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Ulgen Tekerek N, Dursun O, Asilioglu Yener N, Yildizdas D, Anıl AB, Kendirli T, Koker A, Karalok S, Aksoy A, Kinik Kaya E, Ekinci F, Incecik F, Olgac Dundar N, Durak F, Botan E, Havan M, Sahin S, Duman O, Haspolat S. Posttraumatic epilepsy in critically ill children with traumatic brain injury. Childs Nerv Syst 2023; 39:3207-3214. [PMID: 37480521 DOI: 10.1007/s00381-023-06087-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/17/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE The aim of this study was to determine the clinical, laboratory, and radiological factors related with posttraumatic epilepsy (PTE). METHODS The study is a multicenter descriptive cross-sectional cohort study. Children who followed up for TBI in the pediatric intensive care unit between 2014 and 2021 were included. Demographic data and clinical and radiological parameters were recorded from electronic case forms. All patients who were in the 6-month posttraumatic period were evaluated by a neurologist for PTE. RESULTS Four hundred seventy-seven patients were included. The median age at the time of trauma was 66 (IQR 27-122) months, and 298 (62.5%) were male. Two hundred eighty (58.7%) patients had multiple traumas. The mortality rate was 11.7%. The mean duration of hospitalization, pediatric intensive care unit hospitalization and mechanical ventilation, Rotterdam score, PRISM III score, and GCS at admission were higher in patients with epilepsy (p < 0.05). The rate of epilepsy was higher in patients with severe TBI, cerebral edema on tomography and clinical findings of increased intracranial pressure, blood transfusion in the intensive care unit, multiple intracranial hemorrhages, and intubated patients (p < 0.05). In logistic regression analysis, the presence of intracranial hemorrhage in more than one compartment of the brain (OR 6.13, 95%CI 3.05-12.33) and the presence of seizures (OR 9.75, 95%CI 4.80-19.83) were independently significant in terms of the development of epilepsy (p < 0.001). CONCLUSIONS In this multicenter cross-sectional study, intracranial hemorrhages in more than one compartment and clinical seizures during intensive care unit admission were found to be independent risk factors for PTE development in pediatric intensive care unit patients with TBI.
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Affiliation(s)
- Nazan Ulgen Tekerek
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
- Akdeniz University Hospital, Dumlupınar Boulevard, Konyaalti, Antalya, 07059, Turkey.
| | - Oguz Dursun
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Nazik Asilioglu Yener
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Dincer Yildizdas
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ayşe Berna Anıl
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Katip Celebi University, İzmir, Turkey
| | - Tanil Kendirli
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Alper Koker
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Selen Karalok
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Ayşe Aksoy
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Elif Kinik Kaya
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Faruk Ekinci
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Faruk Incecik
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Nihal Olgac Dundar
- Division of Pediatric Neurology, Department of Pediatrics, Katip Celebi Faculty of Medicine, İzmir, Turkey
| | - Fatih Durak
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Katip Celebi University, İzmir, Turkey
| | - Edin Botan
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Merve Havan
- Division of Pediatric Intensive Care, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Suleyman Sahin
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ozgur Duman
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Senay Haspolat
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Lüleyap D, Anıl AB, Küllüoğlu P, Konca Ç, Gökmen Uyanık F, Üstündağ G, Güven B, Çiftdoğan DY. A Case of Measles Initially Diagnosed as MIS-C in the COVID-19 Pandemics. cayd 2023. [DOI: 10.4274/cayd.galenos.2022.25743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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3
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Ağın H, Arslanköylü AE, Aşılıoğlu Yener N, Anıl AB, Dursun O, Kendirli T, Yıldızdaş D. Nutrition in Pediatric Intensive Care Units. cayd 2023. [DOI: 10.4274/cayd.galenos.2023.49002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
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4
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Sık G, Inamlık A, Akçay N, Kesici S, Aygun F, Kendırlı T, Atay G, Sandal O, Varol F, Ozkaya PY, Duyu M, Bırbılen AZ, Ozcan S, Arslan G, Kangın M, Bayraktar S, Altug U, Anıl AB, Havan M, Yetımakman AF, Dalkıran T, Zengın N, Oto A, Kıhtır HS, Gırgın Fİ, Telhan L, Yıldızdas D, Yener N, Yukselmıs U, Alakaya M, Kılınc MA, Celegen M, Dursun A, Battal F, Sarı F, Ozkale M, Topal S, Kocaoglu C, Yazar A, Alacakır N, Odek C, Yaman A, Cıtak A. Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study. Pediatr Res 2023:10.1038/s41390-023-02518-0. [PMID: 36813951 PMCID: PMC9946280 DOI: 10.1038/s41390-023-02518-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. METHODS A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. RESULTS The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. CONCLUSIONS In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. IMPACT MIS-C is a life-threatening condition. Patients need to be followed up in the intensive care unit. Early detection of factors associated with mortality can improve outcomes. Determining the factors associated with mortality and length of stay will help clinicians in patient management. High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality.
