Browsing by Author "Ozer, EA"

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    Lung-protective ventilation in neonatal intensive care unit
    Ozer, EA
    Despite the technological advances in the mechanical ventilation in neonatal intensive care units (NICUs), the lungs of preterm infants are still susceptible particularly to ventilator-induced lung injury. The purposes of lung-protective strategy in preterm infants are to prevent atelectrauma, limit tidal volume to avoid overdistension, and minimize oxygen toxicity. Available data suggest that these goals can be successfully achieved by different modes of respiratory support including ideal ventilation. It is important that ventilation with large tidal volumes should be avoided. Lung-protective ventilation in the newborn infants has been a recent trend as a primary mode of ventilation support for early management of respiratory distress syndrome. To reduce the risk of ventilator-induced oxygen toxicity, supplemental oxygen should be guided by pulse oximetry. In this study, current lung-protective ventilation methods in NICU are reviewed.
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    Efficacy and Safety of Intravenous Colistin in Very Low Birth Weight Preterm Infants
    Ilhan, O; Bor, M; Ozdemir, SA; Akbay, S; Ozer, EA
    BackgroundGiven the severity and high mortality of multidrug-resistant Gram-negative bacilli (MDR-GNB) infections, the use of colistin will increase in patients with MDR-GNB infection.ObjectiveThis study aims to assess the efficacy and safety of intravenous colistin in very low birth weight (VLBW; birth weight <1500g) preterm infants.MethodsWe retrospectively analyzed the medical records of patients who received colistin between June 2016 and December 2017. The patients were assigned to two groups: the VLBW group and the non-VLBW group. Both groups were evaluated for response to treatment and adverse effects.ResultsIn total, 66 infants who received colistin therapy were included; of these, 28 infants were VLBW. All of our patients received standard colistin treatment of 5mg/kg per day in three doses and the median duration of colistin treatment was 14days. No significant differences were observed between the groups with respect to the efficacy of colistin (defined as showing microbiological clearance in control cultures and the absence of mortality during treatment) (89.3 vs 86.8%, p>0.99). Serum magnesium and potassium levels were significantly lower in the VLBW group than in the non-VLBW group during colistin therapy (magnesium, 1.30 vs 1.70mg/dL, p<0.001; potassium, 3.6 vs 4.6mEq/L, p<0.001). Acute kidney injury was observed in four infants in the VLBW group and one in the non-VLBW group, without significant differences (p=0.15).ConclusionsColistin administration appears to be efficacious in VLBW infants; however, renal function tests and serum electrolytes should be monitored more closely in these infants during treatment.
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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.
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    Cord blood nucleated red blood cell level: is it a predictive marker for neonatal jaundice?
    Orhon, A; Topal, H; Hakan, N; Ozer, EA
    Background: The aim of this study was to evaluate if the cord blood nucleated red blood cell (nRBC) levels can predict the development of hyperbilirubinemia in healthy neonates. Methods: All healthy newborn infants born after 35 or more weeks of gestation at our hospital between January 2016 and April 2017 were included. The levels of nRBC were counted in umbilical cord blood samples. Neonates were grouped into two study groups based on the presence or absence of neonatal jaundice. Results: The study included overall 149 eligible newborn infants. The levels of nRBC and absolute nRBC count showed statistically significant differences between newborns with or without jaundice (p =0.01 and 0.02, respectively). Conclusions: We suggest that increased nRBC counts in cord blood may be a predictive marker for hyperbilirubinemia in healthy newborn infants.