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Kraja E, Demirtas F, Kostekci YE, Turker N, Okulu E, Erdeve Ö, Atasay B, Arsan S. Evaluation of the "Neonatal Sequential Organ Failure Assessment" to Predict Mortality in Late-Onset Sepsis in Very Preterm Infants. Z Geburtshilfe Neonatol 2024; 228:174-180. [PMID: 38081215 DOI: 10.1055/a-2165-8307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
INTRODUCTION We aimed to evaluate the use of "Neonatal Sequential Organ Failure Assessment" (nSOFA) scoring in predicting mortality, to compare the accuracy of nSOFA scores at different time points in very preterm infants with late-onset sepsis (LOS), and to investigate other possible parameters that would improve the prediction. METHODS This single-center, retrospective study included preterm infants born atS<32 weeks' gestation with culture-proven LOS. The nSOFA scores of non-fatal and fatal episodes were compared at nine time points. RESULTS Of 120 culture-proven LOS episodes in 106 infants, 90 (75%) episodes were non-fatal and 30 (25%) episodes were fatal. The mean birth weight (BW) of the infants who died was lower than that of survivors (p=0.038). In the fatal LOS episodes, median nSOFA scores were higher at all time points measured before sepsis evaluation, at the time of evaluation, and at all time points measured after the evaluation (p<0.001). nSOFA scores before death and at 48 hours were higher in the fatal episodes (p<0.001). At the time of sepsis assessment, nSOFA score>4 was associated with a 7- to 16-fold increased risk of mortality. Adjustment for BW, lymphocyte and monocyte counts increased the risk to 9- to 18-fold. CONCLUSION This study demonstrated that the use of nSOFA to predict mortality and morbidity in extremely preterm infants seems feasible. The scoring system could be improved by evaluating the other parameters.
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Affiliation(s)
- Elvis Kraja
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ferhan Demirtas
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Yasemin Ezgi Kostekci
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Nazmiye Turker
- Department of Pediatrics, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Ankara University, Ankara, Turkey
| | - Ömer Erdeve
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
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Okulu E, Kraja E, Kostekci YE, Seker E, Ozisik MS, Sarısoy D, Aslan B, Çakır MS, Demirtaş F, Ramoğlu MG, Uçar T, Erdeve O, Atasay B, Koc A, Arsan S. Effect of Antenatal Magnesium Sulfate Exposure on Patent Ductus Arteriosus in Premature Infants. Am J Perinatol 2024. [PMID: 38320597 DOI: 10.1055/s-0044-1779620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Magnesium sulfate (MgSO4) provides effective fetal neuroprotection. However, there is conflicting evidence regarding the association between antenatal MgSO4 exposure and patent ductus arteriosus (PDA). Thus, herein, we aimed to evaluate the association between antenatal MgSO4 exposure and PDA. STUDY DESIGN Preterm infants born between 240/7 and 316/7 weeks of gestation were included in this retrospective study. Infants who died within the first 72 hours of life and those with significant congenital anomalies were excluded from the study. Echocardiographic and clinical assessment parameters were used to define PDA and hemodynamically significant PDA (hsPDA). Treatments were planned according to the standard protocols of the unit. The following data were collected from hospital medical records: perinatal characteristics, neonatal outcomes, detailed PDA follow-up findings, and maternal characteristics including MgSO4 exposure and doses. RESULTS Of the 300 included infants, 98 (32.6%) were exposed to antenatal MgSO4. hsPDA rates were similar in the infants exposed and not exposed to antenatal MgSO4, when adjusted for antenatal steroid administration, gestational age, and birth weight (OR: 1.6, 95% CI: 0.849-3.118, p = 0.146). The rates of PDA ligation and open PDA at discharge were similar between the groups. A cumulative MgSO4 dose of >20 g was associated with an increased risk of hsPDA (crude OR: 2.476, 95% CI: 0.893-6.864, p = 0.076; adjusted OR: 3.829, 95% CI: 1.068-13.728, p = 0.039). However, the cumulative dose had no effect on the rates of PDA ligation or open PDA at discharge. Rates of prematurity-related morbidities and mortality were similar between the groups. CONCLUSION Although antenatal MgSO4 exposure may increase the incidence of hsPDA, it may not affect the rates of PDA ligation or open PDA at discharge. Further studies are required to better evaluate the dose-dependent outcomes and identify the MgSO4 dose that not only provides neuroprotection but also has the lowest risk of adverse effects. KEY POINTS · Antenatal exposure of MgSO4 may cause PDA.. · Antenatal MgSO4 exposure may not increase the rates of PDA ligation or open PDA at discharge.. · Further studies are required to better evaluate the dose-dependent outcomes and optimal MgSO4 dose..
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Affiliation(s)
- Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elvis Kraja
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Ezgi Kostekci
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdal Seker
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Seckin Ozisik
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Doğacan Sarısoy
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Batuhan Aslan
- Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Maide Selin Çakır
- Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ferhan Demirtaş
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Gökhan Ramoğlu
- Division of Pediatric Cardiology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tayfun Uçar
- Division of Pediatric Cardiology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Acar Koc
- Division of Perinatology, Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Kostekci YE, Bakırarar B, Okulu E, Erdeve O, Atasay B, Arsan S. An Early Prediction Model for Estimating Bronchopulmonary Dysplasia in Preterm Infants. Neonatology 2023; 120:709-717. [PMID: 37725910 DOI: 10.1159/000533299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/22/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Accurate assessment of the risk for bronchopulmonary dysplasia (BPD) is critical to determine the prognosis and identify infants who will benefit from preventive therapies. Clinical prediction models can support the identification of high-risk patients. In this study, we investigated the potential risk factors for BPD and compared machine learning models for predicting the outcome of BPD/death on days 1, 7, 14, and 28 in preterm infants. We also developed a local BPD estimator. METHODS This study involved 124 infants. We evaluated the composite outcome of BPD/death at a postmenstrual age of 36 weeks and identified risk factors that would improve BPD/death prediction. SPSS for Windows Version 11.5 and Weka 3.9 software were used for the data analysis. RESULTS To evaluate the combined effect of all variables, all risk factors were taken into consideration. Gestational age, birth weight, mode of respiratory support, intraventricular hemorrhage, necrotizing enterocolitis, surfactant requirement, and late-onset sepsis were risk factors on postnatal days 7, 14, and 28. In a comparison of four different time points (postnatal days 1, 7, 14, and 28), the day 7 model provided the best prediction. According to this model, when a patient was diagnosed with BPD/death, the accuracy rate was 89.5%. CONCLUSION The postnatal day 7 model was the best predictor of BPD or death. Future validation studies will help identify infants who may benefit from preventive therapies and develop individualized care.
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Affiliation(s)
- Yasemin Ezgi Kostekci
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Batuhan Bakırarar
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Kostekci YE, Ocak BO, Ekiyor E, Gucenmez K, Demirtas F, Ergun E, Mehdilli A, Bahadir GG, Okulu E, Erdeve Ö, Arsan S, Atasay B. Acute Abdomen in an Extremely Low-Birth-Weight Preterm Neonate: A Case of Appendicitis. Z Geburtshilfe Neonatol 2023; 227:307-309. [PMID: 37224881 DOI: 10.1055/a-2044-0889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Neonatal appendicitis is a very rare surgical entity. Non-specific symptoms such as feeding intolerance, abdominal distension, vomiting, increased gastric residue, lethargy, and fever may be present. The majority of reported cases could not be identified early. In this report, we present an extremely low-birth-weight preterm neonate who has been diagnosed with appendicitis. CASE PRESENTATION A 980-gram preterm baby girl was born at 31 1/7 weeks of gestation. The physical examination was normal at birth. Her initial clinical course was uneventful. On the 7th day of life, she developed abdominal distention and tenderness. She had an episode of bloody stools and bilious vomiting. An abdominal X-ray suggested localized perforation in the cecum with an air-fluid level in the right lower quadrant. The clinical findings suggested necrotizing enterocolitis and perforation, and a diagnostic laparotomy was performed. The bowel was found to be normal with a necrotic appendix. The appendectomy was performed. She was discharged from the neonatal intensive care unit with no complications. CONCLUSION Appendicitis is extremely rare in the neonatal period. It is quite challenging to evaluate the presentation accurately, which causes a delay in diagnosis. However, if an atypical NEC or peritonitis is present, appendicitis should be considered. Early diagnosis and timely surgical intervention improve the prognosis of neonatal appendicitis.
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Affiliation(s)
- Yasemin Ezgi Kostekci
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Buse Onen Ocak
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ege Ekiyor
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kader Gucenmez
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ferhan Demirtas
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergun Ergun
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aysel Mehdilli
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gulnur Gollu Bahadir
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Okulu
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ömer Erdeve
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
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Yildiz D, Cakir U, Kahvecioglu D, Alan S, Erdeve O, Atasay B, Arsan S. Cornelia de Lange Syndrome Presenting as Hydrops Fetalis due to Intestinal Atresia. Klin Padiatr 2023. [PMID: 37494590 DOI: 10.1055/a-2099-3386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Affiliation(s)
- Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Okulu E, Kraja E, Kostekci YE, Aloyeva R, Erdeve O, Atasay B, Arsan S. Comparison of Definitions for Bronchopulmonary Dysplasia: A Cohort Study. Z Geburtshilfe Neonatol 2023; 227:58-63. [PMID: 36070784 DOI: 10.1055/a-1915-5682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
We aimed to compare the definitions of National Institute of Child Health and Human Development (NICHD) for bronchopulmonary dysplasia (BPD) for determining the incidences, and predicting late death and respiratory outcome. This retrospective cohort study included infants born at<32 weeks' gestation who survived up to 36 weeks' postmenstrual age (PMA). Infants were classified as having BPD or no BPD per thedefinitions of NICHD 2001 and 2018. The incidences of BPD were 49 and 32% according to the 2001 and 2018 NICHD definitions. Gestational age, birth weight and intubation after birth were associated with BPD by both definitions. The NICHD 2018 definition displayed similar sensitivity (100%) and negative predictive value (100%), and higher specificity (70 vs. 52%) for predicting death after 36 weeks' PMA; a higher specificity (72 vs. 53%), comparable negative predictive value (77 vs.76%), but lower sensitivity for predicting adverse respiratory outcome within 12 months corrected age compared with the NICHD 2001 definition. The NICHD 2018 definition is as powerful as the 2001 definition for predicting late death and seems to be a better indicator for long-term respiratory outcome. The use of supplemental oxygen or oxygen plus respiratory support should be considered while predicting both late death and long-term respiratory outcome.
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Affiliation(s)
- Emel Okulu
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elvis Kraja
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Yasemin Ezgi Kostekci
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Rana Aloyeva
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
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Kostekci YE, Kraja E, Ergun E, Demir B, Okulu E, Erdeve O, Yagmurlu A, Fitoz OS, Ceyhan K, Atasay B, Arsan S. Mediastinal teratoma presented with nonimmune hydrops and chylothorax: a case report. Ann Pediatr Surg 2022. [DOI: 10.1186/s43159-022-00188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Nonimmune hydrops fetalis (NIHF) can be caused by different types of etiologies. Some rare intrathoracic lesions are associated with NIHF. Combination of mediastinal teratoma, NIHF, and chylothorax is extremely rare. Mediastinal teratomas which are located in midline should be difficult to be detected. Thoracic imaging should be performed with unknown etiology for hydrops, and in case of chylothorax, the presence of a mass compressing the ductus thoracicus should be considered primarily.