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Affiliation(s)
- Guntulu Sık
- Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey.
| | - Aysegul Inamlık
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Nihal Akçay
- grid.414177.00000 0004 0419 1043Department of Pediatric Intensive Care, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Selman Kesici
- grid.14442.370000 0001 2342 7339Department of Pediatric Intensive Care, Hacettepe University, Ankara, Turkey
| | - Fatih Aygun
- grid.506076.20000 0004 1797 5496Department of Pediatric Intensive Care, İstanbul University-Cerrahpaşa, İstanbul, Turkey
| | - Tanıl Kendırlı
- grid.7256.60000000109409118Department of Pediatric Intensive Care, Ankara University, Ankara, Turkey
| | - Gurkan Atay
- grid.417018.b0000 0004 0419 1887Department of Pediatric Intensive Care, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Sandal
- Department of Pediatric Intensive Care, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Fatih Varol
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Sancaktepe Şehit Prof. MD İlhan Varank Training and Research Hospital, İstanbul, Turkey
| | - Pınar Yazıcı Ozkaya
- grid.8302.90000 0001 1092 2592Department of Pediatric Intensive Care, Ege University, Izmir, Turkey
| | - Muhterem Duyu
- Department of Pediatric Intensive Care, Goztepe Prof. MD Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ahmet Ziya Bırbılen
- Department of Pediatric Intensive Care, Gaziantep Cengiz Gökçek Gynecology and Pediatrics Hospital, Gaziantep, Turkey
| | - Serhan Ozcan
- grid.449874.20000 0004 0454 9762Department of Pediatric Intensive Care, Ankara Yıldırım Beyazıt University, Ankara Children’s Hospital, Ankara, Turkey
| | - Gazi Arslan
- grid.21200.310000 0001 2183 9022Department of Pediatric Intensive Care Unit, Dokuz Eylül University, Izmir, Turkey
| | - Murat Kangın
- Department of Pediatric Intensive Care, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Suleyman Bayraktar
- grid.413752.60000 0004 0419 1465Department of Pediatric Intensive Care, Sultangazi Haseki Training and Research Hospital, Istanbul, Turkey
| | - Umit Altug
- Department of Pediatric Intensive Care, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Ayşe Berna Anıl
- Department of Pediatric Intensive Care, Tepecik Training and Research Hospital, Izmır Katip Çelebi University, Izmir, Turkey
| | - Merve Havan
- Department of Pediatric Intensive Care, Mersin City Hospital, Mersin, Turkey
| | - Ayse Filiz Yetımakman
- grid.411105.00000 0001 0691 9040Department of Pediatric Intensive Care, Kocaeli University, Kocaeli, Turkey
| | - Tahir Dalkıran
- Department of Pediatric Intensive Care, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
| | - Neslihan Zengın
- grid.411688.20000 0004 0595 6052Department of Pediatric Intensive Care, Manisa Celal Bayar Unıversity, Manisa, Turkey
| | - Arzu Oto
- Department of Pediatric Intensive Care, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Hasan Serdar Kıhtır
- grid.413819.60000 0004 0471 9397Department of Pediatric Intensive Care, Antalya Training and Research Hospital, Antalya, Turkey
| | - Feyza İnceköy Gırgın
- grid.16477.330000 0001 0668 8422Department of Pediatric Intensive Care, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey
| | - Leyla Telhan
- grid.411781.a0000 0004 0471 9346Department of Pediatric Intensive Care, Medipol University, Istanbul, Turkey
| | - Dincer Yıldızdas
- grid.98622.370000 0001 2271 3229Department of Pediatric Intensive Care, Cukurova University, Adana, Turkey
| | - Nazik Yener
- grid.411049.90000 0004 0574 2310Department of Pediatric Intensive Care, Samsun 19 Mayıs University, Samsun, Turkey
| | - Ufuk Yukselmıs
- grid.414850.c0000 0004 0642 8921Department of Pediatric Intensive Care, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Alakaya
- grid.411691.a0000 0001 0694 8546Department of Pediatric Intensive Care, Mersin University, Mersin, Turkey
| | - Mehmet Arda Kılınc
- Department of Pediatric Intensive Care, Basaksehir Cam ve Sakura City Hospital, Istanbul, Turkey
| | - Mehmet Celegen
- Department of Pediatric Intensive Care, Afyonkarahisar Tarining and Research Hospital, Afyon, Turkey
| | - Adem Dursun
- grid.513116.1Department of Pediatric Intensive Care, Kayseri City Hospital, Kayseri, Turkey
| | - Fatih Battal
