mehmet geyik

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Objective: To evaluate the clinical, demographic and laboratory characteristics of the patients followed up with the diagnosis of acute respiratory distress syndrome (ARDS) in our pediatric intensive care unit (PICU) and to determine the factors that have an effect on the outcomes. Methods: The files of 40 patients with ARDS who were followed up on mechanical ventilators (MV) in PICU of XXXX University between 2013 and 2018 were retrospectively scanned. Results: Eighteen of the patients were female and 22 were male. The mean age was 45.25±56.63 months. 27 (67.5%) of the patients were classified as pulmonary and 13 (32.5%) as extrapulmonary ARDS. Sixteen (40%) patients were followed in pressure-controlled mode only, 2 (5%) patients in volume-controlled mode only, and 22 (55%) patients in alternately modes. The median value of the length of stay (LOS) in PICU was 17.5 days. The median duration of the stay on MV was 276.5 hours. 17 (42.5%) patients died. The median PIM, PIM-II, PRISM and PELOD scores values of the surviving patients were significantly lower than died patients. Median AST (p=0.003) and LDH (p= 0.008) values were found to be significantly higher in patients who died, while median pH values (p=0.049) were found to be lower. The median LOS in PICU and duration of MV were significantly shorter in patients who died. Also, the median PIM, PIM-II, PRISM and PELOD values of pulmonary ARDS patients were significantly lower than those of extrapulmonary ARDS patients. Conclusion: Despite advances in follow-up and management, mortality due to ARDS is still high. MV duration, LOS in PICU, some MV parameters, mortality scores and laboratory tests associated with mortality. Alternately MV applications may reduce mortality rates.
Background: The aim of this study was to determine the predictive risk factors for development of severe bronchiolitis in patients with acute bronchiolitis with no previous chronic disease. Methods: Four hundred forty children aged 1-24 months hospitalized with acute bronchiolitis, were examined between February 2018 and February 2019 in this prospective study. Results: Eighty-five cases were regarded as severe bronchiolitis and 355 as mild-moderate bronchiolitis. Statistically significant differences were observed between the severe and mild-moderate bronchiolitis groups in terms of weight-for-age z-scores, history of bronchiolitis, hemoglobin levels, and time elapsed between onset of symptoms and admission. Weight-for-age z-scores, the mean time interval between onset of symptoms and admission, and mean hemoglobin values were lower in the severe bronchiolitis group while the mean number of bronchiolitis attacks was higher than in the mild-moderate bronchiolitis group. Logistic regression analysis determined that a low weight-for-age z-score increased the risk of severe bronchiolitis development 0.56-fold (CI: 0.409 – 0.760), a short duration between the onset of symptoms and admission increased the risk 0.62-fold (CI: 0.519 – 0.735), a frequent history of bronchiolitis increased the risk 1.81-fold (CI: 1.135 – 2.968) and low hemoglobin levels increased the risk 0.72-fold (CI: 0.537 – 0.969). Conclusion: Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks, and low hemoglobin levels were identified as independent parameters of severe bronchiolitis development. Key words: Bronchiolitis, Infant, Risk factors, Severity degree