Case presentation
An infant was born with a diagnosis of NIHF. Bilateral chest tubes were inserted cause of bilateral pleural effusions. After enteral feeding, the previously clear pleural fluid became chylous. Medium-chain triglyceride infant formula and somatostatin analog octreotide were initiated. A mass was appeared on her neck with the disappearance of skin edema. Magnetic resonance imaging confirmed a large, heterogeneous mass which was suggesting immature teratoma originating from thyroid gland. Complete surgical excision of the mass was performed. Histology confirmed high-grade immature teratoma. The neonate made an uneventful recovery. Following complete cessation of pleural fluid drainage, octreotide was stopped. She was discharged home on exclusive breast milk on day 34 of life.
Conclusions
Mediastinal teratomas are rare masses that cause hydrops fetalis. Although the association of NIHF and mediastinal teratoma is rare, thoracic imaging can be performed if an etiology cannot be found despite basic evaluations for hydrops. In case of chylothorax, the presence of a mass compressing the ductus thoracicus should be considered primarily, and thoracic imaging should be performed.
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Kostekci YE, Okulu E, Akin DG, Erdeve O, Atasay B, Arsan S. Oxygen Saturation Index to Predict Surfactant Requirement in Preterm Infants. Indian J Pediatr 2022; 89:1262. [PMID: 36173538 DOI: 10.1007/s12098-022-04380-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Yasemin Ezgi Kostekci
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, 06590, Mamak, Ankara, Turkey.
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, 06590, Mamak, Ankara, Turkey
| | - Dilara Gungor Akin
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, 06590, Mamak, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, 06590, Mamak, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, 06590, Mamak, Ankara, Turkey
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Kostekci YE, Okulu E, Bakirarar B, Kraja E, Erdeve O, Atasay B, Arsan S. Nasal Continuous Positive Airway Pressure vs. Nasal Intermittent Positive Pressure Ventilation as Initial Treatment After Birth in Extremely Preterm Infants. Front Pediatr 2022; 10:870125. [PMID: 35547537 PMCID: PMC9082746 DOI: 10.3389/fped.2022.870125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022] Open
Abstract
Objective Non-invasive respiratory support strategies are known to reduce the complications of invasive mechanical ventilation in preterm infants. Nasal continuous positive airway pressure (NCPAP) and nasal intermittent positive pressure ventilation (NIPPV) are commonly used ones. The recent meta-analyses indicated that early NIPPV did appear to be superior to NCPAP for decreasing respiratory failure and the need for intubation among preterm infants with respiratory distress syndrome (RDS). The aim of the study was to compare the short-term outcomes of extremely preterm infants who received NCPAP or NIPPV as an initial treatment of RDS. Methods This retrospective study included infants born before 29 weeks' gestation between 1 January 2018 and 31 December 2021 who received non-invasive respiratory support with NCPAP or NIPPV. For every infant included in the cohort, only the first episode of NCPAP or NIPPV as initial treatment was evaluated. The primary outcome was the need for intubation within 72 h, and the secondary outcomes were the need for intubation within 7 days, administration of surfactant, prematurity-related morbidities, mortality, and death or bronchopulmonary dysplasia (BPD). Results During the study period, there were 116 inborn admissions of preterm infants born <29 weeks' gestation and 60 of them met the inclusion criteria. Of these, 31 (52%) infants received NCPAP while 29 (48%) infants received NIPPV at the first hours after birth. There were no differences in the baseline demographics between the groups (p > 0.05). Blood gas parameters (pH, pCO2, HCO3, and lactate) at admission were not different. The need for intubation within 72 h as the primary outcome was similar between NCPAP and NIPPV groups (35.5 vs. 34.5%, p = 0.935). The rates of surfactant requirement, need for intubation within 7 days, prematurity-related morbidities, mortality, and death/BPD were similar among the groups (p > 0.05). Conclusion Nasal intermittent positive pressure ventilation is non-inferior to NCPAP as an initial treatment in extremely preterm infants with RDS. Although the rate of intubation in the first week, mortality, and BPD did not differ between groups, additional studies are needed and the synchronization of NIPPV should be evaluated.
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Affiliation(s)
- Yasemin Ezgi Kostekci
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Batuhan Bakirarar
- Department of Biostatistics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Elvis Kraja
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
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Okulu E, Haskologlu S, Guloglu D, Kostekci E, Erdeve O, Atasay B, Koc A, Soylemez F, Dogu F, Ikinciogullari A, Arsan S. Effects of Umbilical Cord Management Strategies on Stem Cell Transfusion, Delivery Room Adaptation, and Cerebral Oxygenation in Term and Late Preterm Infants. Front Pediatr 2022; 10:838444. [PMID: 35444969 PMCID: PMC9013943 DOI: 10.3389/fped.2022.838444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/21/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The umbilical cord blood contains a high concentration of stem cells. There is not any published study evaluating the amount of stem cells that have the potential to be transferred to the infant through placental transfusion methods as delayed cord clamping (DCC) and umbilical cord milking (UCM). The aim of this study is to measure the concentrations of endothelial progenitor cell (EPC) and CD34+ hematopoietic stem cell (HSC) in the placental residual blood volume (PRBV), and evaluate the delivery room adaptation and cerebral oxygenation of these infants. METHODS Infants with ≥36 gestational weeks were randomized to receive DCC (120 s), UCM, or immediate cord clamping (ICC). EPC and CD34+ HSC were measured by flow cytometry from the cord blood. PRBV was collected in the setup. The cord blood gas analysis and complete blood count were performed. The heart rate (HR), oxygen saturation (SpO2), and cerebral regional oxygen saturation (crSO2) were recorded. RESULTS A total of 103 infants were evaluated. The amount of PRBV (in ml and ml/kg) was higher in the ICC group (p < 0.001). The number of EPCs in the PRBV content (both ml and ml/kg) were the highest in the ICC group (p = 0.002 and p = 0.001, respectively). The number of CD34+ HSCs in PRBV content (ml and ml/kg) was similar in all groups, but nonsignificantly higher in the ICC group. The APGAR scores at the first and fifth min were lower in the ICC group (p < 0.05). The mean crSO2 values were higher at the 3rd and 10th min in the DCC group (p = 0.042 and p = 0.045, respectively). cFOE values were higher at the 3rd and 10th min in the ICC group (p = 0.011 and p < 0.001, respectively). CONCLUSION This study showed that placental transfusion methods, such as DCC and UCM, provide both higher blood volume, more stem cells transfer to the infant, and better cerebral oxygenation in the first minutes of life, whereas many lineages of stem cells is lost to the placenta by ICC with higher residual blood volume. These cord management methods rather than ICC do not require any cost or technology, and may be a preemptive therapeutic source for diseases of the neonatal period.
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Affiliation(s)
- Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sule Haskologlu
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Guloglu
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ezgi Kostekci
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Acar Koc
- Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Feride Soylemez
- Department of Obstetrics and Gynecology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Figen Dogu
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydan Ikinciogullari
- Division of Pediatric Immunology and Allergy, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Okulu E, Erdeve O, Kilic I, Olukman O, Calkavur S, Buyukkale G, Cetinkaya M, Ulubas D, Demirel N, Hanta D, Ertugrul S, Gultekin ND, Tuncer O, Demir N, Bilgin L, Narli N, Yildiz D, Terek D, Koroglu OA, Seren C, Ozyazici E, Ozdemir R, Turgut H, Narter F, Akin Y, Ozyazici A, Zenciroglu A, Asker HS, Gokmen Z, Salihli M, Bulbul A, Zubarioglu U, Atasay B, Koc E. Intravenous Immunoglobulin Use in Hemolytic Disease Due to ABO Incompatibility to Prevent Exchange Transfusion. Front Pediatr 2022; 10:864609. [PMID: 35573949 PMCID: PMC9095978 DOI: 10.3389/fped.2022.864609] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Intravenous immunoglobulin (IVIG) has been widely used to treat the hemolytic disease of the newborn (HDN). Although it has been shown that IVIG treatment reduces the duration of phototherapy and hospitalization, the use of IVIG in hemolytic disease due to ABO incompatibility has been controversial in recent years. This study aimed to investigate the role of IVIG in the prevention of exchange transfusion in infants with ABO HDN who presented with bilirubin levels at or above the level of exchange transfusion. MATERIALS AND METHODS This study evaluated the data of infants with ABO HDN in the Turkish Neonatal Jaundice Online Registry. The infants with ABO HDN who met the total serum bilirubin level inclusion criteria (within 2-3 mg/dL of exchange transfusion or even above exchange transfusion level) were included in the study according to the guidelines from the American Academy of Pediatrics and the Turkish Neonatal Society. All patients were managed according to the unit protocols recommended by these guidelines and received light-emitting diode (LED) phototherapy. Infants who only received LED phototherapy, and who received one dose of IVIG with LED phototherapy were compared. RESULTS During the study period, 531 term infants were included in the study according to inclusion criteria. There were 408 cases in the phototherapy-only group, and 123 cases in the IVIG group. The demographic findings and the mean bilirubin and reticulocyte levels at admission were similar between the groups (p > 0.05), whereas the mean hemoglobin level was slightly lower in the IVIG group (p = 0.037). The mean age at admission was earlier, the need for exchange transfusion was higher, and the duration of phototherapy was longer in the IVIG group (p < 0.001, p = 0.001, and p < 0.001, respectively). The rate of re-hospitalization and acute bilirubin encephalopathy (ABE) was higher in the IVIG group (p < 0.001 and p = 0.01, respectively). CONCLUSION In this study, we determined that one dose of IVIG did not prevent an exchange transfusion nor decrease the duration of phototherapy in infants, who had bilirubin levels near or at exchange transfusion level, with hemolytic disease due to ABO incompatibility.
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Affiliation(s)
- Emel Okulu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ilknur Kilic
- Department of Neonatology, Atasehir Florence Nightingale Hospital, Istanbul, Turkey
| | - Ozgur Olukman
- Department of Neonatology, Izmir Behcet Uz Children's Hospital, University of Health Sciences, Izmir, Turkey
| | - Sebnem Calkavur
- Department of Neonatology, Izmir Behcet Uz Children's Hospital, University of Health Sciences, Izmir, Turkey
| | - Gokhan Buyukkale
- Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Merih Cetinkaya
- Department of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Ulubas
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nihal Demirel
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey.,Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Deniz Hanta
- Department of Neonatology, Adana Delivery and Child Disease Hospital, Adana, Turkey
| | - Sabahattin Ertugrul
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
| | - Nazli Dilay Gultekin
- Division of Neonatology, Department of Pediatrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Oguz Tuncer
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yuzuncuyil University, Van, Turkey
| | - Nihat Demir
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Yuzuncuyil University, Van, Turkey
| | - Leyla Bilgin
- Department of Neonatology, Umraniye Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nejat Narli
- Neonatal Intensive Care Unit, Adana Metro Hospital, Adana, Turkey
| | - Duran Yildiz
- Nenehatun Obstetrics and Gynecology Hospital, Erzurum, Turkey
| | - Demet Terek
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ozge Altun Koroglu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Canan Seren
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Elif Ozyazici
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ramazan Ozdemir
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Hatice Turgut
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Fatma Narter
- Department of Neonatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yasemin Akin
- Department of Neonatology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ahmet Ozyazici
- Department of Neonatology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
| | - Aysegul Zenciroglu
- Department of Neonatology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey
| | | | - Zeynel Gokmen
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Konya Hospital, Başkent University, Konya, Turkey
| | - Musa Salihli
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Konya Hospital, Başkent University, Konya, Turkey
| | - Ali Bulbul
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Umut Zubarioglu
- Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Esin Koc
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey
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Cetinkaya M, Atasay B. Editorial: Transfusions in the neonatal period. Front Pediatr 2022; 10:982918. [PMID: 35958180 PMCID: PMC9358285 DOI: 10.3389/fped.2022.982918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Merih Cetinkaya
- Division of Neonatology, Department of Pediatrics, Cam Sakura City Hospital, Health Sciences University, Istanbul, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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13
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Erkol Tuncer GH, Ekim M, Okulu E, Atasay B, Kendirli T. Continuous renal replacement therapy in critically ill children: single-center experience. Turk J Med Sci 2021; 51:188-194. [PMID: 33172226 PMCID: PMC7991869 DOI: 10.3906/sag-2006-227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 11/07/2020] [Indexed: 11/22/2022] Open
Abstract
Background/aim Continuous renal replacement therapy (CRRT) has significant benefits in the treatment of critically ill children.The objective of this study is to describe the treatment indications, methods, demographics, and outcome of the patients who received CRRT in our pediatric intensive care unit and neonatal care unit, and, according to these results, we also aimto make improvements in our unit-based interventions. Materials and methods In this single-centered study, we retrospectively evaluated medical charts of the patients admitted to our intensive care units and received CRRT between February 2010 and November 2015. Results Fifty of 60 patients were included in this study. Newborns made up 28% (n = 14) of the patients. The mean body weight was 18.4 kg (2.3-98 kg). CRRT indications were fluid overload (30%), acute kidney injury (40%), metabolic disease (24%), electrolyte impairment (4%), and drug intoxication (2%). The most common method of CRRT was continuous venovenous hemodiafiltration (CVVHDF) (72%). The mean duration of CRRT was 135 hours (1-864) and totally 143 filters, polyarylethersulfon (n = 23.46%) and polyacrylonitrile (n = 27.54%) were used. Overall survival was 42%. The survival rate of newborns was significantly higher (P = 0.046). Conclusion CRRT is a lifesaving method that can be applied to critically ill children with acute kidney injury and fluid overload at any age and weight by experienced teams.