- grid.412364.60000 0001 0680 7807Department of Pediatric Intensive Care, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Ferhat Sarı
- grid.14352.310000 0001 0680 7823Department of Pediatric Intensive Care, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Murat Ozkale
- grid.411548.d0000 0001 1457 1144Department of Pediatric Intensive Care, Dr Turgut NOYAN Hospital, Baskent University, Adana, Turkey
| | - Sevgi Topal
- Department of Pediatric Intensive Care, Erzurum Bölge Training and Research Hospital, Erzurum, Turkey
| | - Celebi Kocaoglu
- Department of Pediatric Intensive Care, Konya City Hospital, Konya, Turkey
| | - Abdullah Yazar
- grid.411124.30000 0004 1769 6008Department of Pediatric Intensive Care, Necmettin Erbakan University, Konya, Turkey
| | - Nuri Alacakır
- grid.411693.80000 0001 2342 6459Department of Pediatric Intensive Care, Trakya University, Edirne, Turkey
| | - Caglar Odek
- grid.34538.390000 0001 2182 4517Department of Pediatric Intensive Care, Bursa Uludağ University, Bursa, Turkey
| | - Ayhan Yaman
- grid.508740.e0000 0004 5936 1556Department of Pediatric Intensive Care, Istınye University Liv Hospital, Istanbul, Turkey
| | - Agop Cıtak
- grid.411117.30000 0004 0369 7552Department of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
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Küllüoğlu EP, Lüleyap D, Çiçek A, Anıl AB, Konca Ç, Berksoy E, Gökalp G, Özel Doğruöz A, Alaygut D. A Case of Severe Poisoning due to Oral Hydrofluoric Acid Ingestion that Could Survive with Timely Effective Treatments. buchd 2022. [DOI: 10.4274/buchd.galenos.2022.38159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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6
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Demir Ş, Anıl M, Yalçın G, Bardak Ş, Demir G, Berksoy E, Gökalp G, Kamit F, Yılmaz SB, Anıl AB. Early predictors of high-flow nasal cannula oxygen treatment failure in patients with respiratory distress admitted to the pediatric emergency department. Turk J Pediatr 2022; 64:648-657. [PMID: 36082639 DOI: 10.24953/turkjped.2020.587] [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] [Indexed: 06/15/2023]
Abstract
BACKGROUND High-flow nasal cannula (HFNC) therapy is a relatively new method used in patients with respiratory distress. The aim of the study was to evaluate the outcomes and to determine the baseline predictors of HFNC treatment failure in children with acute respiratory distress/failure in the pediatric emergency department. METHODS Children with respiratory distress/failure aged 1 month to 18 years who underwent HFNC therapy with the pre-established protocol were retrospectively analyzed. HFNC therapy was used in respiratory and non-respiratory pathologies. HFNC failure was defined as the need for escalation to non-invasive ventilation or invasive mechanical ventilation. HFNC responders and non-responders were compared based on baseline clinical data. RESULTS Of the 524 cases (median age:13 months; 292 males / 232 females), 484 (92.4%) had respiratory tract and 40 (7.6%) had non-respiratory tract pathologies. HFNC therapy was unsuccessful in 62 (11.8%) patients. The success rates were 81% and 55% in respiratory and non-respiratory diseases, respectively. In children with respiratory system pathologies, the pre-treatment venous pCO2 level (p: 0.045; OR: 0.958; 95%CI: 0.821-0.990) and the clinically important radiological finding on chest X-ray (lobar infiltration, atelectasis, pleural effusion) (p: 0.045; OR: 3.262; 95%CI: 1.178-9.034) were the most significant parameters in predicting HFNC failure. In children with non-respiratory pathologies, the pre-treatment venous lactate level (p: 0.008; OR: 1.558; 95%CI: 1.125-2.158) was a significant predictor of HFNC failure. There were no cases of pneumothorax or any other reported adverse effects related to HFNC therapy. CONCLUSIONS HFNC treatment is a safe oxygen therapy in children with respiratory distress/failure due to various etiologies in the emergency department. The lower venous pCO2 level increases and the clinically important radiological finding on chest radiograph decreases the success of HFNC treatment in respiratory pathologies. The higher venous lactate level is a predictor of HFNC treatment failure in non-respiratory pathologies.
