicine, Ankara, Turkey
| | - Deniz Balcı
- Deparment of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Zehra Şule Haskoloğlu
- Division of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Division of Pediatric Intensive Care, Ankara University School of Medicine, Ankara, Turkey
| | - Meltem Bingöl-Koloğlu
- Deparment of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Ceyda Tuna-Kırsaçlıoğlu
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara University School of Medicine, Ankara, Turkey
| | - Sevgi Bal
- Division of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Suna Selbuz
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara University School of Medicine, Ankara, Turkey
| | - Onur Kırımker
- Deparment of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Berna Savaş
- Deparment of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Cansu Altuntaş
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara University School of Medicine, Ankara, Turkey
| | - Şükrü Nail Güner
- Division of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Özlem Selvi Can
- Department of Anesthesiology and Reanimation, Ankara University School of Medicine, Ankara, Turkey
| | - Kaan Karayalçın
- Deparment of General Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Figen Doğu
- Division of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
| | - Aydan Kansu Tanca
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Ankara University School of Medicine, Ankara, Turkey
| | - Aydan İkincioğulları
- Division of Pediatric Immunology and Allergy, Ankara University School of Medicine, Ankara, Turkey
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Ateş U, Taştekin NY, Mammadov F, Ergün E, Göllü G, Can ÖS, Uçar T, Bingöl-Koloğlu M, Yağmurlu A, Aktuğ T. Stuck tunneled central venous catheters in children: Four cases removed by angiography assistance. Turk J Pediatr 2019; 60:221-224. [PMID: 30325134 DOI: 10.24953/turkjped.2018.02.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ateş U, Taştekin NY, Mammadov F, Ergün E, Göllü G, Can ÖS, Uçar T, Bingöl-Koloğlu M, Yağmurlu A, Aktuğ T. Stuck tunneled central venous catheters in children: Four cases removed by angiography assistance. Turk J Pediatr 2018; 60: 221-224. Adherent tunneled catheters can usually be removed by a surgical cut down, but in some cases the line can become stuck to the wall of the central veins. In such cases, forceful traction can cause vascular injury, or fracture of the catheter. We present four cases of fixated cuffed tunneled catheters. Three children had acute lymphoblastic leukemia and one had an immunodeficiency syndrome. All catheters were made from polyurethane. Indwelling times were 12-24 months. All patients` catheters were removed with great difficulty by trans-femoral access. The angiography-assisted technique is safe and easily-applied for the removal of stuck catheters in pediatric patients. These cases raise important questions concerning the maximum indwelling time and the choice of catheter material when implanting permanent central venous catheters (CVCs) in children.
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Affiliation(s)
- Ufuk Ateş
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nil Yaşam Taştekin
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fuad Mammadov
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergun Ergün
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülnur Göllü
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Özlem Selvi Can
- Departments of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tayfun Uçar
- Pediatric Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Bingöl-Koloğlu
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydın Yağmurlu
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tanju Aktuğ
- Departments of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
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Alanoğlu Z, Erkoç SK, Güçlü ÇY, Meço BCO, Baytaş V, Can ÖS, Alkiş N. CHALLENGES OF OBSTETRIC ANESTHESIA: DIFFICULT LARYNGEAL VISUALIZATION. Acta Clin Croat 2016; 55 Suppl 1:68-72. [PMID: 27276775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Obstetric anesthesia is one of the high risk subspecialties of anesthesia practice. Anesthesia related complications are the sixth leading cause of maternal mortality. Difficult or failed intubation following induction of general anesthesia for CS remains the major contributory factor to anesthesia-related maternal complications. The airway management of obstetric patients is a challenging issue for several reasons. Anatomic and physiologic changes related to pregnancy may increase the difficult and failed intubation rates compared to the general surgical population. Proper evaluation of the airway anatomy and airway structures is vital to prevent airway management related catastrophes. In addition to basic airway and intubation equipment, each anesthesia department must have difficult intubation equipment cart including fiber optic laryngoscope, video laryngoscopes, and different types of laryngeal masks. It is essential that all anesthesiologists have a preconceived and well thought-out algorithm and emergency airway equipment to deal with airway emergencies during difficult or failed intubation of a parturient.
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Can ÖS, Yalçin S, Memikoglu O, Özgencil E, Oba S, Tulunay M, Ünal N, Oral M. Seropositivity incidence of anti-Toxoplasma gondii antibodies in critically ill intensive care unit patients. Crit Care 2007. [PMCID: PMC4095168 DOI: 10.1186/cc5274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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