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Affiliation(s)
| | - Mesiha Ekim
- Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey,Department of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Emel Okulu
- Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey,Department of Neonatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey,Department of Neonatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Tanil Kendirli
- Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey,Department of Pediatric Intensive Care Unit, Faculty of Medicine, Ankara University, Ankara, Turkey
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14
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Singh Y, Fraisse A, Erdeve O, Atasay B. Echocardiographic Diagnosis and Hemodynamic Evaluation of Patent Ductus Arteriosus in Extremely Low Gestational Age Newborn (ELGAN) Infants. Front Pediatr 2020; 8:573627. [PMID: 33330274 PMCID: PMC7717963 DOI: 10.3389/fped.2020.573627] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/16/2020] [Indexed: 11/13/2022] Open
Abstract
Persistent Patent ductus arteriosus (PDA) is a common finding in extremely low gestational age newborn infants and its prevalence is inversely proportional to the gestational age. The presence of a persistent PDA is associated with increased mortality and several significant morbidities including intraventricular hemorrhage, pulmonary hemorrhage, necrotizing enterocolitis, and chronic lung disease or bronchopulmonary dysplasia. However, treating PDA has not been demonstrated to have beneficial impact on the long term outcomes. Currently there is no consensus on whether to treat the PDA or not, and if treat, when to treat and how to treat. The echocardiography is the investigation of choice to diagnose PDA, estimating the magnitude of shunt volume and assessing its hemodynamic significance, and to exclude/diagnose any associated congenital heart defect before any intervention. Various echocardiographic parameters and staging/scoring systems have been described to help the clincians making the clinical decisions and some of theses scoring systems are quite complex to apply in a busy day to day clinical practice. This concised review paper is focused to help the clinicians in making a clinical decision based upon clincial and echocardiography parameters. Hence, only the parameters which are commonly used and helpful in making the clinical decisions in day to day clincial practice have been described in this paper.
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Affiliation(s)
- Yogen Singh
- Department of Pediatrics - Pediatric Cardiology and Neonatal Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,University of Cambridge Clinical School of Medicine, Cambridge, United Kingdom
| | - Alain Fraisse
- Pediatric Cardiology Services, Royal Brompton Hospital, London, United Kingdom.,Imperial College London, National Heart and Lung Institute, London, United Kingdom
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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15
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Cakir U, Yildiz D, Okulu E, Kahvecioglu D, Alan S, Erdeve O, Atasay B, Arsan S. A Comparative Trial of the Effectiveness of Nasal Interfaces Used to Deliver Continuous Positive Airway Pressure for a Brief Period in Infants With Transient Tachypnea of the Newborn. Arch Bronconeumol 2019; 56:373-379. [PMID: 31740083 DOI: 10.1016/j.arbres.2019.07.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION There is insufficient data on the effectiveness of the interfaces used for nasal continuous airway pressure (nCPAP) in newborn infants. Transpulmonary pressure (PTP) calculated from a measured esophageal pressure (Pes) could be used as a surrogate for the pressure transmitted to the distal airways during nCPAP. We aimed to compare the effectiveness of two nasal interfaces, the nasal mask and bi-nasal short prongs, during a relatively brief period of respiratory support by calculated PTP (cPTP) in infants with transient tachypnea of the newborn (TTN). METHODS Newborns with TTN who needed respiratory assistance with nCPAP were randomized to use either bi-nasal short prongs or a nasal mask. Esophageal pressure measurements were done in order to calculate PTP with either interface. The primary outcome was the cPTP transmitted with each nasal interface. Esophageal pressure measurements were recorded and PTP values were calculated from Pes measurements at the 1st, 6th, 12th and 24th hours in each patient as long as the respiratory support lasted. RESULTS Sixty-two newborns with TTN and on nCPAP were randomized into two groups: Group 1 to use bi-nasal short prongs (n: 31) and Group 2 to use a nasal mask (n: 31). Inspiratory and expiratory Pes and cPTP values at the 1st, 6th, 12th and 24th hours were similar with the two interfaces (P<.05). CONCLUSIONS A nasal mask is similarly effective and safe as bi-nasal short prongs during a brief period of non-invasive respiratory support with nCPAP in late preterm and term neonates with TTN.
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Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey.
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Serdar Alan
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Children's Hospital, Ankara University School of Medicine, Ankara, Turkey
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16
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Okulu E, Tunc G, Erdeve O, Mumcu Y, Atasay B, Ince E, Arsan S. Netherton syndrome: A neonatal case with respiratory insufficiency. ARCH ARGENT PEDIATR 2019; 116:e609-e611. [PMID: 30016041 DOI: 10.5546/aap.2018.eng.e609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/31/2018] [Indexed: 11/12/2022]
Abstract
Netherton syndrome (NS) is a rare, autosomal recessive disease characterized with congenital ichthyosiform erythroderma, hair abnormality and atopic manifestations. This syndrome is caused by recessive mutation in the SPINK5 gene. Disease manifestations vary considerably among NS individuals. We report a newborn presented with severe respiratory insufficiency, hypothermia and erythroderma, was diagnosed as having NS and confirmed with molecular genetic testing.
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Affiliation(s)
- Emel Okulu
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey.
| | - Gaffari Tunc
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Yelda Mumcu
- Neonatal Intensive Care Unit, Ankara TOBB ETU Hospital, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Erdal Ince
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University, Faculty of Medicine, Ankara, Turkey
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17
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Erdeve O, Okulu E, Tunc G, Celik Y, Kayacan U, Cetinkaya M, Buyukkale G, Ozkan H, Koksal N, Satar M, Akcali M, Aygun C, Ozkiraz S, Zubarioglu U, Unal S, Turgut H, Mert K, Gokmen T, Akcan B, Atasay B, Arsan S. An observational, prospective, multicenter study on rescue high-frequency oscillatory ventilation in neonates failing with conventional ventilation. PLoS One 2019; 14:e0217768. [PMID: 31181092 PMCID: PMC6557483 DOI: 10.1371/journal.pone.0217768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 05/17/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To achieve gas exchange goals and mitigate lung injury, infants who fail with conventional ventilation (CV) are generally switched to high-frequency oscillatory ventilation (HFOV). Although preferred in many neonatal intensive care units (NICUs), research on this type of rescue HFOV has not been reported recently. METHODS An online registry database for a multicenter, prospective study was set to evaluate factors affecting the response of newborn infants to rescue HFOV treatment. The study population consisted of 372 infants with CV failure after at least 4 hours of treatment in 23 participating NICUs. Patients were grouped according to their final outcome as survived (Group S) or as died or received extracorporeal membrane oxygenation (ECMO) (Group D/E). Patients' demographic characteristics and underlying diseases in addition to their ventilator settings, arterial blood gas (ABG) analysis results at 0, 1, 4, and 24 hours, type of device, ventilation duration, and complications were compared between groups. RESULTS HFOV as rescue treatment was successful in 58.1% of patients. Demographic and treatment parameters were not different between groups, except that infants in Group D/E had lower birthweight (BW) (1655 ± 1091 vs. 1858 ± 1027 g, p = 0.006), a higher initial FiO2 setting (83% vs. 72%, p < 0.001), and a higher rate of nitric oxide exposure (21.8% vs. 11.1%, p = 0.004) in comparison to infants who survived (Group S). The initial cut-offs for a successful response on ABG were defined as pH >7.065 (OR: 19.74, 95% CI 4.83-80.6, p < 0.001), HCO3 >16.35 mmol/L (OR: 1.06, 95% CI 1.01-1.1, p = 0.006), and lactate level <3.75 mmol/L (OR: 1.09%95 CI 1.01-1.16, p = 0.006). Rescue HFOV duration was associated with retinopathy of prematurity (p = 0.005) and moderate or severe chronic lung disease (p < 0.001), but not with patent ductus arteriosus or intraventricular hemorrhage, in survivors (p > 0.05). CONCLUSION Rescue HFOV as defined for this population was successful in more than half of the patients with CV failure. Although the response was not associated with gestational age, underlying disease, device used, or initial MV settings, it seemed to be more effective in patients with higher BW and those not requiring nitric oxide. Initial pH, HCO3, and lactate levels on ABG may be used as predictors of a response to rescue HFOV.