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Affiliation(s)
- Şule Demir
- Departments of Pediatric Emergency, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Murat Anıl
- Department of Pediatric Emergency, Demokrasi University Faculty of Medicine, İzmir, Turkey
| | - Gülşen Yalçın
- Department of Pediatric Emergency, Pediatric Hospital, Diyarbakır, Turkey
| | - Şefika Bardak
- Departments of Pediatric Emergency, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Gülşah Demir
- Departments of Pediatric Emergency, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Emel Berksoy
- Departments of Pediatric Emergency, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Gamze Gökalp
- Departments of Pediatric Emergency, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Fulya Kamit
- Department of Pediatric Intensive Care, Yeniyüzyıl University Gaziosmanpaşa Hospital, İstanbul, Turkey
| | - Sema Bozkaya Yılmaz
- Department of Pediatric Neurology, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
| | - Ayşe Berna Anıl
- Department of Pediatric Intensive Care, University of Health Sciences, Tepecik Training and Research Hospital İzmir, Turkey
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Öztan MO, Anıl M, Anıl AB, Yaldız D, Uz İ, Turgut A, Köse I, Acar K, Sofuoğlu T, Akbulut G. First step toward a better trauma management: Initial results of the Northern Izmir Trauma Registry System for children. ULUS TRAVMA ACIL CER 2019; 25:20-28. [PMID: 30742282 DOI: 10.5505/tjtes.2018.82780] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Trauma is an important health problem in children, and improvement in national trauma care is only possible through the knowledge gathered from trauma registry systems. This information is not available in our country, because there is no current trauma registry system at the hospitals. Our aim is to explain the trauma registry system we have developed and present the first year's data. METHODS The planned trauma registry system was integrated into the emergency department registry system of 14 hospitals in Izmir province. The data of pediatric multiple trauma patients have been recorded automatically through the registry system. Demographics, vital signs, mechanism, type of trauma, anatomical region, ISS, PTS, GCS, length of hospital stay and need for blood transfusion/endotracheal intubation/surgery/hospitalization were evaluated by patient transfer status and outcome. RESULTS At the end of one year, a total of 356 pediatric major trauma patients were included in the study. The most common type of trauma was blunt trauma (91.9%) and the mechanism was vehicle-related traffic accidents (28.1%). In the group with the worse outcome than the Glasgow outcome score, age was greater, ISS was higher and PTS was lower. Motorcycle accidents, sports injuries, and penetrating injuries were more frequent in this group. All the scales were significantly different between direct and transferred patients. The referral time to the hospital of the transferred patients were longer than directly admitted patients, but the results were not different. CONCLUSION Pediatric major trauma is an important cause of mortality and morbidity, and our trauma registry system, which is a successful example abroad, is not enough in the country. We hope that the trauma registry system we planned and started the pilot application will be expanded to include other hospitals throughout the country with the aim of developing a national registry system.
