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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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Baş EK, Bülbül A, Şirzai H, Arslan S, Uslu S, Baş V, Zubarioglu U, Celik M, Dursun M, Güran Ö, Kuran B. The long-term impacts of preterm birth and associated morbidities on bone health in preschool children: a prospective cross-sectional study from Turkey. J Matern Fetal Neonatal Med 2020; 35:677-684. [PMID: 32102581 DOI: 10.1080/14767058.2020.1730801] [Citation(s) in RCA: 3] [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] [Indexed: 10/24/2022]
Abstract
Objective: To evaluate the impact of preterm birth on bone health in preschool children.Methods: A total of 166 preschool children (aged 7-8 years) born preterm (n = 86, <37-week gestation) and at term (n = 80, ≥37 weeks of gestation) in our hospital were included in this prospective cross-sectional study. Data on antenatal, perinatal, and early postnatal characteristics and maternal obstetric history were obtained from medical records. Bone densitometry data including total bone mineral content (BMC), bone mineral density (BMD; total, lumbar, and femoral), z-scores, and bone loss were collected for each participant.Results: Current height, weight, and BMI values were significantly lower in the preterm group (p < .001). Serum calcium, phosphorus and alkaline phosphatase (ALP) levels did not differ among groups, whereas VitD3 levels were significantly higher in the preterm group (p = .039). The mean total BMC, total BMD, lumbar (L2-L4) BMD, femur BMD, total z-score, and L2-L4 z-score values were significantly lower for the preterm group, whereas the total, lumbar, and femoral bone loss were significantly higher (p < .001), regardless of the severity of prematurity. Intraventricular hemorrhage (IVH) and retinopathy were significantly associated with lower total BMC (p = .004, p = .012, respectively). Fortified breastfeeding was associated with lumbar bone loss (p = .043), and formula feeding was associated with both femur and lumbar bone loss (p = .006, p = .012, respectively).Conclusions: Our findings revealed long-term adverse effects of preterm birth on bone health, with significantly lower anthropometric values (weight, height, and BMI), lower scores for total BMC, BMD (total, lumbar, femoral), and z-scores (total, femur), along with higher bone loss (total, lumbar, femoral) and higher rates of osteopenia and osteoporosis in preschool children born preterm (whether moderate or very preterm) compared with those born at term. Exclusive breastfeeding appears to reduce the likelihood of long-term bone loss in preterm infants.
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Affiliation(s)
- Evrim Kıray Baş
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ali Bülbül
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hülya Şirzai
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Selda Arslan
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Vedat Baş
- Department of pediatrics, Istanbul Arel University, Istanbul, Turkey
| | - Umut Zubarioglu
- Department of neonatology, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
| | - Muhittin Celik
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mesut Dursun
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ömer Güran
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Banu Kuran
- Department of neonatology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Dursun M, Uslu S, Bulbul A, Celik M, Zubarioglu U, Bas EK. Comparison of Early Nasal Intermittent Positive Pressure Ventilation and Nasal Continuous Positive Airway Pressure in Preterm Infants with Respiratory Distress Syndrome. J Trop Pediatr 2019; 65:352-360. [PMID: 30239857 DOI: 10.1093/tropej/fmy058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 11/13/2022]
Abstract
AIMS To compare the effect of early nasal intermittent positive pressure ventilation (nIPPV) and nasal continuous positive airway pressure (nCPAP) in terms of the need for endotracheal ventilation in the treatment of respiratory distress syndrome (RDS) in preterm infants born between 24 and 32 gestational weeks. METHODS This is a randomized, controlled, prospective, single-centered study. Forty-two infants were randomized to nIPPV and 42 comparable infants to nCPAP (birth weight 1356 ± 295 and 1359 ± 246 g and gestational age 29.2 ± 1.7 and 29.4 ± 1.5 weeks, respectively). RESULTS The need for endotracheal intubation and invasive mechanical ventilation was significantly lower in the nIPPV group than the nCPAP group (11.9% and 40.5%, respectively, p < 0.05). There were no differences in the duration of total nasal respiratory support, duration of invasive mechanical ventilation, bronchopulmonary dysplasia or other early morbidities. CONCLUSION nIPPV compared with nCPAP reduced the need for endotracheal intubation and invasive mechanical ventilation in premature infants with RDS.
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Affiliation(s)
- Mesut Dursun
- Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Assistance Professor, Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Ali Bulbul
- Assistance Professor, Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Muhittin Celik
- Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Umut Zubarioglu
- Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Evrim Kiray Bas
- Specialist in Neonatology, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
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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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Bulbul A, Bulbul L, Uslu S, Zubarioglu U. Nutritional support in preterm infants. Pediatr Neonatol 2017; 58:562. [PMID: 28888880 DOI: 10.1016/j.pedneo.2017.08.011] [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: 12/07/2016] [Accepted: 08/22/2017] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ali Bulbul
- Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey.
| | - Lida Bulbul
- Department of Pediatrics, Bakırköy Dr. Sadi Konuk Educational and Research Hospital, Istanbul, Turkey.
| | - Sinan Uslu
- Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey.
| | - Umut Zubarioglu
- Department of Pediatrics, Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey.