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Affiliation(s)
- Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Gaffari Tunc
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Yalcın Celik
- Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
| | - Ugur Kayacan
- Division of Neonatology, Department of Pediatrics, Mersin University School of Medicine, Mersin, Turkey
| | - Merih Cetinkaya
- Department of Neonatology, University of Health Sciences, Kanuni Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Buyukkale
- Department of Neonatology, University of Health Sciences, Kanuni Training and Research Hospital, Istanbul, Turkey
| | - Hilal Ozkan
- Division of Neonatology, Department of Pediatrics, Uludag University School of Medicine, Bursa, Turkey
| | - Nilgun Koksal
- Division of Neonatology, Department of Pediatrics, Uludag University School of Medicine, Bursa, Turkey
| | - Mehmet Satar
- Division of Neonatology, Department of Pediatrics, Cukurova University School of Medicine, Adana, Turkey
| | - Mustafa Akcali
- Division of Neonatology, Department of Pediatrics, Cukurova University School of Medicine, Adana, Turkey
| | - Canan Aygun
- Division of Neonatology, Department of Pediatrics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Servet Ozkiraz
- Neonatal Intensive Care Unit, Medicalpark Hospital, Gaziantep, Turkey
| | - Umut Zubarioglu
- Department of Neonatology, University of Health Sciences, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sezin Unal
- Department of Neonatology, University of Health Sciences, Etlik Zubeyde Hanim Maternity Training and Research Hospital, Ankara, Turkey
| | - Hatice Turgut
- Division of Neonatology, Department of Pediatrics, Inonu University School of Medicine, Malatya, Turkey
| | - Kurthan Mert
- Neonatal Intensive Care Unit, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Tulin Gokmen
- Department of Neonatology, University of Health Sciences, Zeynep Kamil Training and Research Hospital, Istanbul, Turkey
| | - Barıs Akcan
- Division of Neonatology, Department of Pediatrics, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Kilic A, Okulu E, Kocabas BA, Alan S, Cakir U, Yildiz D, Kahvecioglu D, Akin IM, Erdeve O, Arsan S, Ince E, Atasay B. Health care-associated infection surveillance: A prospective study of a tertiary neonatal intensive care unit. J Infect Dev Ctries 2019; 13:181-187. [PMID: 32040446 DOI: 10.3855/jidc.10688] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/25/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Health care-associated infection (HCAI) is a serious problem of neonatal intensive care units (NICUs) which is related to morbidity, mortality and increased cost of medical care. This study aimed to determine the incidence of HCAI in a tertiary NICU and identify the risk factors. METHODOLOGY This prospective cohort study was conducted between July 1, 2011 and June 30, 2012. All newborns admitted to the NICU except for those who died or were discharged within 48 hours after admission were included. The definitions of Centers for Disease Control and Prevention (CDC) were used to diagnose specific types of infections. The incidence, causative organisms, risk factors and mortality of HCAIs were evaluated. RESULTS Among 352 newborns, a total of 60 HCAI episodes were evaluated in 37 (10.5%) of the patients over 5,212 patient-days. The overall incidence of HCAI was 17%, and the rate was 11.5/1,000 patient-days. Blood stream infection (BSI) was the most common HCAI (n = 42, 70%). In a multivariable logistic regression analysis, the presence of a central venous catheter/umbilical catheter (CVC/UC), the presence of a urinary catheter, and gestational age (< 32 weeks of gestation) were identified as significant independent risk factors. Gram-negative pathogens were the most common isolates. The overall mortality rate was 4%. The HCAI-related mortality rate was 10.8%. CONCLUSIONS Patient care quality can be improved with surveillance of HCAI. The incidence and rate of HCAI in our NICU were found to be higher than international reports with a direct impact on mortality of preterm infants.
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Affiliation(s)
- Atila Kilic
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Bilge Aldemir Kocabas
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Dilek Kahvecioglu
- Department of Neonatology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Ilke Mungan Akin
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Erdal Ince
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
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Okulu E, Ates U, Kahveci A, Erdeve O, Atasay B, Yagmurlu A, Dindar H, Eyileten Z, Arsan S. Effect of Extracorporeal Membrane Oxygenation Availability on the Survival of Neonates with Congenital Diaphragmatic Hernia. J Neonatal Surg 2019. [DOI: 10.47338/jns.v8.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Neonatal congenital diaphragmatic hernia (CDH) is one of the major congenital anomalies with high mortality rates. Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for CDH patients who do not respond to conventional ventilation strategies. The aim of this study is to compare the epochs before and after the introduction of neonatal ECMO program and to determine its impact on response and survival of neonates with isolated CDH.Materials and Methods: Admitted neonates with CDH patients since 2012 were separated into two epochs according to the establishment of ECMO: Pre-ECMO period (January 2012–August 2015) and ECMO period (September 2015–December 2017). The demographic, clinical, and surgical data of the patients were compared between these two periods.Results: During the study period, a total of 35 neonates with CDH were admitted. Patient characteristics and surgical data were similar in both groups. Need for high-frequency oscillatory ventilation (HFOV) was higher in the pre-ECMO period (P = 0.04). The length of hospitalization was longer in ECMO period (P = 0.01). Three among seven patients who received ECMO survived (43%). Survival rates at the time of discharge were similar in groups (39% vs. 47%, P = 0.625). It was demonstrated that having oxygenation index >40 at first 24 h (odds ratio (OR): 12, 95% Cl 2.37–60.64, P = 0.03) and the ratio of pulmonary artery pressure to systolic pressure > 1 (OR: 6, 95% Cl 1.33–27.04, P = 0.02) increased mortality.Conclusion: The establishment of neonatal ECMO program was not associated with an improvement in survival of isolated CDH patients. We suggest that better outcomes may be achieved with defining selective criteria for ECMO candidates.
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Okulu E, Erdeve O, Pekcici BB, Kendirli T, Eyileten Z, Atasay B, Arsan S. A Successful Whole Body Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy During an ECMO Run in a Newborn. Front Pediatr 2019; 7:95. [PMID: 30968010 PMCID: PMC6439343 DOI: 10.3389/fped.2019.00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 03/04/2019] [Indexed: 11/30/2022] Open
Abstract
Data regarding the safety of using therapeutic hypothermia (TH) with extracorporeal membrane oxygenation (ECMO) in neonates with both hypoxic ischemic encephalopathy (HIE), and respiratory failure are lacking. TH is not associated with an increased incidence of hemostatic complications, but hypothermia may impair coagulation. Herein, we report a case of a newborn who had meconium aspiration syndrome and HIE and underwent both TH and ECMO. He did not have any bleeding or circuit complications, and mortality as short-term outcome along with well-neurodevelopmental outcome.
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Affiliation(s)
- Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Bahar Bingoler Pekcici
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Tanil Kendirli
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Eyileten
- Department of Pediatric Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Erdeve O, Okulu E, Olukman O, Ulubas D, Buyukkale G, Narter F, Tunc G, Atasay B, Gultekin ND, Arsan S, Koc E. The Turkish Neonatal Jaundice Online Registry: A national root cause analysis. PLoS One 2018; 13:e0193108. [PMID: 29474382 PMCID: PMC5825038 DOI: 10.1371/journal.pone.0193108] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/05/2018] [Indexed: 11/30/2022] Open
Abstract
Background Neonatal jaundice (NNJ) is common, but few root cause analyses based on national quality registries have been performed. An online registry was established to estimate the incidence of NNJ in Turkey and to facilitate a root cause analysis of NNJ and its complications. Methods A multicenter prospective study was conducted on otherwise healthy newborns born at ≥35 weeks of gestation and hospitalized for only NNJ in 50 collaborator neonatal intensive care units across Turkey over a 1-year period. Patients were analyzed for their demographic and clinical characteristics, treatment options, and complications. Results Of the 5,620 patients enrolled, 361 (6.4%) had a bilirubin level ≥25 mg/dL on admission and 13 (0.23%) developed acute bilirubin encephalopathy. The leading cause of hospital admission was hemolytic jaundice, followed by dehydration related to a lack of proper feeding. Although all infants received phototherapy, 302 infants (5.4%) received intravenous immunoglobulin in addition to phototherapy and 132 (2.3%) required exchange transfusion. The infants who received exchange transfusion were more likely to experience hemolytic causes (60.6% vs. 28.1%) and a longer duration of phototherapy (58.5 ± 31.7 vs. 29.4 ± 18.8 h) compared to infants who were not transfused (p < 0.001). The incidence of short-term complications among discharged patients during follow-up was 8.5%; rehospitalization was the most frequent (58%), followed by jaundice for more than 2 weeks (39%), neurological abnormality (0.35%), and hearing loss (0.2%). Conclusions Severe NNJ and bilirubin encephalopathy are still problems in Turkey. Means of identifying at-risk newborns before discharge during routine postnatal care, such as bilirubin monitoring, blood group analysis, and lactation consultations, would reduce the frequency of short- and long-term complications of severe NNJ.
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Affiliation(s)
- Omer Erdeve
- Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
| | - Emel Okulu
- Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
- * E-mail:
| | - Ozgur Olukman
- Department of Pediatrics, Division of Neonatology, Behcet Uz Children’s Hospital, Izmir, Turkey
| | - Dilek Ulubas
- Department of Neonatology, Etlik Zubeyde Hanım Women’s Health Teaching and Research Hospital, Ankara, Turkey
| | - Gokhan Buyukkale
- Department of Pediatrics, Division of Neonatology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Fatma Narter
- Department of Neonatology, Kartal Lutfi Kirdar Education and Training Hospital, Istanbul, Turkey
| | - Gaffari Tunc
- Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
| | - Nazli Dilay Gultekin
- Department of Pediatrics, Division of Neonatology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
| | - Esin Koc
- Department of Pediatrics, Division of Neonatology, Gazi University School of Medicine, Ankara, Turkey
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Kahvecioglu D, Erdeve O, Akduman H, Ucar T, Alan S, Çakır U, Yıldız D, Atasay B, Arsan S, Atalay S. Influence of platelet count, platelet mass index, and platelet function on the spontaneous closure of ductus arteriosus in the prematurity. Pediatr Neonatol 2018; 59:53-57. [PMID: 28739214 DOI: 10.1016/j.pedneo.2017.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 12/27/2016] [Accepted: 01/23/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This study aims at evaluating the influence of platelet count, platelet mass index, and platelet function on the spontaneous closure of ductus arteriosus in prematurity. METHODS All preterm babies were divided into two groups, including Group 1 with "open PDA" and Group 2 with "closed PDA". The variables of platelet count, mean platelet volume, platelet mass index, and platelet function were analyzed and compared between two groups of patients to identify the factors that significantly influenced spontaneous closure of ductus arteriosus. RESULTS Twenty-four patients were in the "open PDA" group, whereas 36 patients were in the "closed PDA" group. Mean GA and BW were 27.6 ± 1.8 (23.1-30.4) and 28 ± 1.6 (23.4-30.6) weeks and 1009 ± 270 (585-1480) g and 1035 ± 298 (505-1500) g in "open PDA" and "closed PDA" groups, respectively (p > 0.05). The incidence of "Collagen-ADP > 130 s" was significantly higher in the "open PDA" group, and the levels of hemoglobin and hematocrit were significantly lower in the "open PDA" group (p < 0.05). Multivariate logistic regression analysis showed that respiratory distress syndrome (OR: 9, CI: 1.5-51.8) and collagen-ADP > 130 s (OR: 5.7 CI: 1.55-21.3) are two independent factors associated with ductal patency. CONCLUSION This is the first study in the English literature providing evidence of the influence of platelet dysfunction on the spontaneous closure of ductus arteriosus in prematurity. Longer collagen-ADP duration is identified as a risk factor of ductal closure.
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Affiliation(s)
- Dilek Kahvecioglu
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey.
| | - Omer Erdeve
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Hasan Akduman
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Tayfun Ucar
- Ankara University, School of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Ankara, Turkey
| | - Serdar Alan
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Ufuk Çakır
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Duran Yıldız
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Begum Atasay
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Saadet Arsan
- Ankara University, School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Semra Atalay
- Ankara University, School of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, Ankara, Turkey
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Cakir U, Alan S, Akduman H, Erdeve O, Atasay B, Arsan S. Is fully automated simultaneous umbilical arteriovenous exchange transfusion safe enough? J Matern Fetal Neonatal Med 2017; 30:1333-1334. [DOI: 10.1080/14767058.2016.1212830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Karadag A, Ozdemir R, Degirmencioglu H, Uras N, Dilmen U, Bilgili G, Erdeve O, Cakir U, Atasay B. Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome. Pediatr Neonatol 2016; 57:105-12. [PMID: 26190853 DOI: 10.1016/j.pedneo.2015.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/23/2015] [Accepted: 04/15/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The aim of this study was to compare the efficacy and adverse effects of various intratracheal beractant administration positions in preterm newborns with respiratory distress syndrome. METHODS This study was performed on preterm newborns with respiratory distress syndrome. The inclusion criteria were being between 26 weeks and 32 weeks of gestational age, having a birth weight between 600 g and 1500 g, having received clinical and radiological confirmation for the diagnosis of respiratory distress syndrome (RDS) within 3 hours of life, having been born in one of the centers where the study was carried out, and having fractions of inspired oxygen (FiO2) ≥ 0.40 to maintain oxygen saturation by pulse oximeter at 88-96%. Beractant was administered in four positions to Group I newborns, in two positions to Group II, and in neutral position to Group III. RESULTS Groups I and II consisted of 42 preterm infants in each whereas Group III included 41 preterm infants. No significant differences were detected among the groups with regards to maternal and neonatal risk factors. Groups were also similar in terms of the following complications: patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH), chronic lung disease (CLD), retinopathy of prematurity (ROP), necrotising enterocolitis (NEC), death within the first 3 days of life, death within the first 28 days of life, and rehospitalization within 1 month after discharge. Neither any statistically significant differences among the parameters related with surfactant administration, nor any significant statistical differences among the FiO2 levels and the saturation levels before and after the first surfactant administration among the groups were determined. CONCLUSION In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position.