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Affiliation(s)
- Mustafa Onur Öztan
- Department of Pediatric Surgery, Katip Çelebi University Faculty of Medicine, İzmir-Turkey.
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Kockuzu E, Bayrakcı B, Kesici S, Cıtak A, Karapınar B, Emeksiz S, Anıl AB, Kendirli T, Yukselmis U, Sevketoglu E, Paksu Ş, Kutlu O, Agın H, Yıldızdas D, Keskin H, Kalkan G, Hasanoglu A, Yazıcı MU, Sık G, Kılınc A, Durak F, Perk O, Talip M, Yener N, Uzuner S. Comprehensive Analysis of Severe Viral Infections of Respiratory Tract admitted to PICUs during the Winter Season in Turkey. Indian J Crit Care Med 2019; 23:263-269. [PMID: 31435144 PMCID: PMC6698354 DOI: 10.5005/jp-journals-10071-23177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives To analyze the course of seasonal viral infections of respiratory tract in patients hospitalized in pediatric intensive care units (PICU) of 16 centers in Turkey. Materials and methods It is a retrospective, observational, and multicenter study conducted in 16 tertiary PICUs in Turkey includes a total of 302 children with viral cause in the nasal swab which required PICU admission with no interventions. Results Median age of patients was 12 months. Respiratory syncytial virus (RSV) was more common in patients over one year of age whereas influenza, human Bocavirus in patients above a year of age was more common (p <0.05). Clinical presentations influencing mortality were neurologic symptoms, tachycardia, hypoxia, hypotension, elevated lactate, and acidosis. The critical pH value related with mortality was ≤7.10, and critical PCO2 ≥60 mm Hg. Conclusion Our findings demonstrate that patients with neurological symptoms, tachycardia, hypoxia, hypotension, acidosis, impaired liver, and renal function at the time of admission exhibit more severe mortal progressions. Presence of acidosis and multiorgan failure was found to be predictor for mortality. Knowledge of clinical presentation and age-related variations among seasonal viruses may give a clue about severe course and prognosis. By presenting the analyzed data of 302 PICU admissions, current study reveals severity of viral respiratory tract infections and release tips for handling them. How to cite this article Kockuzu E, Bayrakcı B, Kesici S, Cıtak A, Karapınar K, Emeksiz S, et al. Comprehensive Analysis of Severe Viral Infections of Respiratory Tract admitted to PICUs During the Winter Season in Turkey. Indian J Crit Care Med 2019;23(6):263–269.
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Affiliation(s)
- Esra Kockuzu
- Department of Pediatric Intensive Care Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Benan Bayrakcı
- Department of Pediatric Intensive Care Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Selman Kesici
- Clinic of Pediatric Intensive Care Unit, Dr. Sami Ulus Child Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Agop Cıtak
- Department of Pediatric Intensive Care Unit, Acıbadem University Faculty of Medicine, Istanbul, Turkey
| | - Bulent Karapınar
- Department of Pediatric Intensive Care Unit, Ege University Faculty of Medicine, Izmir, Turkey
| | - Serhat Emeksiz
- Clinic of Pediatric Intensive Care Unit, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Ayşe Berna Anıl
- Clinic of Pediatric Intensive Care Unit, Ankara Tepecik Training and Research Hospital, Izmir, Turkey
| | - Tanıl Kendirli
- Department of Pediatric Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ufuk Yukselmis
- Clinic of Pediatric Intensive Care Unit, Kartal Lutfi Kırdar Education Research Hospital, Istanbul, Turkey
| | - Esra Sevketoglu
- Clinic of Pediatric Intensive Care Unit, Bakırkoy Sadi Konuk Education Research Hospital, Istanbul, Turkey
| | - Şukru Paksu
- Department of Pediatric Intensive Care Unit, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey
| | - Onur Kutlu
- Department of Pediatric Intensive Care Unit, Bezmialem University Faculty of Medicine, Istanbul, Turkey
| | - Hasan Agın
