Browsing by Author "Vatansever, ED"

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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    (OXFORD UNIV PRESS) Bakkaloglu, SA; Delibas, A; Döven, SS; Taner, S; Yavuz, S; Erfidan, G; Vatansever, ED; Aynaci, F; Yílmaz, K; Tasdemir, M; Akaci, O; Akinci, N; Güven, S; Çiçek, N; Dursun, I; Kelesoglu, E; Sancaktar, M; Alaygut, D; Saygili, S; Yavascan, Ö; Yilmaz, A; Gülleroglu, K; Ertan, P; Demir, BK; Poyrazoglu, H; Pinarbasi, S; Gençler, A; Bastug, F; Günay, N; Çelegen, K; Noyan, A; Parmaksiz, G; Avci, B; Çayci, FS; Bayrakçi, U; Özlü, SG; Aksoy, ÖY; Yel, S; Inal, GA; Köse, S; Bayazit, AK; Atmis, B; Saribas, E; Çagli, Ç; Tabel, Y; Elmas, AT; Selçuk, SZ; Kiliç, BD; Kara, MA; Büyükçelik, M; Balat, A; Tiryaki, BD; Erdogdu, B; Aksu, B; Mahmudova, G; Dursun, H; Candan, C; Göknar, N; Mutlubas, F; Çamlar, SA; Basaran, C; Akbulut, BB; Düzova, A; Gülhan, B; Oruç, Ç; Peru, H; Alpay, H; Türkkan, ÖN; Gülmez, R; Çelakil, M; Dogan, K; Bilge, I; Pehlivanoglu, C; Büyükkaragöz, B; Leventoglu, E; Alpman, N; Zeybek, C; Tülpar, S; Gülsan, RYÇ; Kara, A; Gürgöze, MK; Önder, ENA; Atikel, YÖ; Pul, S; Sönmez, F; Yildiz, G; Akman, S; Elmaci, M; Küçük, N; Yüksel, S; Kavaz, A; Nalçacioglu, H; Alparslan, C; Dinçel, N; Elhan, AH; Sever, L
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of >120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age >15 years, creatine phosphokinase (CK) >= 20 950 U/L, TUR >= 10 h and the first-day IVF volume <3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of >20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m(2) BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days.