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Öğe Could the COVID-19 infection have a better prognosis than expected in pediatric hematology oncology and bone marrow transplant patients?(AVES, 2021) Öner, Özlem Başoğlu; Aksoy, Başak Adaklı; Yaman, Ayhan; Sütçü, Murat; Erol Çipe, Funda; Atça, Ali Önder; Bozkurt, Ceyhun; Fışgın, TunçCoronavirus disease 2019 (COVID-19) is a pandemic that spread rapidly worldwide (1). So far, very few reports concerning the impact of COVID-19 among patients with pediatric hematologic-oncologic diseases are available (2). We aimed to describe the clinical features, prevalence, treatments, and outcomes in the COVID-19 patient population.Öğe Covid-19 transmission and clinical features in pediatric intensive care health care workers(2022) Botan, Edin; Uyar, Emel; Öztürk, Zeynelabidin; Şevketoğlu, Esra; Sarı, Yusuf; Dursun, Oğuz; Sincar, Şahin; Duyu, Muhterem; Oto, Arzu; Çelegen, Mehmet; Özçiftçi, Gökçen; Havan, Merve; Öztürk, Makbule Nilüfer; Ağın, Hasan; Yener, Nazik; Yaman, Ayhan; Gün, Emrah; Yılmaz, Merve; Şimşek, Naile; Özdemir, Halil; Yıldızdaş, Dinçer; Kendirli, TanılObjective: This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units. Materials and Methods: This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus disease 2019, treatment modalities, and loss of workdays were recorded. Results: Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 +/- 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died. Conclusion: Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients.Öğe Evaluation of forensic cases in the pediatric intensive care unit(KARE PUBL, 2021) Polat, Sinem; Terece, Cem; Yaman, Ayhan; Gürpınar, KağanObjectives: Traffic accidents, falls, assaults, occupational accidents, intoxications, burns, electric shock, lightning strike, all cases of asphyxia, penetrating and firearm injuries, suspected or definite cases of sexual abuse, and suicide attempts should be evaluated in the forensic category. In this study, we aimed to present our intensive care experiences in forensic cases. Methods: We retrospectively evaluated forensic cases admitted to our Pediatric Intensive Care Unit between 1 February 2017 and 1 September 2018. Results: This study included 153 children, 65 (42.5%) boys and 88 (57.5%) girls. The forensic causes of hospitalizations in the intensive care unit included drug intoxication with a rate of 54.9%, followed by suicide attempts with 24.2%, falling from a high place with 5.2%, child abuse with 5.2%, pedestrian (out-of-vehicle) traffic accidents with 2.6%, drowning in water with 2.6%, road (in-vehicle) traffic accidents with 2%, electric shocks with 2%, and CO (carbon monoxide) poisoning with 1.3%. The drug intoxication was caused by drugs prescribed to the mother and the child with a rate of 40.6% and 27.1%, respectively. Analgesic anti-inflammatory drugs (33.1%) and antidepressant drugs (22.3%) were identified as major causes of intoxication. In addition, paracetamol was the most common cause of intoxication, with a rate of 21.9% among all intoxication cases and 72.5% in the analgesic group. Amitriptyline was the most common agent in the antidepressant group (59.2%). The admission rate to the intensive care unit between 08:00 and 14:00 was 35.1% for suicide attempts and 16.4% for non-suicide attempts, with a statistically significant difference (p=0.025; p<0.05, respectively). Conclusion: Drug intoxications had the highest rate of forensic cases followed in our pediatric intensive care unit. The majority of these intoxications (69.4%) arose from accidental drug ingestion. Therefore, we believe that there may be a significant decrease in the number of hospitalizations of forensic cases associated with drug intoxications in pediatric intensive care units by preventing children's access to drugs.Öğe High flow nasal oxygen therapy in pediatric intensive care unit(Galenos, 2021) Yaman, AyhanObjective: Acute respiratory failure is the most common reason for hospitalization to pediatric intensive care units. Invasive and non-invasive respiratory support methods are used for the treatment of patients with acute respiratory failure findings. The aim of this study is to evaluate the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in pediatric intensive care. Method: This retrospective observational study was conducted between February 2017 and January 2018 in pediatric intensive care unit of Bahçeşehir Liv Hospital, İstinye University Faculty of Medicine. Patients aged between 1 month and 18 years, who received HFNC oxygen therapy for respiratory support in the pediatric intensive care unit, were included in the study. Results: HFNC therapy was received by 67 patients during one year of the study. 