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Kara Elitok G, Bulbul L, Zubarioglu U, Kıray Bas E, Acar D, Uslu S, Bulbul A. How should we give vitamin D supplementation? evaluation of the pediatricians' knowledge in Turkey. Ital J Pediatr 2017; 43:95. [PMID: 29041957 PMCID: PMC5646103 DOI: 10.1186/s13052-017-0415-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 06/29/2017] [Accepted: 10/09/2017] [Indexed: 11/20/2022] Open
Abstract
Background We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement. Methods The study was planned cross-sectional to be carried out between April–May 2015 in Turkey. A questionnaire form that determined the participants’ opinions and practices concerning vitamin D supplement was completed via face-to-face interview. Results A total of 107 pediatricians (49.3%) and 110 pediatric residents (50.7%) participated in the study. Of the physicians, 85.2% recommended vitamin D supplement for all infants and children regardless of diet, 13.4% recommended for the infants which are solely breastfed. Vitamin D supplement is recommended at a dose of 400 IU/day by 88.8% of pediatricians and by 90% of pediatric residents. Of the pediatricians and pediatric residents, 72% and 68.2%, respectively commence vitamin D supplement when the newborn is 15 days old. The rates of recommending vitamin D supplement until the age of one and two years were higher among pediatricians (48.6% and 41.1%, respectively) than pediatric residents (40.9% and 32.7%, respectively). The rate of starting vitamin D supplement for fontanelle closure was significantly higher among pediatric residents (15.5%) than pediatricians (3.7%) (p = 0.002). It was determined that the rate of prescribing vitamin D supplement until fontanelle closure was higher among pediatric residents (18.2%) than pediatricians (0.9%). Conclusions The present study suggest that the knowledge of pediatricians about recommendation of vitamin D needs to be enhanced by education programs in addition to free vitamin D supplement provided by the Ministry of Health.
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Affiliation(s)
- Gizem Kara Elitok
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.
| | - Lida Bulbul
- Department of Pediatrics, Bakırköy Dr. Sadi Konuk Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Umut Zubarioglu
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Evrim Kıray Bas
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Duygu Acar
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sinan Uslu
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali Bulbul
- Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Celik M, Bulbul A, Uslu S, Dursun M, Guran O, Kıray Bas E, Arslan S, Zubarioglu U. A comparison of the effects of invasive mechanic ventilation/surfactant therapy and non-invasive nasal-continuous positive airway pressure in preterm newborns. J Matern Fetal Neonatal Med 2017; 31:3225-3231. [DOI: 10.1080/14767058.2017.1367380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Muhittin Celik
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Ali Bulbul
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Sinan Uslu
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Mesut Dursun
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Omer Guran
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Evrim Kıray Bas
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Selda Arslan
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
| | - Umut Zubarioglu
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Research Hospital, Istanbul, Turkey
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Uslu S, Zubarioglu U, Sozeri S, Dursun M, Bulbul A, Kiray Bas E, Turkoglu Unal E, Uslu A. Factors Affecting the Target Oxygen Saturation in the First Minutes of Life in Preterm Infants. J Trop Pediatr 2017; 63:286-293. [PMID: 28013253 DOI: 10.1093/tropej/fmw090] [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] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this study was to describe the effect of factors on time to reach a pulse oxygen saturation (SpO2) level of 90% in preterm infants in the delivery room. METHODS Preterm (<35 gestational age) infants who did not require supplemental oxygen were included in the study. Continuous recordings were taken by pulse oximetry during the first 15 min of life. RESULTS Of 151 preterm infants, 79 (52.3%) were female and 126 (83.5%) were delivered by cesarean section. Target saturation level (≥90%) was achieved faster in preductal measurements. Mean times taken to have a preductal and postductal SpO2 level of 90% were significantly lower in preterm babies born by vaginal delivery, with umbilical arterial pH ≥ 7.20 and whose mothers were non-smokers during pregnancy. CONCLUSIONS Differences in achievement of target saturation level were influenced by multiple factors (birth way, probe location, maternal smoking and umbilical blood gas pH) in the delivery room during resuscitation of preterm babies.
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Affiliation(s)
- Sinan Uslu
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Umut Zubarioglu
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Sehrinaz Sozeri
- Nurse of Neonatal Intensive Care Unit, Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Mesut Dursun
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Ali Bulbul
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Evrim Kiray Bas
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Ebru Turkoglu Unal
- Division of Neonatology, Department of Pediatrics, Sisli Hamidiye Etfal Educational and Research Hospital, 34360 Istanbul, Turkey
| | - Aysegul Uslu
- Division of Pediatrics, Kagithane State Hospital, 34416 Istanbul, Turkey
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Bas EK, Bulbul A, Uslu S, Bas V, Zubarioglu U. Child motherhood: the incapability remains. World J Pediatr 2017; 13:283. [PMID: 28474280 DOI: 10.1007/s12519-017-0040-7] [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: 11/30/2022]
Affiliation(s)
- Evrim Kiray Bas
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey.