- Clinic of Pediatric Intensive Care Unit Dr. Behcet Uz Education Research Hospital, Izmir, Turkey
| | - Dincer Yıldızdas
- Department of Pediatric Intensive Care Unit, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Halil Keskin
- Department of Pediatric Intensive Care Unit, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Gokhan Kalkan
- Department of Pediatric Intensive Care Unit, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Arzu Hasanoglu
- Department of Pediatric Intensive Care Unit, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Mutlu Uysal Yazıcı
- Department of Pediatric Intensive Care Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Guntulu Sık
- Clinic of Pediatric Intensive Care Unit, Dr. Sami Ulus Child Health and Disease Training and Research Hospital, Ankara, Turkey
| | - Arda Kılınc
- Department of Pediatric Intensive Care Unit, Ege University Faculty of Medicine, Izmir, Turkey
| | - Fatih Durak
- Department of Pediatric Intensive Care Unit, Ege University Faculty of Medicine, Izmir, Turkey
| | - Oktay Perk
- Department of Pediatric Intensive Care Unit, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mey Talip
- Clinic of Pediatric Intensive Care Unit, Bakırkoy Sadi Konuk Education Research Hospital, Istanbul, Turkey
| | - Nazik Yener
- Department of Pediatric Intensive Care Unit, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey
| | - Selcuk Uzuner
- Department of Pediatric Intensive Care Unit, Bezmialem University Faculty of Medicine, Istanbul, Turkey
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Alparslan C, Kamit-Can F, Anıl AB, Olgaç-Dündar N, Çavuşoğlu D, Göç Z. Febrile infection-related epilepsy syndrome (FIRES) treated with immunomodulation in an 8-year-old boy and review of the literature. Turk J Pediatr 2018; 59:463-466. [PMID: 29624228 DOI: 10.24953/turkjped.2017.04.014] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Alparslan C, Kamit-Can F, Anıl AB, Olgaç-Dündar N, Çavuşoğlu D, Göç Z. Febrile infection-related epilepsy syndrome (FIRES) treated with immunomodulation in an 8-year-old boy and review of the literature. Turk J Pediatr 2017; 59: 463-466. Febrile infection-related epilepsy syndrome (FIRES) is a catastrophic epilepsy syndrome which is characterized by acute onset of refractory status epilepticus following a febrile infection occurring in previously normal children. Despite the various treatment options that have been tried, exact treatment strategy is still undetermined. This is the first pediatric case of FIRES from Turkey which was successfully treated with intravenous immunoglobulin (IVIG). A previously healthy 8-year-old boy was referred to our hospital with a pre-diagnosis of status epilepticus and encephalitis. He presented with acute onset of convulsions and unconsciousness following fever and malaise lasting 7 days. On physical examination Glasgow coma scale was 12, his pupils were miotic. He had cafe-au-lait spots on his body. His fundus examination, cerebrospinal fluid findings and cranial magnetic resonance imaging did not reveal any abnormality. Results of comprehensive search for metabolic, toxicological, infectious and autoimmune etiologies were all negative. Generalized slowing was seen on the electroencephalography (EEG) of the patient indicating possible encephalopathy. The patient developed convulsive status epilepticus and was intubated on day 5. His seizures were controlled by continuous infusion of midazolam, thiopental and used for 4 days. Phenytoin, levetiracetam, topiramate were used simultaneously. IVIG was administered as an immunomodulator for refractory seizures on day-9. The patient was extubated on day 11. The diagnosis was made after a comprehensive negative search for central nervous system infection, autoimmune and metabolic diseases. At follow up it was learnt that he had had only two seizures in two years. Status epilepticus did not recur. Clinicians should keep in mind FIRES which is a diagnosis of exclusion especially in refractory status epilepticus. IVIG treatment could have a benefit in these patients.
