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RISS 인기검색어
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- 저자 : Uçmak Hacer (검색결과 2 건)
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Kahveci Fevzi,Ocak Buse Önen,Gün Emrah,Gurbanov Anar,Uçmak Hacer,Aslan Ayşen Durak,Ceran Ayşegül,Özen Hasan,Balaban Burak,Botan Edin,Şıklar Zeynep,Berberoğlu Merih,Kendirli Tanıl 대한중환자의학회 2023 Acute and Critical Care Vol.38 No.3
Background: Diabetic ketoacidosis (DKA) is a common endocrine emergency in pediatric patients. Early presentation to health facilities, diagnosis, and good management in the pediatric intensive care unit (PICU) are crucial for better outcomes in children with DKA. Methods: This was a single-center, retrospective cohort study conducted between February 2015 and January 2022. Patients with DKA were divided into two groups according to pandemic status and diabetes diagnosis. Both groups were examined in two subcategories (pandemic status: pre-pandemic vs. pandemic; and diabetes diagnosis status: previously diagnosed vs. newly diagnosed).Results: The study enrolled 59 patients, and their mean age was 11±5 years. Forty (68%) had newly diagnosed type 1 diabetes mellitus (T1DM), and 61% received follow-up in the pre-pandemic period. Blood glucose, blood ketone, potassium, phosphorus, creatinine, and alanine transaminase levels were significantly higher in the new-onset T1DM group compared with the previously diagnosed group (P=0.01, P=0.02, P=0.01, P=0.039, and p=0.001, respectively). In patients with newly diagnosed T1DM, length of PICU stays were longer than in those with previously diagnosed T1DM (28.5±8.9 vs. 17.3±6.7 hours, p<0.005). The pandemic group was compared with pre-pandemic group, there was a statistically significant difference in laboratory parameters of pH, HCO3, and lactate and also Pediatric Risk Of Mortality (PRISM) III score. All patients survived, and there were no neurologic sequelae. Conclusion: Patients admitted during the pandemic period were admitted with more severe DKA and had higher PRISM III scores. During the pandemic period, there was an increase in the incidence of DKA in the participating center compared to that before the pandemic. Although the reason for this is not fully known, it could be public health presentations were not effective during the coronavirus disease 2019 (COVID-19) period.
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Botan Edin,Gün Emrah,Şden Emine Kübra,Yöndem Cansu,Gurbanov Anar,Balaban Burak,Kahveci Fevzi,Özen Hasan,Uçmak Hacer,Gençay Ali Genco,Kendirli Tanil 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.4
Background: Pediatric intensive care units (PICUs), where children with critical illnesses are treated, require considerable manpower and technological infrastructure in order to keep children alive and free from sequelae. Methods: In this retrospective comparative cohort study, hospital records of patients aged 1 month to 18 years who died in the study PICU between January 2015 and December 2019 were reviewed. Results: A total of 2,781 critically ill children were admitted to the PICU. The mean±standard deviation age of 254 nonsurvivors was 64.34±69.48 months. The mean PICU length of stay was 17 days (range, 1–205 days), with 40 children dying early (<1 day of PICU admission). The majority of nonsurvivors (83.9%) had comorbid illnesses. Children with early mortality were more likely to have neurological findings (62.5%), hypotension (82.5%), oliguria (47.5%), acidosis (92.5%), coagulopathy (30.0%), and cardiac arrest (45.0%) and less likely to have terminal illnesses (52.5%) and chronic illnesses (75.6%). Children who died early had a higher mean age (81.8 months) and Pediatric Risk of Mortality (PRISM) III score (37). In children who died early, the first three signs during ICU admission were hypoglycemia in 68.5%, neurological symptoms in 43.5%, and acidosis in 78.3%. Sixty-seven patients needed continuous renal replacement therapy, 51 required extracorporeal membrane oxygenation support, and 10 underwent extracorporeal cardiopulmonary resuscitation. Conclusions: We found that rates of neurological findings, hypotension, oliguria, acidosis, coagulation disorder, and cardiac arrest and PRISM III scores were higher in children who died early compared to those who died later.
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