| | - Ali Bulbul
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
| | - Sinan Uslu
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
| | - Vedat Bas
- Istanbul Arel University, Istanbul, Turkey
| | - Umut Zubarioglu
- Sisli Etfal Children's Hospital, Kazım Orbay Street, number:1 Sisli, Istanbul, Turkey
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Uslu S, Bulbul A, Dursun M, Zubarioglu U, Turkoglu E, Guran O. Agreement of Mixed Venous Carbon Dioxide Tension (PvCO2) and Transcutaneous Carbon Dioxide (PtCO2) Measurements in Ventilated Infants. Iran J Pediatr 2015. [PMID: 26199686 PMCID: PMC4505968 DOI: 10.5812/ijp.184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Noninvasive transcutaneous carbon dioxide monitoring has been shown to be accurate in infants and children, limited data are available to show the usefulness and limitations of partial transcutaneous carbon dioxide tension (PtCO2) value. Objectives: The current study prospectively determines the effectiveness and accuracy of PtCO2 measurements in newborns. Materials and Methods: Venous blood gas sampling and monitoring of the PtCO2 level (TCM TOSCA, Radiometer) were done simultaneously. All measurements are performed on mechanically ventilated infants. Partial venous carbon dioxide tension (PvCO2) values divided into three groups according to hypocapnia (Group 1: < 4.68 kPa), normocapnia (Group 2: 4.68–7.33 kPa), hypercapnia (Group 3: > 7.33 kPa) and then PvCO2 and PtCO2 data within each group were compared separately. Results: A total of 168 measurements of each PvCO2 and PtCO2 data were compared in three separated groups simultaneously (13 in Group 1, 118 in Group 2, and 37 in Group 3). A bias of more than ± 0.7 kPa was considered unacceptable. PtCO2 was related to PvCO2 with acceptable results between the two measurements in hypocapnia (mean difference 0.20 ± 0.19 kPa) and normocapnia (0.002 ± 0.30 kPa) groups. On the other hand in hypercapnia group PtCO2 values were statistically significant (P < 0.001) and lower than PvCO2 data (mean difference 0.81 ± 1.19 kPa) Conclusions: PtCO2 measurements have generally good agreement with PvCO2 in hypocapnic and normocapnic intubated infants but there are some limitations especially with high level of CO2 tension. Monitoring of PtCO2 is generally a useful non-invasive indicator of PvCO2 in hypocapnic and normocapnic infants.
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Affiliation(s)
- Sinan Uslu
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
- Corresponding author: Sinan Uslu, Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey. Tel: +90-5327370015, E-mail:
| | - Ali Bulbul
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
| | - Mesut Dursun
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
| | - Umut Zubarioglu
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
| | - Ebru Turkoglu
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
| | - Omer Guran
- Division of Neonatology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey
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Uslu S, Bulbul A, Can E, Zubarioglu U, Salihoglu O, Nuhoglu A. Relationship between oxygen saturation and umbilical cord pH immediately after birth. Pediatr Neonatol 2012; 53:340-5. [PMID: 23276437 DOI: 10.1016/j.pedneo.2012.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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] [Received: 05/10/2011] [Revised: 03/01/2012] [Accepted: 03/15/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of this study is to determine the relationship between oxygen saturation (SpO(2)) by pulse oximetry levels and umbilical cord arterial pH values in healthy newborns during the first 15 minutes of life. METHODS The study was performed with healthy term, appropriate-for-gestational-age newborn infants. The infants were divided in two groups: umbilical cord arterial blood pH value ≤7.19 (group 1) and >7.19 (group 2); SpO(2) levels during the first 15 minutes of life were compared between groups. RESULTS The study was completed with 129 infants (33 in group 1 and 96 in group 2). A significant correlation was found between first-measured preductal and postductal SpO(2) levels by pulse oximetry and umbilical cord arterial pH values ([r²:0.72(0.62 -0.79); p < 0.001] and [r²:0.32(0.25 - 0.54); p < 0.001], respectively). In group 1, infants had lower SpO(2) levels at both preductal and postductal measurements during the first 11 minutes of life and time to reach ≥90% SpO(2) level was longer compared with infants in group 2. CONCLUSION Determination of umbilical arterial blood pH values, in addition to clinical findings and oxygen saturation measurements, might be helpful in deciding the concentration of oxygen and whether or not to continue oxygen supplementation in the delivery room.
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Affiliation(s)
- Sinan Uslu
- Department of Pediatrics, Division of Neonatology, Sisli Etfal Children Hospital, Istanbul, Turkey.
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Zubarioglu U, Uslu S, Can E, Bülbül A, Nuhoglu A. Oxygen Saturation Levels during the First Minutes of Life in Healthy Term Neonates. TOHOKU J EXP MED 2011; 224:273-9. [DOI: 10.1620/tjem.224.273] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Sinan Uslu
- Department of Neonatology, Sisli Etfal Children Hospital
| | - Emrah Can
- Department of Neonatology, Sisli Etfal Children Hospital
| | - Ali Bülbül
- Department of Neonatology, Sisli Etfal Children Hospital
| | - Asiye Nuhoglu
- Department of Neonatology, Sisli Etfal Children Hospital
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