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Affiliation(s)
- Ahmet Karadag
- Department of Pediatrics, Division of Neonatology, School of Medicine, Inonu University, Malatya, Turkey
| | - Ramazan Ozdemir
- Department of Pediatrics, Division of Neonatology, School of Medicine, Inonu University, Malatya, Turkey.
| | - Halil Degirmencioglu
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey
| | - Nurdan Uras
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey
| | - Ugur Dilmen
- Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey
| | - Gokmen Bilgili
- Department of Pediatrics, Division of Neonatology, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Omer Erdeve
- Department of Pediatrics, Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Ufuk Cakir
- Department of Pediatrics, Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
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Akduman H, Eminoglu T, Okulu E, Erdeve O, Atasay B, Arsan S. A NEONATE PRESENTING WITH GRACILE SYNDROME AND BJORNSTAD PHENOTYPE ASSOCIATED WITH BCS1L MUTATION. Genet Couns 2016; 27:509-512. [PMID: 30226971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
GRACILE Syndrome, is an autosomal recessive disease presenting with growth retardation, severe lactic acidosis, Fanconi type tubulopathy, cholestasis, iron overload and early death without any dysmorphological or neurological features. The BCSIL gene mutation is responsible for GRACILE syndrome, Bjornstad syndrome and complex III deficiency. Bjomstad syndrome is characterized by sensorineural hearing loss and abnormal flat twisted hair shafts. The case is GRACILE syndrome with Bjomstad phenotype in neonatal period due to BCSL1 gene mutation.
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Celebi MY, Alan S, Kahvecioglu D, Cakir U, Yildiz D, Erdeve O, Arsan S, Atasay B. Impact of Prophylactic Continuous Positive Airway Pressure on Transient Tachypnea of the Newborn and Neonatal Intensive Care Admission in Newborns Delivered by Elective Cesarean Section. Am J Perinatol 2016; 33:99-106. [PMID: 26295966 DOI: 10.1055/s-0035-1560041] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aims to evaluate the effect of the prophylactic continuous positive airway pressure (CPAP) administration in the delivery room to newborns who were delivered by elective cesarean section (CS). STUDY DESIGN Inborn infants with gestational age between 34(0/7) to 38(6/7) and born by elective CS were prospectively randomized to receive either prophylactic CPAP for 20 minutes via face mask or standardized care without CPAP in the delivery room. Primary outcomes were the incidence of transient tachypnea of the newborn (TTN) and neonatal intensive care unit (NICU) admission due to respiratory distress. RESULTS A total of 259 infants with a mean gestational age of 37.7 ± 0.8 weeks and birth weight of 3,244 ± 477 g were included. A total of 134 infants received prophylactic CPAP and 125 received control standard care. The rate of NICU admission was significantly lower in prophylactic CPAP group (p = 0.045). Although the rate of TTN was lower in the prophylactic CPAP group, the difference was not statistically significant (p = 0.059). The rate of NICU admission due to respiratory distress was significantly higher in late-preterm cohort than early-term cohort (p < 0.0001). CONCLUSION Prophylactic CPAP administration decreases the rate of NICU admission without any side effect in late-preterm and early-term infants delivered by elective CS.
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Affiliation(s)
- Miray Yilmaz Celebi
- Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Serdar Alan
- Neonatal Intensive Care Unit, Hitit University Corum Training and Research Hospital, Corum, Turkey
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Alan S, Erdeve O, Cakir U, Akduman H, Zenciroglu A, Akcakus M, Tunc T, Gokmen Z, Ates C, Atasay B, Arsan S. Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study. J Matern Fetal Neonatal Med 2015; 29:2186-93. [PMID: 26365531 DOI: 10.3109/14767058.2015.1079614] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine the incidence and outcomes of respiratory syncytial virus (RSV)-related acute lower respiratory tract infection (ALRI) including morbidity, nosocomial infection and mortality among newborn infants who were admitted to the neonatal intensive care units (NICUs). METHODS A multicenter, prospective study was conducted in newborns who were hospitalized with community acquired or nosocomial RSV infection in 44 NICUs throughout Turkey. Newborns with ALRI were screened for RSV infection by Respi-Strip®-test. Main outcome measures were the incidence of RSV-associated admissions in the NICUs and morbidity, mortality and epidemics results related to these admissions. FINDINGS The incidence of RSV infection was 1.24% (n: 250) and RSV infection constituted 19.6% of all ALRI hospitalizations, 226 newborns (90.4%) had community-acquired whereas 24 (9.6%) patients had nosocomial RSV infection in the NICUs. Of the 250 newborns, 171 (68.4%) were full-term infants, 183 (73.2%) had a BW >2500 g. RSV-related mortality rate was 1.2%. Four NICUs reported seven outbreaks on different months, which could be eliminated by palivizumab prophylaxis in one NICU. CONCLUSION RSV-associated ALRI both in preterm and term infants accounts an important percent of hospitalizations in the season, and may threat other high-risk patients in the NICU.
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Affiliation(s)
- Serdar Alan
- a Neonatal Intensive Care Unit, Hitit University Corum Training and Research Hospital , Corum , Turkey
| | - Omer Erdeve
- b Division of Neonatology, Department of Pediatrics , Ankara University School of Medicine , Ankara , Turkey
| | - Ufuk Cakir
- b Division of Neonatology, Department of Pediatrics , Ankara University School of Medicine , Ankara , Turkey
| | - Hasan Akduman
- b Division of Neonatology, Department of Pediatrics , Ankara University School of Medicine , Ankara , Turkey
| | - Aysegul Zenciroglu
- c Neonatal Intensive Care Unit, Dr Sami Ulus Maternity and Children Training and Research Hospital , Ankara , Turkey
| | - Mustafa Akcakus
- d Division of Neonatology, Department of Pediatrics , Akdeniz University Medical School , Antalya , Turkey
| | - Turan Tunc
- e Division of Neonatology, Department of Pediatrics , Gulhane Military School of Medicine , Ankara , Turkey
| | - Zeynel Gokmen
- f Neonatal Intensive Care Unit, Konya Training and Research Hospital , Konya , Turkey , and
| | - Can Ates
- g Department of Biostatistics , Ankara University School of Medicine , Ankara , Turkey
| | - Begum Atasay
- b Division of Neonatology, Department of Pediatrics , Ankara University School of Medicine , Ankara , Turkey
| | - Saadet Arsan
- b Division of Neonatology, Department of Pediatrics , Ankara University School of Medicine , Ankara , Turkey
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Okulu E, Akin IM, Arsan S, Atasay B, Ciftci E, Ince E. Secondary Bacteremia: A Serious Complication of Rotavirus Gastroenteritis in Neonates. Clin Pediatr (Phila) 2015; 54:894-6. [PMID: 25940615 DOI: 10.1177/0009922815584930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Emel Okulu
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Saadet Arsan
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Begum Atasay
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ergin Ciftci
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Erdal Ince
- Faculty of Medicine, Ankara University, Ankara, Turkey
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Cakir U, Kahvecioglu D, Alan S, Yildiz D, Akduman H, Erdeve O, Bahadir GG, Kologlu M, Atasay B, Arsan S. Extra-lobar Pulmonary Sequestration Requiring Intrauterine Thoracentesis. APSP J Case Rep 2015; 6:3. [PMID: 25628992 PMCID: PMC4288834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 07/21/2014] [Indexed: 12/02/2022] Open
Abstract
Congenital lung malformations can result in significant morbidity and mortality in children. Pulmonary sequestration is an uncommon congenital malformation of the lung that can cause complications even in fetal life. We herein present a newborn with extra-lobar sequestration (ELS) that lead to hydrops fetalis necessitating fetal intervention.
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Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Serdar Alan
- Neonatal Intensive Care Unit, Hitit University Corum Training and Research Hospital, Corum, Turkey.
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Hasan Akduman
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Gulnur Gollu Bahadir
- Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey.
| | - Meltem Kologlu
- Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey.
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey.
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Akin IM, Atasay B, Dogu F, Okulu E, Arsan S, Karatas HD, Ikinciogullari A, Turmen T. Oral lactoferrin to prevent nosocomial sepsis and necrotizing enterocolitis of premature neonates and effect on T-regulatory cells. Am J Perinatol 2014; 31:1111-20. [PMID: 24839144 DOI: 10.1055/s-0034-1371704] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Lactoferrin (LF) is effective in the prevention of sepsis in very low birth weight (VLBW) neonates. T-regulatory cells (Tregs) are important subsets of T lymphocytes that control pathogen-specific immune responses and are essential for intestinal immune homoeostasis. The aim of the present study is to determine whether oral LF at a dosage of 200 mg/d reduces nosocomial sepsis episodes and necrotizing enterocolitis (NEC) in premature infants and to evaluate the possible effects of LF on Treg levels. STUDY DESIGN In this prospective, placebo-controlled, double-blind, randomized trial, infants either VLBW or born before 32 weeks were assigned to receive either placebo (n = 25), or 200 mg LF (n = 25) daily throughout hospitalization. Episodes of culture proven nosocomial sepsis and NEC were recorded. The level of FOXP3 + CD4 + CD25hi lymphocytes was studied by flow cytometry at birth and discharge. A third comparison was made with healthy term neonates (n = 16). RESULTS Fewer sepsis episodes were observed in LF-treated infants (4.4 vs. 17.3/1,000 patient days, p = 0.007) with none developing NEC, without statistical significance. Treg levels at birth and discharge were similar, while preterm infants showed significantly lower levels than term controls. However, individual increases in Treg levels were higher in the LF group. CONCLUSION LF prophylaxis reduced nosocomial sepsis episodes. Treg levels in preterm infants were lower than in term infants and an increase of Treg levels under LF prophylaxis was observed. Increase in Treg levels can be the mechanism for protective effects of LF on nosocomial sepsis.
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Affiliation(s)
- Ilke Mungan Akin
- Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Figen Dogu
- Division of Pediatric Allergy and Immunology, School of Medicine, Ankara University, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
| | - H Deniz Karatas
- Division of Pediatric Allergy and Immunology, School of Medicine, Ankara University, Ankara, Turkey
| | - Aydan Ikinciogullari
- Division of Pediatric Allergy and Immunology, School of Medicine, Ankara University, Ankara, Turkey
| | - Tomris Turmen
- Division of Neonatology, School of Medicine, Ankara University, Ankara, Turkey
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Alan S, Yildiz D, Erdeve O, Cakir U, Kahvecioglu D, Okulu E, Ates C, Atasay B, Arsan S. Efficacy and safety of intravenous colistin in preterm infants with nosocomial sepsis caused by Acinetobacter baumannii. Am J Perinatol 2014; 31:1079-86. [PMID: 24584997 DOI: 10.1055/s-0034-1371361] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To describe the efficacy of intravenous colistin on clinical and microbiological outcomes in preterm infants with nosocomial sepsis in neonatal intensive care unit (NICU) and define adverse events observed with this treatment. METHODS The records of preterm infants who received colistin with or without positive cultures in the NICU were retrospectively reviewed. Patients were evaluated for response to therapy and side effects. RESULTS A total of 21 preterm infants with medians of 28 weeks (23-36) gestational age and 870 g (620-2,650) birth weight were included. The median duration and dose of colistin therapy were 9 days (3-26) and 3 mg/kg/d (2-5). Recovery rate in patients including all with/without positive culture was 81% (17/21). Microbiological clearance by colistin was 69% (9/13). The major side effect observed was acute kidney injury (19%). At least 24% of infants required electrolyte supplementation during the colistin therapy. Magnesium levels were significantly lower at the end of the colistin therapy (p < 0.001). Acute kidney injury and electrolyte disturbances including hypomagnesemia were reversible in all surviving patients. CONCLUSION We suggest that renal function tests and serum electrolytes should be monitored closely and replaced in case of any need during the colistin therapy in preterm infants.
