Browsing by Author "Evren, G"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study)
    (SPRINGER) Yilmaz, D; Keles, YE; Emiroglu, M; Duramaz, BB; Ugur, C; Kocabas, BA; Celik, T; Ozdemir, H; Bayturan, S; Turel, O; Erdeniz, EH; Cakici, O; Taskin, EC; Erbas, IC; Genceli, M; Sari, EE; Caymaz, C; Kizil, MC; Sutcu, M; Demirbuga, A; Alkan, G; Bagci, Z; Dayar, GT; Ozkan, EA; Yilmaz, AT; Akca, M; Yesil, E; Kara, SS; Akturk, H; Yasar, B; Umit, Z; Uygun, H; Erdem, N; Buyukcam, A; Oncel, EK; Oz, SKT; Cetin, HS; Anil, AB; Yilmaz, R; Zengin, N; Uzuner, S; Albayrak, H; Borakay, O; Topal, S; Arslan, G; Yazar, A; Ozer, A; Kendirli, T; Kara, EM; Demirkol, D; Battal, F; Kosker, M; Akcan, OM; Kihtir, HS; Gul, D; Zararci, K; Alakaya, M; Kula, N; Celik, E; Petmezci, E; Evren, G; Aksay, AK; Konca, C; Sert, A; Arslan, D; Bornaun, H; Tekeli, O; Bal, A; Sahin, IO; Demir, S; Sap, F; Akyol, MB; Tanidir, IC; Donmez, YN; Ucar, T; Coban, S; Arga, G; Torun, SH; Karpuz, D; Celik, SF; Varan, C; Elmali, F; Oncel, S; Belet, N; Hatipoglu, N; Karabulut, ND; Turgut, M; Somer, A; Kuyucu, N; Dinleyici, EC; Ciftci, E; Kara, A
    Purpose Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU).Methods This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented.Results A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells x mu L, platelet count 153 vs. 212 cells x 10(3)/ mu L, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 mu g/L, ferritin 644 vs. 334 mu g/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log d-dimer (mu g/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively. Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care.
  • No Thumbnail Available
    Item
    The Effect of Therapeutic Hypothermia on Prognosis in Patients Receiving Continuous Renal Replacement Therapy
    (MARY ANN LIEBERT, INC) Evren, G; Zengin, N
    Continuous renal replacement therapy (CRRT) is a commonly used therapeutic modality in the pediatric intensive care unit (PICU) for the treatment of severe acute kidney injury, as well as for addressing metabolic abnormalities, fluid-electrolyte imbalances, and acid-base disorders. According to reports, therapeutic hypothermia treatment has demonstrated the ability to decrease cellular metabolism, oxygen consumption, formation of free radicals, cell death, and inflammatory signals. The study encompassed all individuals who underwent CRRT at both Manisa City Hospital and Manisa Celal Bayar University Hospital throughout the period from February 2021 to November 2022. A total of 14 patients who received CRRT were subjected to a warming procedure utilizing an external blanket and an external heater attached to the CRRT venous return line, resulting in the attainment of a body temperature exceeding 36 degrees C. Therapeutic hypothermia was implemented on 12 patients to maintain their body temperature within the range of 32-35 degrees C. The study population exhibited a median age of 24.5 months, with males comprising 61.5% of the sample. A therapeutic hypothermia treatment was administered to a cohort of 12 patients. The patients who had therapeutic hypothermia exhibited a significantly reduced vasoactive-inotropic score (p = 0.038). Patients who did not receive therapeutic hypothermia exhibited a prolonged need for mechanical ventilation (p = 0.020). The duration of stay in the PICU for patients who underwent therapeutic hypothermia was shown to be considerably shorter compared to those who did not receive therapeutic hypothermia (p = 0.047). The potential efficacy of moderate therapeutic hypothermia appears promising, particularly in the context of patients who are receiving CRRT for severe sepsis and acute respiratory distress syndrome. This is attributed to the anti-inflammatory properties and hypometabolic effects associated with this intervention. To the best of our current understanding, this study represents the initial investigation showcasing the effectiveness of combining therapeutic hypothermia with CRRT in the pediatric population.