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Affiliation(s)
- Caner Alparslan
- Department of Pediatrics, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Fulya Kamit-Can
- Department of Pediatric Intensive Care Unit, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayşe Berna Anıl
- Department of Pediatric Intensive Care Unit, Katip Çelebi University, Izmir, Turkey
| | - Nihal Olgaç-Dündar
- Department of Pediatric Neurology, Katip Çelebi University, Izmir, Turkey
| | - Dilek Çavuşoğlu
- Department of Pediatric Neurology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Zeynep Göç
- Department of Pediatrics, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
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Can FK, Anıl AB, Anıl M, Gümüşsoy M, Çitlenbik H, Kandoğan T, Zengin N. The outcomes of children with tracheostomy in a tertiary care pediatric intensive care unit in Turkey. Turk Arch Pediatr 2018; 53:177-184. [PMID: 30459517 DOI: 10.5152/turkpediatriars.2018.6586] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 12/04/2017] [Accepted: 03/14/2018] [Indexed: 11/22/2022]
Abstract
Aim We aimed to describe which clinical characteristics were associated with the outcome of tracheostomy in our tertiary care pediatric intensive care unit. Material and Methods This was a retrospective review of medical records of pediatric patients who underwent tracheostomy in our Pediatric Intensive Care unit from 2008 to 2014 in Turkey. Results Sixty-three patients were included the study. The median age of patients was 11 (range, 1-195) months. Twenty-five (39.7%) patients were female. The tracheostomy rate was 8.5% over a six-year period. Forty-nine (77.7%) patients were able to be discharged and sent home. The decannulation rate was 12.6% (n=8). The indications for tracheostomy were upper airway obstruction (n=9) and prolonged mechanical ventilation (n=54). The median intubation period before tracheostomy was 32 (range, 1-122) days and the median duration of pediatric intensive care unit stay after tracheostomy was 37 days. A total of 21 (52.5%) patients were weaned off mechanical ventilation. The rate of successful weaning from mechanical ventilation was higher in patients with upper airway obstruction than in those in the prolonged mechanical ventilation group (p=0.021). The complication rate was 25.3% in the pediatric intensive care unit and 11.1% at home. Conclusions Tracheostomy seems safe and improves pediatric patients' outcomes. The most important factor that affects the prognosis of children who underwent tracheostomy is the indication for tracheostomy. The outcomes are always better if the tracheostomy has been performed because of upper airway obstruction. Performing tracheostomy helps weaning from and off ventilator support and finally the discharge of patients with prolonged mechanical ventilation from the pediatric intensive care unit setting.
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Affiliation(s)
- Fulya Kamit Can
- Unit of Pediatric Intensive Care, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
| | - Ayşe Berna Anıl
- Unit of Pediatric Intensive Care, Katip Çelebi Univercity School of Medicine, İzmir, Turkey
| | - Murat Anıl
- Clinic of Child Emergency Service, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
| | - Murat Gümüşsoy
- Department of Otorhinolaryngology, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
| | - Hale Çitlenbik
- Unit of Pediatric Intensive Care, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
| | - Tolga Kandoğan
- Department of Otorhinolaryngology, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
| | - Neslihan Zengin
- Unit of Pediatric Intensive Care, İzmir Tepecik Training and Research and Hospital, İzmir, Turkey
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Anıl M, Yurtseven A, Yurtseven İ, Ülgen M, Anıl AB, Helvacı M, Aksu N. The evaluation of burnout and job satisfaction levels in residents of pediatrics. Turk Arch Pediatr 2017; 52:66-71. [PMID: 28747836 DOI: 10.5152/turkpediatriars.2017.4982] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/04/2016] [Accepted: 02/06/2017] [Indexed: 11/22/2022]
Abstract
AIM The aim of the study was to examine the level of job-related burnout and the level of job satisfaction among residents of pediatrics. MATERIAL AND METHODS A total of 102 residents of pediatrics who were trained in two Ministry of Health teaching and research hospitals and in two university hospitals in Izmir were included in the study. Demographic data (age, sex), lifestyle (living with parents or not, marital status, number of children) and professional characteristics (total time spent in profession, time spent in residency, number of night shifts per month, institution type: teaching hospital/university) were collected. Maslach Burnout Inventory (subscales: emotional exhaustion, desensitization, personal accomplishment) and Minnesota Satisfaction Questionnaire were used. RESULTS High levels of emotional exhaustion and desensitization, and low levels of personal accomplishment and job satisfaction were found in residents of pediatrics. Low levels of emotional exhaustion in teaching and research hospitals and low levels of desensitization in university hospitals were determined (p<0.05). We found a positive correlation between age and job satisfaction levels and a negative correlation between age and emotional exhaustion levels (p<0.05). There were negative correlations between the length of time in education and desensitization and between the number of night shifts per month and desensitization (p<0.05). CONCLUSIONS In residents of pediatrics, there is a high-level burnout and low-level of job satisfaction. Emotional exhaustion is more common in teaching and research hospitals and desensitization is more common in universities. Younger age, lower seniority, and the higher number of work-shift increases the burnout.
