Browsing by Author "Akcan, AB"

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    Experience with Real-Time Continuous Glucose Monitoring in Newborns with Congenital Hyperinsulinemic Hypoglycemia
    Anik, A; Türkmen, MK; Akcan, AB; Ünüvar, T; Öztürk, S; Anik, A
    Background Effective treatment and close monitoring of hypoglycemia in children with congenital hyperinsulinemic hypoglycemia (CHH) is vital to prevent brain damage. The current use of capillary sampling schedules does not provide a comprehensive assessment of glycemic status and fails to detect asymptomatic hypoglycemia episodes. Aim To investigate the efficacy and accuracy of a real-time continuous glucose monitoring system (RT-CGMS) in neonates with CHH. Methods A sensor connected to RT-CGMS was inserted into the newborn patients and maintained for at least 6 days during their stay in the hospital. We compared the readings of CGMS with capillary blood glucose values using Bland-Altman analysis. Results A total of 110 blood glucose values were compared to readings from the CGMS. All results were calculated and plotted for CGMS values at 0- 4, 5-9, 10-14, 15-19, 20-24, and 25-29 min after capillary blood glucose sampling. CGMS readings were highly correlated with blood glucose values, especially during normoglycemia. In case of hypoglycemia, the mean difference between the CGMS and capillary glucose values was higher. Although the false positive rate for hypoglycemia was relatively high in CGMS, RT-CGMS may show some episodes of hypoglycemia earlier than blood measurement. Conclusion RT-CGMS is accurate during normoglycemia, and it can reduce the number of capillary blood samples in children with CHH.
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    Caffeine use in preterm neonates: national insights into Turkish NICU practices
    Unal, S; Beken, S; Ince, DA; Turan, O; Toygar, AK; Ecevit, A; Akcan, AB; Akin, MA; Aktas, S; Ciftdemir, NA; Altuncu, E; Altunhan, H; Arcagok, BC; Armangil, D; Ozer, EA; Aydin, B; Bezirganoglu, H; Bilgin, L; Calisici, E; Calkavur, S; Celik, K; Celik, Y; Cetinkaya, B; Cetinkaya, M; Demirel, A; Demirel, G; Dogan, NN; Dogan, P; Durukan, M; Engur, D; Ercan, TE; Gokmen, Z; Varal, IG; Gulasi, S; Gunlemez, A; Gursoy, T; Toptan, HH; Hamitoglu, S; Isleyen, F; Iyigun, I; Kader, S; Kahvecioglu, D; Kayki, G; Kostu, M; Kurnaz, D; Mammadaliyev, T; Akin, IM; Narli, N; Okulu, E; Okur, N; Olukman, O; Ovali, F; Ozcan, B; Ozdemir, A; Ozdemir, O; Ozkan, H; Sandal, G; Sarici, D; Sivrikaya, C; Bilgin, BS; Sundus, S; Onay, OS; Simsek, H; Tandircioglu, UA; Tanriverdi, S; Tekgunduz, KS; Terek, D; Tunc, G; Tunc, T; Tutak, E; Tufekcioglu, E; Erdogan, FT; Ulu, E; Isik, DU; Uras, N; Uslu, SI; Unal, I; Yilmaz, FH; Moniri, A
    Objective: Caffeine is a proven medication used for the prevention and treatment of apnea in premature infants, offering both short- and long-term benefits. International guidelines provide a range of recommendations regarding the preterm population eligible for caffeine prophylaxis, including the timing, dosage, and duration of treatment. Our national guidelines, published prior to the most recent updates of the international guidelines, recommend the use of caffeine citrate starting from the first day after delivery for preterm infants with a gestational age of <28 weeks. For infants up to 32 weeks, if positive pressure ventilation is required, the decision should be made on an individual basis. This study aims to describe the variability in caffeine usage across neonatal intensive care units in our country. Methods: An online survey was sent to neonatologist who are members of the Turkish Neonatology Society to describe the variability in caffeine usage in neonatal intensive care units in our country. Results: We collected responses from 74 units. Prophylactic caffeine usage was observed as; GA <= 27(6/7): 98.6%, GA 28(0/7)-28(6/7): 89.0%, GA 29(0/7)-29(6/7): 75.3%, GA 30(0/7)-31(6/7): 53.4%. 62.2% of units reported administering loading dose within the first two hours. The initial maintenance dose was 5 mg/kg in 64.8% of units, 10 mg/kg in 32.4% of units, and intermediate dose in 5.3% of units. 47.3% of units reported no routine dose adjustment. The postmenstrual age that caffeine treatment was stopped was found to be 34 (min-max; 32-36) weeks for infants without apnea and respiratory support, 36 (min-max; 34-52) weeks for infants without apnea but any respiratory support. The time to discharge after treatment cessation was found as; 1-4 days: 37.8%, 5-7 days: 68.9%. Among the 56 units with multiple responsible physicians, 32.1% reported intra-unit variations. Conclusion: The significant differences in caffeine usage characteristics between and within units highlight the need for clear recommendations provided by standardized guidelines.