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Affiliation(s)
- Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Duran Yildiz
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Can Ates
- Depatrment of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Alan S, Arsan S, Okulu E, Akin IM, Kilic A, Taskin S, Cetinkaya E, Erdeve O, Atasay B. Effects of umbilical cord milking on the need for packed red blood cell transfusions and early neonatal hemodynamic adaptation in preterm infants born ≤1500 g: a prospective, randomized, controlled trial. J Pediatr Hematol Oncol 2014; 36:e493-8. [PMID: 24633297 DOI: 10.1097/mph.0000000000000143] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effects of umbilical cord milking (UCM) on the need for packed red blood cell (PRBC) transfusion and hematologic and hemodynamic parameters in very-low-birth-weight infants. METHODS The infants were randomized into 2 groups: group 1 (UCM) and group 2 (control). The primary outcome was the number of PRBC transfusions during the first 35 days of life. The secondary outcome measures were the hemodynamic variables during the first 24 hours of life. RESULTS A total of 44 infants were included with 22 infants in each group. Two of 21 infants in group 1 and 4 of 21 infants in group 2 received transfusion in the first 3 days of life (P=0.384). The number and volume of PRBC transfusions were similar in both groups. However, the levels of hemoglobin (Hb) at the first and 24th hour of life were significantly higher in group 1. Phlebotomy volume was found as a statistically significant risk factor for the need for PRBC transfusion (P=0.005). CONCLUSIONS UCM in delivery room results in a higher Hb level in the first day of life. In these groups of infants, phlebotomy losses may impact the transfusion need.
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Affiliation(s)
- Serdar Alan
- *Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey †Department of Pediatrics, Division of Neonatology, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey ‡Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Turkey
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Cetinkaya SE, Okulu E, Soylemez F, Akin İM, Sahin S, Akyel T, Alan S, Atasay B, Arsan S, Koc A. Perinatal risk factors and mode of delivery associated with mortality in very low birth weight infants. J Matern Fetal Neonatal Med 2014; 28:1318-1323. [PMID: 25208229 DOI: 10.3109/14767058.2014.953476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the association of perinatal risk factors including delivery mode with mortality in very low birthweight (VLBW) in a tertiary hospital setting. METHODS Medical records of 241 live-born VLBW infants (≤1500 g) were retrospectively reviewed. Details of maternal, obstetrical, perinatal risk factors and their associations with infant mortality were evaluated. RESULTS The overall infant mortality rate was 23.2%. Mortality was significantly higher for infants born at ≤27 gestational weeks and with a birthweight of ≤750 g (p = 0.000 and p = 0.000, respectively), showing a steep decrease thereafter. On ROC analysis, a cut off of 26.5 weeks was determined for mortality with a sensitivity of 57.1% and a specificity of 90.3% (area under the curve = 0.792, 95% CI: 0.719-0.866). On multivariate regression analysis, gestational week at birth, birthweight, antenatal steroid treatment and pathologic Doppler ultrasound findings were found as independent risk factors for mortality. CONCLUSIONS Gestational week at birth, birthweight and antenatal steroid treatment remain the most important perinatal risk factors for infant mortality in VLBW infants. Mode of delivery does not seem to be associated with mortality when adjusted for other perinatal risk factors.
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Affiliation(s)
| | - Emel Okulu
- b Division of Neonatology, Department of Pediatrics , and
| | - Feride Soylemez
- c Division of Perinatology, Department of Obstetrics and Gynecology , Ankara University School of Medicine , Ankara , Turkey
| | | | - Seda Sahin
- a Department of Obstetrics and Gynecology
| | | | - Serdar Alan
- b Division of Neonatology, Department of Pediatrics , and
| | - Begum Atasay
- b Division of Neonatology, Department of Pediatrics , and
| | - Saadet Arsan
- b Division of Neonatology, Department of Pediatrics , and
| | - Acar Koc
- c Division of Perinatology, Department of Obstetrics and Gynecology , Ankara University School of Medicine , Ankara , Turkey
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Rosenthal VD, Maki DG, Mehta Y, Leblebicioglu H, Memish ZA, Al-Mousa HH, Balkhy H, Hu B, Alvarez-Moreno C, Medeiros EA, Apisarnthanarak A, Raka L, Cuellar LE, Ahmed A, Navoa-Ng JA, El-Kholy AA, Kanj SS, Bat-Erdene I, Duszynska W, Van Truong N, Pazmino LN, See-Lum LC, Fernández-Hidalgo R, Di-Silvestre G, Zand F, Hlinkova S, Belskiy V, Al-Rahma H, Luque-Torres MT, Bayraktar N, Mitrev Z, Gurskis V, Fisher D, Abu-Khader IB, Berechid K, Rodríguez-Sánchez A, Horhat FG, Requejo-Pino O, Hadjieva N, Ben-Jaballah N, García-Mayorca E, Kushner-Dávalos L, Pasic S, Pedrozo-Ortiz LE, Apostolopoulou E, Mejía N, Gamar-Elanbya MO, Jayatilleke K, de Lourdes-Dueñas M, Aguirre-Avalos G, Maurizi DM, Montanini A, Spadaro ML, Marcos LS, Botta P, Jerez FM, Chavez MC, Ramasco L, Colqui MI, Olivieri MS, Rearte AS, Correa GE, Juarez PD, Gallardo PF, Brito MP, Mendez GH, Valdez JR, Cardena LP, Harystoy JM, Chaparro GJ, Rodriguez CG, Toomey R, Caridi M, Viegas M, Bernan ML, Romani A, Dominguez CB, Davalos LK, Richtmann R, Silva CA, Rodrigues TT, Filho AM, Seerig Palme ED, Besen A, Lazzarini C, Cardoso CB, Azevedo FK, Pinheiro APF, Camacho A, De Carvalho BM, De Assis MJM, Carneiro APV, Canuto MLM, Pinto Coelho KH, Moreira T, Oliveira AA, Sousa Colares MM, De Paula Bessa MM, Gomes Bandeira TDJP, De Moraes RA, Campos DA, De Barros Araújo TML, Freitas Tenório MT, Amorim S, Amaral M, Da Luz Lima J, Pino Da Silva Neta L, Batista C, De Lima Silva FJ, Ferreira De Souza MC, Arruda Guimaraes K, Marcia Maluf Lopes J, Nogueira Napoles KM, Neto Avelar LLS, Vieira LA, Gustavo De Oliveira Cardo L, Takeda CF, Ponte GA, Eduardo Aguiar Leitão F, De Souza Kuchenbecker R, Pires Dos Santos R, Maria Onzi Siliprandi E, Fernando Baqueiro Freitas L, Martins IS, Casi D, Maretti Da Silva MA, Blecher S, Villins M, Salomao R, Oliveira Castro SR, Da Silva Escudero DV, Andrade Oliveira Reis M, Mendonca M, Furlan V, Claudio do Amaral Baruzzi A, Sanchez TE, Moreira M, Vasconcelos de Freitas W, Passos de Souza L, Velinova VA, Hadjieva N, Petrov MM, Karadimov DG, Kostadinov ED, Dicheva VJ, Wang C, Guo X, Geng X, Wang S, Zhang J, Zhu L, Zhuo S, Guo C, Lili T, Ruisheng L, Kun L, Yang X, Yimin L, Pu M, Changan L, Shumei Y, Kangxiong W, Meiyi L, Ye G, Ziqin X, Yao S, Liqiang S, Marino Cañas Giraldo L, Margarita Trujillo Ramirez E, Rios PA, Carlos Torres Millan J, Giovanny Chapeta Parada E, Eduardo Mindiola Rochel A, Corchuelo Martinez AH, Marãa Perez Fernandez A, Guzman NB, Guzman AL, Ferrer MR, Vega YL, Munoz HJ, Moreno GC, Romero Torres SL, Hernandez HT, Valderrama MarquezClaudia Linares IA, Valencia ME, Corrales LS, Bonilla SM, Ivan Marin Uribe J, Gomez DY, Martinez JO, Dary Burgos Florez L, Osorio J, Santofimio D, Cortes LM, Villamil-Gomez W, Gutierrez GM, Ruiz AA, Fuentes CG, Chinchilla AS, Hernandez IC, Ugalde OC, Garcell HG, Perez CM, Bardak S, Ozkan S, Mejia N, Puello Guerrero Glenny Mirabal AM, Delgado M, Severino R, Lacerda E, Tolari G, Bovera MM, Pinto DB, González PF, Santacruz G, Alquinga N, Zaruma C, Remache N, Morocho D, Arboleda M, Zapata MC, Garcia MF, Picoita F, Velez J, Valle M, Yepez ES, Tutillo DM, Mora RA, Padilla AP, Chango M, Cabezas K, Tenorio López S, Lucía Bonilla Escudero A, Sánchez GT, Alberto Gonzalez Flores H, Garcia MF, Ghazi IA, Hassan M, Ismail GA, Hamed R, Abdel-Halim MM, El-Fattah MA, Abdel-Aziz D, Seliem ZS, Elsherif RH, Dewdar RA, Mohmed AA, Abdel-Fatteh Ahmed L, De Jesus Machuca L, Bran De Casares C, Kithreotis P, Daganou M, Veldekis D, Kartsonaki M, Gikas A, Luque Torres MT, Padgett D, Rivera DM, Jaggi N, Rodrigues C, Shah B, Parikh K, Patel J, Thakkar R, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Vini T, Rangaswamy S, Patnaik SK, Venkateshwar V, John B, Dalal S, Sahu S, Sahu S, Ray B, Misra S, Mohanty N, Mishra BM, Sahoo P, Parmar N, Mishra S, Pati BK, Singh S, Pati BS, Panda A, Banergee S, Padhihari D, Samal S, Sahu S, Varma K, Suresh Kumar VP, Gopalakrishnan R, Ramakrishnan N, Abraham BK, Rajagopal S, Venkatraman R, Mani AK, Devaprasad D, Ranganathan L, Francis T, Cherain KM, Ramachandran B, Krupanandan R, Muralidharan