58.2% of the patients were male. The mean age of the patients was 37.2 months (R, 1-192), and their average body weight was 11.8 kg (R, 2.8-50). 65.7% of patients had an underlying disease. The most underlying disease was neurological disease with the rate of 35.8%. 94% of our patients received HFNC therapy due to acute respiratory failure, 3% due to acute heart failure and 3% due to shock. 40.3% of our patients received HFNC therapy due to pneumonia, 16.4% due to bronchopneumonia, 14.9% due to bronchiolitis, and 11.9% due to postextubation. 71.6% of patients receiving HFNC therapy improved their clinical findings without intubation. After HFNC therapy, there was a statistically considerable decrease in the respiratory rate, heart rate and retraction of the patients. HFNC therapy failure rates were statistically significantly higher in patients with underlying disease and especially in those with cardiac disease. Conclusion: As a result, it is known that HFNC therapy has been used effectively in children in recent years, and it provides improvement in vital findings and blood gas parameters. In our study, 71.6% of our patients benefited from HFNC therapy.Öğe Immediate Extubation in the Operating Room Following Pediatric Liver Transplantation: A Retrospective Cohort Study(Elsevier Science Inc, 2023) Sahin, Taylan; Yaman, Ayhan; Kavakli, Ali Sait; Eren, Eryigit; Dinckan, AyhanBackground. Although immediate extubation in the operating room following pediatric liver transplantation can be safe and beneficial for select patients, many surgeons and anesthesiologists are still cautious. The study aimed to evaluate the safety and efficiency of immediate extubation in the operating room following pediatric liver transplantation.Methods. Sixty-four pediatric liver transplant recipients were included in this retrospective study. Patients were divided into 2 groups: immediate extubation (IE) (those who were extubated in the operating room) and delayed extubation (DE) (those who were extubated in the intensive care unit). Preoperative, intraoperative, and postoperative variables were recorded.Results. Although a total of 19 (29.7%) patients were extubated in the pediatric intensive care unit (group DE), 45 (70.3%) were extubated in the operating room at the end of surgery (group IE). The use of fresh frozen plasma and platelets was statistically higher in group DE (P = .017 and P = .002, respectively). Duration of anesthesia and length of stay in the pediatric intensive care unit was statistically longer in group DE (P = .020 and P = .0001, respectively). Three (15.8%) patients required reintubation in group DE and 2 (4.4%) in group IE. Hospital stay was statistically longer in group DE (P = .012).Conclusions. The current study demonstrated that immediate extubation in the operating room after surgery for pediatric patients who have undergone liver transplantation was safe. The duration of anesthesia and the intraoperative use of blood products such as platelet and fresh frozen plasma can effectively decide immediate extubation.Öğe Kidney transplantation in children weighing 15 kilograms or less(SPRINGER, 2021) Özkaya, Ozan; Evrengül, Havva; Eren, Eryiğit; Tokaç, Mehmet; Yaman, Ayhan; Şahin, Taylan; Sütçü, Murat; Dursun, İsmail; Dinçkan, Ayhan[No Abstract Available]Öğe Severe rhabdomyolysis and acute renal failure treated by continuous venovenous hemodiafiltration in a child with diabetic ketoacidosis(Jaypee Brothers Medical Publishers, 2022) Yaman, AyhanDiabetic ketoacidosis (DKA) is the most serious hyperglycemic emergency in patients with type I diabetes mellitus and is associated with significant morbidity and mortality. DKA may be a life-threatening condition due to severe clinical and biological impairments and treatment-associated complications [cerebral edema, acute respiratory failure, acute renal failure (ARF), hypokalemia, hypophosphatemia]. The development of ARF with rhabdomyolysis is a rare but potentially lethal disorder in children with DKA with an estimated mortality of about 50%. Continuous renal replacement therapy is commonly used in intensive care units to provide renal replacement and fluid management. We successfully treated a 13-year-old boy with continuous venovenous hemodiafiltration, who had been diagnosed with severe DKA, complicated with hypophosphatemia-induced acute respiratory failure, rhabdomyolysis and ARF, persistent acidosis, and coma.