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Affiliation(s)
- Murat Anıl
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - Ali Yurtseven
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - İlkay Yurtseven
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - Mevlüt Ülgen
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - Ayşe Berna Anıl
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - Mehmet Helvacı
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
| | - Nejat Aksu
- Clinic of Peditrics, Ministry of Health Tepecik Education and Research Hospital, İzmir, Turkey
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Zengin N, Anıl M, Anıl AB, Kamit Can F, Bal A, Bıcılıoğlu Y, Durak F, Gökalp G. Clinical Characteristics of Pediatric Scorpion Envenomation in the Aegean Region: An Experience of a Training and Research Hospital. cayd 2016. [DOI: 10.4274/cayd.52714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kamit-Can F, Alparslan C, Anıl AB, Anıl M, Zengin N, Can E. The need for mechanical ventilation in a child exposed to a laundry detergent pod. Turk J Pediatr 2016; 58:323-326. [PMID: 28266202 DOI: 10.24953/turkjped.2016.03.017] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Laundry detergent pods (LDPs) are a new, concentrated form of detergent covered by a membrane of polyvinyl alcohol or other water-soluble material. In contrast to traditional laundry detergents, the spectrum of responses to exposure to LDPs ranges from mild to life-threatening events. This is a case report of a 3-year-old male who ingested part of an LDP, leading to a depressed level of consciousness, upper airway obstruction, and severe respiratory distress. The patient required intubation and mechanical ventilation for 2 days before being discharged. This rare, severe clinical pattern demonstrates the potential toxicity of these laundry detergents. In the literature, few cases that required intubation and ventilation have been reported. To our knowledge, this is also the first case of LDP exposure reported from Turkey.
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Affiliation(s)
- Fulya Kamit-Can
- Department of Pediatric Intensive Care Unit, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
| | - Caner Alparslan
- Department of Pediatric Nephrology, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
| | - Ayşe Berna Anıl
- Intensive Care Unit, Department of Pediatrics, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
| | - Murat Anıl
- Pediatric Emergency Care Unit, Tepecik Training and Research Hospital, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
| | - Neslihan Zengin
- Department of Pediatric Intensive Care Unit, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
| | - Ender Can
- Department of Pediatric Intensive Care Unit, Katip Çelebi Univercity, Faculty of Medicine, İzmir, Turkey
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Anıl AB. Hospital Infections in the Pediatric Intensive Care Unit: 4-Year Evaluation 2010-2013. J Pediatr Inf 2015. [DOI: 10.5152/ced.2015.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Anıl AB, Can FK, Turhan S, Zengin N, Anıl M, Bakiler AR, Doğrusöz B. The first succesful extracorporeal membranous oxygenation treatment in a child with refractory fulminant myocarditis in Turkey. Anatol J Cardiol 2015; 15:1036-7. [PMID: 26663231 PMCID: PMC5368464 DOI: 10.5152/anatoljcardiol.2015.6681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ayşe Berna Anıl
- Pediatric Intensive Care Unit, Faculty of Medicine, İzmir Katip Celebi University; İzmir-Turkey.
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Anıl AB. The Role of the Micronutrients; Vitamin A, Vitamin B12, Iron, Zinc, Copper Levels of Children with Lower Respiratory Tract Infections. J Pediatr Inf 2014. [DOI: 10.5152/ced.2014.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Şahbudak Bal Z, Bal A, Anıl M, Bayram SN, Cefa Arslan N, Köse E, Kamit Can F, Anıl AB, Helvacı M. Clinical and Laboratory Features of Hospitalized Children with Pandemic Influenza: Is it Different from the Other Respiratory Tract Infections? J Pediatr Inf 2012. [DOI: 10.5152/ced.2012.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Anıl AB, Anıl M, Köse E, Zengin N, Alparslan C, Bayram N, Yavaşcan Ö, Aksu N. Serum Sodium Levels in Children with Lower Respiratory Tract Infection. J Pediatr Inf 2011. [DOI: 10.5152/ced.2011.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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