S, Karpagam M, Padmini B, Saranya S, Kumar S, Pandya N, Kakkar R, Zompa T, Saini N, Samavedam S, Jagathkar G, Nirkhiwale S, Gehlot G, Bhattacharya S, Sood S, Singh S, Singh S, Todi SK, Bhattacharyya M, Bhakta A, Basu S, Agarwal A, Agarwal M, Kharbanda M, Sengupta S, Karmakar A, Gupta D, Sarkar AK, Dey R, Bhattacharya C, Chandy M, Ramanan V, Mahajan A, Roy M, Bhattacharya S, Sinha S, Roy I, Gupta U, Mukherjee S, Bej M, Mukherjee P, Baidya S, Azim A, Sakle AS, Sorabjee JS, Potdar MS, Subhedar VR, Udwadia F, Francis H, Dwivedy A, Binu S, Shetty S, Nair PK, Khanna DK, Chacko F, Blessymole S, Mehta PR, Singhal T, Shah S, Kothari V, Naik R, Patel MH, Aggarwal DG, Jawadwala BQ, Pawar NK, Kardekar SN, Manked AN, Myatra S, Divatia J, Kelkar R, Biswas S, Raut V, Sampat S, Thool A, Karlekar A, Nandwani S, Gupta S, Singhal S, Gupta M, Mathur P, Kumar S, Sandhu K, Dasgupta A, Raha A, Raman P, Wadhera A, Badyal B, Juneja S, Mishra B, Sharma S, Mehrotra M, Shelgaonkar J, Padbidri V, Dhawale R, Sibin SM, Mane D, Sale HK, Mukhit Abdul Gaffar Kazi M, Chabukswar S, Mathew A, Gaikwad D, Harshe A, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Mendonca A, Malik S, Kamble A, Kumari N, Arora S, Munshi N, Divekar DG, Kavathekar MS, Kulkarni AK, Kavathekar MS, Suryawanshi MV, Bommala ML, Bilolikar A, Joshi KL, Pamnani C, Wasan H, Khamkar S, Steephen L, Rajalakshmi A, Thair A, Mubarak A, Sathish S, Kumar S, Sunil H, Sujith S, Dinesh, Sen N, Thool A, Shinde N, Alebouyeh M, Jahani-Sherafat S, Zali MR, Sarbazi MR, Mansouri N, Tajeddin E, Razaghi M, Seyedjavadi S, Tajeddin E, Rashidan M, Razaghi M, Masjedi M, Maghsudi B, Sabetian G, Sanaei A, Yousefipour A, Alebouyeh M, Assiri AM, Furukawa-Cinquini EM, Alshehri AD, Giani AF, Demaisip NL, Cortez EL, Cabato AF, Gonzales Celiz JM, Al-Zaydani Asiri IA, Mohammed YK, Abdullah Al Raey M, Omer Abdul Aziz A, Ali Al Darani S, Aziz MR, Basri RH, Al-Awadi DK, Bukhari SZ, Aromin RG, Ubalde EB, Molano AM, Abdullah Al Enizy H, Baldonado CF, Al Adwani FM, Marie Casuyon Pahilanga A, Tan AM, Joseph S, Nair DS, Al-Abdullah NA, Sindayen G, Malificio AA, Mohammed DA, Mesfer Al Ghamdi H, Silo AC, Valisto MBV, Foteinakis N, Ghazal SS, Joseph MV, Hakawi A, Hasani A, Jusufi I, Spahija G, Baftiu N, Gecaj-Gashi A, Aly NY, El-Dossoky Noweir M, Varghese ST, Ramapurath RJ, Mohamed AM, George SM, Kurian A, Sayed AF, Salama MF, Omar AA, Rebello FM, Narciso DM, Zahreddine NK, Kanafani Z, Kardas T, Molaeb B, Jurdi L, Al Souheil A, Ftouni M, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Gailiene G, Dagys A, Petrovska M, Popovska K, Bogoevska-Miteva Z, Jankovska K, Guroska ST, Anguseva T, Wan Yusoff WN, Shiham Zainal Abidin A, Gan CS, Zainol H, Rai V, Kwong WK, Hasan MS, Sri La Sri Ponnampala S, Veerakumaran J, Assadian O, Phuong DM, Binh NG, Kaur K, Lim J, Tan LH, Manikavasagam J, Cheong YM, Magaña HC, Cesar Mijangos Méndez J, Jiménez FC, Esparza-Ahumada S, Morfin-Otero R, Rodriguez-Noriega E, Gutierrez-Martinez S, Perez-Gomez HR, León-Garnica G, Mendoza-Mujica C, Cecilia Culebro Burguet M, Portillo-Gallo JH, Almazán FA, Miramontes GI, Olivas MDRV, Aguilar Angel LA, Vargas MS, Orlando Flores Alvarado A, Carlos Mares Morales R, Carlos Fernandez Alvarez L, Armando Rincon Leon H, Navarro Fuentes KR, Mariela Perez Hernandez Y, Falcon GM, Vargas AG, Trujillo Juarez MA, Mulia AM, Alma Ulloa Camacho P, Martinez-Marroquin MY, Garcia MM, Martinez AM, Sanchez EL, Flores GG, Martínez MDRG, Alfonso Galindo Olmeda J, Olivarez G, Rodriguez EB, Magdalena Gutierrez Castillo M, Guadalupe Villa González M, Beatriz Sauceda Castañeda I, Rodriguez JM, Baatar O, Batkhuu B, Meryem K, Amina B, Abouqal R, Zeggwagh AA, Dendane T, Abidi K, Madani N, Mahmood SF, Memon BA, Bhutto GH, Paul N, Parveen A, Raza A, Mahboob A, Nizamuddin S, Sultan F, Nazeer H, Khan AA, Hafeez A, Lara L, Mapp T, Alvarez B, Rojas-Bonilla MI, Castano E, De Moros DA, Atarama RE, Calisto Pazos ME, Paucar A, Ramos MT, Jurado J, Moreno D, Cruz Saldarriaga ME, Ramirez E, La Hoz Vergara CE, Enrique Prudencio Leon W, Isidro Castillo Bravo L, Fernanda Aibar Yaranga K, Pichilingue Chagray JE, Marquez Mondalgo VA, Zegarra ST, Astete NS, Guevara FC, Pastrana JS, Enrique Prudencio Leon W, Linares Calderon CF, Jesus Mayorga Espichan M, Martin Santivanez Monge L, Changano Rodriguez MV, Rosa Diaz Tavera Z, Martin Ramirez Wong F, Chavez SM, Rosa Diaz Tavera Z, Martin Ramirez Wong F, Atencio-Espinoza T, Villanueva VD, Blanco-Abuy MT, Tamayo AS, Bergosa LD, Llames CMJP, Trajano MF, Bunsay SA, Amor JC, Berba R, Sg Buenaflor MC, Labro E, Mendoza MT, Javellana OP, Salvio LG, Rayco RG, Bermudez V, Kubler A, Zielinska M, Kosmider-Zurawska M, Barteczko-Grajek B, Szewczyk E, Dragan B, Mikaszewska-Sokolewicz MA, Lazowski T, Cancel E, Licker MS, Dragomirescu LA, Dumitrascu V, Sandesc D, Bedreag O, Papurica M, Muntean D, Kotkov I, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Vasiljevic S, Lesnakova A, Marcekova A, Furova K, Gamar Elanbya MO, Ali MA, Kadankunnel SK, Somabutr S, Pimathai R, Wanitanukool S, Luxsuwong M, Supa N, Prasan P, Thamlikitkul V, Jamulitrat S, Suwalak N, Phainuphong P, Asma B, Aida B, Sarra BH, Ammar K, Ertem GT, Bulut C, Hatipoglu CA, Erdinc FS, Demiroz AP, Ozcelik M, Meco BC, Oral M, Unal N, Guclu CY, Kendirli T, İnce E, Çiftçi E, Yaman A, Ödek Ç, Karbuz A, Kocabaş BA, Altın N, Cesur S, Atasay B, Erdeve O, Akduman H, Kahvecioglu D, Cakir U, Yildiz D, Kilic A, Arsan S, Arman D, Unal S, Gelebek Y, Zengin H, Sen S, Cabadak H, Erbay A, Yalcin AN, Turhan O, Cengiz M, Dursun O, Gunasan P, Kaya S, Ramazanoglu A, Ustun C, Yasayacak A, Akdeniz H, Sirmatel F, Otkun AM, Sacar S, Sener A, Turgut H, Sungurtekin H, Ugurcan D, Necan C, Yilmaz C, Ozdemir D, Geyik MF, Ince N, Danis A, Erdogan SY, Erben N, Usluer G, Ozgunes I, Uzun C, Oncul O, Gorenek L, Erdem H, Baylan O, Ozgultekin A, Inan A, Bolukcu S, Senol G, Ozdemir H, Gokmen Z, Ozdemir SI, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Kaya Z, Guclu E, Kaya G, Karabay O, Esen S, Aygun C, Ulger F, Dilek A, Yilmaz H, Sunbul M, Engin A, Bakir M, Elaldi N, Koksal I, Yildizdas D, Horoz OO, Willke A, Koç MM, Azak E, Elahi N, Annamma P, El Houfi A, Pirez Garcia MC, Vidal H, Perez F, Empaire GD, Ruiz Y, Hernandez D, Aponte D, Salinas E, Diaz C, Guzmán Siritt ME, Gil De Añez ZD, Bravo LM, Orozco N, Mejías E, Hung NV, Anh NQ, Chau NQ, Thu TA, Phuong DM, Binh NG, Thi Diem Tuyet L, Thi Van Trang D, Hong Thoa VT, Tien NP, Anh Thu LT, Hang PT, My Hanh TT, Thuy Hang TT, Phuong Anh DP. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module. Am J Infect Control 2014; 42:942-56. [PMID: 25179325 DOI: 10.1016/j.ajic.2014.05.029] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 12/14/2022]
Abstract
We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN.
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Okulu E, Arsan S, Akin IM, Ates C, Alan S, Kilic A, Atasay B. Serum Levels of Soluble Urokinase Plasminogen Activator Receptor in Infants with Late-onset Sepsis. J Clin Lab Anal 2014; 29:347-52. [PMID: 25043869 DOI: 10.1002/jcla.21777] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 04/29/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Soluble urokinase plasminogen activator receptor (suPAR) has been studied in a variety of diseases. The aim of the study is to investigate the levels of suPAR in neonates with sepsis. METHODS The infants enrolled to this prospective study were classified into four groups. Group 1, 2, and 3 were referred as the patient groups (40 infants), and group 4 was referred as control group (26 infants). Blood samples for whole blood count, C-reactive protein (CRP), suPAR and blood culture were obtained before initiating antimicrobial therapy, and two further samples were obtained on day 3 and at the end of the treatment for CRP and suPAR. RESULTS The mean gestational ages of patient and control groups was similar. The median level of initial suPAR was 18.8 ng/mL (range 6.8-30.1 ng/mL) in the patient groups, and 6.0 ng/mL (range 3.7-10.8 ng/mL) in the control group (P < 0.001). A significant decrease in suPAR level was observed from the inclusion to the third day and end of the treatment (P < 0.001). The area under the curve (AUC) for suPAR is 0.959 (95% Cl: 0.919-0.999) and for CRP is 0.782 (95% Cl: 0.669-0.895). At a cut-off value of 11.3 ng/mL for suPAR the specificity was 100%, and the sensitivity was 82.5%. There was a positive correlation between laboratory values of CRP and suPAR (r: 0.359, P = 0.003). CONCLUSION This is the first study that investigated the levels of suPAR in neonates and our results demonstrate that suPAR is a powerful marker of inflammation in infants with sepsis.
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Affiliation(s)
- Emel Okulu
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Saadet Arsan
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ilke Mungan Akin
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Can Ates
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serdar Alan
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Atila Kilic
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Begum Atasay
- Department of Pediatrics, Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
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Caridi G, Dagnino M, Erdeve O, Di Duca M, Yildiz D, Alan S, Atasay B, Arsan S, Campagnoli M, Galliano M, Minchiotti L. Congenital analbuminemia caused by a novel aberrant splicing in the albumin gene. Biochem Med (Zagreb) 2014; 24:151-8. [PMID: 24627724 PMCID: PMC3936982 DOI: 10.11613/bm.2014.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/10/2013] [Indexed: 12/25/2022] Open
Abstract
Introduction: Congenital analbuminemia is a rare autosomal recessive disorder manifested by the presence of a very low amount of circulating serum albumin. It is an allelic heterogeneous defect, caused by variety of mutations within the albumin gene in homozygous or compound heterozygous state. Herein we report the clinical and molecular characterization of a new case of congenital analbuminemia diagnosed in a female newborn of consanguineous (first degree cousins) parents from Ankara, Turkey, who presented with a low albumin concentration (< 8 g/L) and severe clinical symptoms. Materials and methods: The albumin gene of the index case was screened by single-strand conformation polymorphism, heteroduplex analysis, and direct DNA sequencing. The effect of the splicing mutation was evaluated by examining the cDNA obtained by reverse transcriptase - polymerase chain reaction (RT-PCR) from the albumin mRNA extracted from proband’s leukocytes. Results: DNA sequencing revealed that the proband is homozygous, and both parents are heterozygous, for a novel G>A transition at position c.1652+1, the first base of intron 12, which inactivates the strongly conserved GT dinucleotide at the 5′ splice site consensus sequence of this intron. The splicing defect results in the complete skipping of the preceding exon (exon 12) and in a frame-shift within exon 13 with a premature stop codon after the translation of three mutant amino acid residues. Conclusions: Our results confirm the clinical diagnosis of congenital analbuminemia in the proband and the inheritance of the trait and contribute to shed light on the molecular genetics of analbuminemia.
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Affiliation(s)
- Gianluca Caridi
- Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
| | - Monica Dagnino
- Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
| | - Omer Erdeve
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Marco Di Duca
- Laboratory on Pathophysiology of Uremia, Istituto Giannina Gaslini IRCCS, Genova, Italy
| | - Duran Yildiz
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Serdar Alan
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Begum Atasay
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Saadet Arsan
- Ankara University School of Medicine, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | | | - Monica Galliano
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Kahvecioglu D, Erdeve O, Alan S, Cakir U, Yildiz D, Atasay B, Arsan S. The impact of evaluating platelet transfusion need by platelet mass index on reducing the unnecessary transfusions in newborns. J Matern Fetal Neonatal Med 2014; 27:1787-9. [DOI: 10.3109/14767058.2013.879708] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kahvecioglu D, Yildiz D, Atasay B, Erdeve O. Erythema multiforme due to parainfluenza virus in a newborn: A case report and review of the literature. Indian J Paediatr Dermatol 2014. [DOI: 10.4103/2319-7250.143663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kahvecioglu D, Atasay B, Berberoglu M, Yildiz D, Cakir U, Akduman H, Erdeve O, Siklar Z, Magdelaine C, Lienhardt-Roussie A, Akar M, Ozbek MN, Arsan S. A novel mutation in the calcium sensing receptor gene in a neonate with severe hyperparathyroidism. Genet Couns 2014; 25:331-335. [PMID: 25365856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Alan S, Atasay B, Cakir U, Yildiz D, Kilic A, Kahvecioglu D, Erdeve O, Arsan S. An intention to achieve better postnatal in-hospital-growth for preterm infants: adjustable protein fortification of human milk. Early Hum Dev 2013; 89:1017-23. [PMID: 24035039 DOI: 10.1016/j.earlhumdev.2013.08.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 07/10/2013] [Accepted: 08/20/2013] [Indexed: 01/16/2023]
Abstract
OBJECTIVE We assessed the effect of human milk (HM) fortification with extra protein supplement by an adjustable protein fortification method according to the weekly blood urea nitrogen (BUN) levels on growth in hospitalized preterm infants. METHOD A prospective observational intervention study in 58 preterms born ≤32 weeks of gestation and fed with breast milk was conducted. Preterms who were given a commercial HM fortifier which provides an additional protein of 0.8 g/3 scales according to the standard feeding strategy served as a historical control group. Infants who were given extra protein in addition to the HM fortifier with another commercial protein supplement which provides an additional protein of 2.2g/1 scale comprised the intervention group. Additional protein supplementation was adjusted according to BUN levels weekly in the intervention group. Weight gain velocities (g/kg/day), length, head circumferences (HC) gain velocities (mm/day) and daily growth indexes for weight, height and HC (percentage per day) were calculated. RESULTS The median amount of daily enteral protein intake [4 (3.4-4.6) vs. 2.78 (2.1-3.1) g/kg/day, p < 0.0001] was significantly higher in the interventional group. Length (p = 0.008) and HC (p < 0.0001) gain velocities were significantly higher in the intervention group. Daily growth indexes for weight (2.2% vs. 1.8%, p = 0.026), for length (0.4% vs. 0.3%, p = 0.027) and for HC (0.48% vs. 0.36% per day, p = 0.003) were significantly higher in the intervention group. CONCLUSION A higher protein intake by adjustable protein fortification method without energy or volume change leads to improved postnatal in-hospital-growth in very low birth weight infants.
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Affiliation(s)
- Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Turkey.
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Alan S, Karadeniz C, Okulu E, Kılıc A, Erdeve O, Ucar T, Atasay B, Atalay S, Arsan S. Management of patent ductus arteriosus in preterm infants: clinical judgment might be a fair option. J Matern Fetal Neonatal Med 2013; 26:1850-4. [PMID: 23650906 DOI: 10.3109/14767058.2013.801956] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to find out the percentage of preterm infants that needed treatment for patent ductus arteriosus (PDA), when treatment decision was based on clinical signs and symptoms, besides echocardiographic findings. METHODS Daily echocardiographic evaluation was conducted in 39 preterms ≤29(6/7) weeks' gestation. Patients with ductus arteriosus were closely followed-up for clinical symptoms of PDA for treatment decision until ductus arteriosus was closed either spontaneously or by treatment. RESULTS PDA was found in 25 (64%) infants. Mean gestational age and birth weight (BW) of the patients with PDA were 27.8 ± 1.2 and 998 ± 221 g, respectively. PDA closed spontaneously or had minimal ductal shunting before any signs and symptoms attributable to PDA were observed in 16 (41%) infants. Mean ductus size/BW ratio and mean left atrial/aortic root ratio were significantly higher in 9 (23%) symptomatic patients (2.06 ± 0.75 versus 1.32 ± 0.75 mm, p = 0.012 and 1.31 ± 0.52 versus 1.19 ± 0.2 mm, p = 0.043, respectively). PDA closure was observed after the first dose of ibuprofen in six of nine patients. CONCLUSION Correlation of clinical signs with echocardiographic findings for the decision of PDA treatment can be appropriate to prevent unnecessary medical treatments.
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Alan S, Cakir U, Kahvecioglu D, Gordu Z, Erdeve O, Dincaslan H, Atasay B, Beken S, Yavuz G, Arsan S. Neonatal neuroblastoma with inferior vena cava syndrome. APSP J Case Rep 2013; 4:10. [PMID: 24040588 PMCID: PMC3754395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 03/17/2013] [Indexed: 11/29/2022] Open
Abstract
Neuroblastoma (NBL) is a neuroectodermal tumor derived from neural crest cells. The biological and clinical behavior of NB is extremely heterogenous. We here report a newborn who presented as 4S NBL with a massive hepatomegaly resulting in IVC syndrome.
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Affiliation(s)
- Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Dilek Kahvecioglu
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Zulfikar Gordu
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Omer Erdeve
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Handan Dincaslan
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Begum Atasay
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Serdar Beken
- Division of Neonatology, Dr. Sami Ulus Children Hospital, Ankara, TURKEY
| | - Gulsan Yavuz
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
| | - Saadet Arsan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, TURKEY
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Atasay B, Erdeve O, Arsan S, Türmen T. Effect of Sodium Alginate on Acid Gastroesophageal Reflux Disease in Preterm Infants: A Pilot Study. J Clin Pharmacol 2013; 50:1267-72. [DOI: 10.1177/0091270009338483] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Atasay B, Ergun H, Okulu E, Mungan Akın I, Arsan S. The association between cord hormones and transient tachypnea of newborn in late preterm and term neonates who were delivered by cesarean section. J Matern Fetal Neonatal Med 2013; 26:877-80. [DOI: 10.3109/14767058.2013.765846] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Cakir U, Alan S, Zeybek C, Erdeve O, Atasay B, Yalcinkaya F, Arsan S. Acquired bartter-like syndrome associated with colistin use in a preterm infant. Ren Fail 2013; 35:411-3. [PMID: 23342992 DOI: 10.3109/0886022x.2012.761084] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acquired Bartter-like syndrome (BLS), characterized by hypokalemic metabolic alkalosis, hypomagnesemia, hypocalcemia, and normal kidney function, can be induced by diuretics or antibiotics. It is a very rare condition and only anecdotal cases mostly in adults were reported. Although tubulopathy associated with colistin was reported in adults, to the best of our knowledge, colistin-associated BLS neither in adults nor in children has been reported in the literature. We here report a-28-week, 740 g female preterm infant who developed BLS just after colistin treatment for Acinetobacter baumannii infection and recovered few days after the drug cessation, and discuss the possible association of colistin and tubulopathy. More research on colistin pharmacokinetics and pharmacodynamics in critically ill patients and preterm infants is needed to guide adequate colistin dosing at the least toxicity.
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Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Ankara University School of Medicine Children's Hospital, Ankara, Turkey.
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Alan S, Kahvecioglu D, Erdeve O, Atasay B, Arsan S. Is paracetamol a useful treatment for ibuprofen-resistant patent ductus arteriosus? Concerning the article by M.Y. Oncel et al: intravenous paracetamol treatment in the management of patent ductus arteriosus in extremely low birth weight infants [Neonatology 2013;103:166-169]. Neonatology 2013; 104:168-9. [PMID: 23921529 DOI: 10.1159/000352068] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 05/16/2013] [Indexed: 12/20/2022]
Affiliation(s)
- Serdar Alan
- Division of Neonatology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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Yildiz D, Alan S, Kilic A, Yaman A, Erdeve O, Kuloglu Z, Atasay B, Arsan S. Crigler-Najjar syndrome type I in a Turkish newborn caused by a novel mutation and Gilbert type genetic defect. Genet Couns 2013; 24:273-277. [PMID: 24341141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Crigler-Najjar syndrome (CNS), caused by deficiency of bilirubin uridine diphosphate glucuronosyltransferase (UGT) 1A1, is a rare and autosomal recessive inherited disorder characterized by severe unconjugated nonhemolytic hyperbilirubinemia since birth. We present a girl with CNS type I caused by a novel mutation and Gilbert type genetic defect. Gilbert's Syndrome (GS) and CNS type I both involve abnormalities in bilirubin conjugation secondary to deficiency of bilirubin UGT. The combined defects even in benign genetic forms were shown to cause more serious clinical disease. The patient has been treated with daily home-based phototherapy for more than nine months and considered as a candidate for liver transplantation.
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Affiliation(s)
- D Yildiz
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey.
| | - S Alan
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - A Kilic
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - A Yaman
- Division of Pediatric Gastroenterology, Ankara, Turkey
| | - O Erdeve
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - Z Kuloglu
- Division of Pediatric Gastroenterology, Ankara, Turkey
| | - B Atasay
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
| | - S Arsan
- Ankara University School of Medicine Children's Hospital, Department of Pediatrics, Division of Neonatology, Ankara, Turkey
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Alan S, Okulu E, Kiliç A, Atasay B, Arsan S. Palivizumab use during respiratory syncytial virus outbreak in the neonatal intensive care unit. J Hosp Infect 2012; 81:292-3. [PMID: 22727129 PMCID: PMC7134468 DOI: 10.1016/j.jhin.2012.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 05/14/2012] [Indexed: 11/30/2022]
Affiliation(s)
- S. Alan
- Corresponding author. Address: Vedat Dolakay Cad. No: 90A/16 Gaziosmanpasa, 06100 Ankara, Turkey. Tel.: +90 532 599 12 59; fax: +90 312 236 21 01.
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Erdeve O, Atasay B, Arsan S, Türmen T. Authors' Response. J Clin Pharmacol 2012. [DOI: 10.1177/0091270011401738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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