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Amaç: Bu çalışmanın amacı, pediatrik yoğun bakım takibi gereken travma hastalarında, travma nedenlerini ve klinik seyrini incelemek ve mülteci çocuklar özelinde demografik özellikler, travma oluşum mekanizması, travma şiddeti ve prognoz açısından olası farklılıkları değerlendirmektir.Gereç ve Yöntemler: 1 Mayıs 2020-30 Nisan 2021 tarihleri arasında çocuk yoğun bakım ünitemize travma ön tanısı ile başvuran 175 hastanın kayıtları geriye dönük olarak incelendi. Hastalar Türk vatandaşları ve Suriye vatandaşları (mülteci hastalar) olarak iki gruba ayrıldı. Elde edilen veriler bu iki grup arasında karşılaştırıldı.Bulgular: Hastaların 119’u (%68) T.C. vatandaşı ve 56’sı (%32) mülteci hastaydı. T.C. vatandaşı hastaların ortanca yaşı 6 (3-12; IQR) ve mülteci hastaların ortanca yaşı 4 (2-10; IQR) olarak saptandı (p=0.092). T.C. vatandaşlarının 70’i (%58.8), mülteci hastaların 43’ü (%76.8) erkekti (p=0.027). Araç içi trafik kazası T.C. vatandaşların 27’sinde (%22.7), mülteci hastaların 4’ünde (%7.2) görüldü ve farklılık istatistiksel olarak anlamlı bulundu (p=0.011). Mülteci hastalardaki araç dışı trafik kazası oranı T.C. vatandaşlarına göre daha fazlaydı (%23.2 ve %10; sırasıyla) (p=0.035). Travma nedeni ile 10 hasta hayatını kaybetmişti. Ölen hastaların yedisi (%5.8) T.C. vatandaşı, üçü (%5.3) göçmendi.Sonuç: Çalışmamızda mülteci çocuklarda araç dışı trafik kazasının daha fazla görüldüğünü ancak her iki grupta klinik olarak bir fark olmadığını saptadık. Göçmen sorunlarının daha dikkatli değerlendirilmesi, çocuk nüfusuna odaklı projeler ve çalışmalar, sosyo-ekonomik koşullarının iyileştirilmesi, eğitim sistemine düzenli katılımın sağlanması yaralanma oranlarını azaltabileceğini düşünmekteyiz., Objective: This study aimed to examine the causes and clinical course of trauma in trauma patients requiring pediatric intensive care unit (PICU) follow-up and evaluate possible differences related to demographic characteristics, trauma mechanism, trauma severity, and prognosis in refugee children.Material and Methods: The records of 175 patients admitted to our PICU between May 1, 2020 and April 30, 2021 with a preliminary diagnosis of trauma were retrospectively reviewed. The patients were divided into two groups as Turkish citizens and Syrian citizens (refugee children). The obtained data were compared between these two groups.Results: 119 (68%) were Turkish citizens and 56 (32%) were refugees. The median age of the Turkish citizens was 6 (3–12; IQR) years and the median age of the refugee patients was 4 (2–10; IQR) years (p = 0.092). Further, 70 (58.8%) of the Turkish citizens and 43 (76.8%) of the refugee patients were males (p = 0.027). In-vehicle traffic accidents were observed in 27 (22.7%) of the Turkish citizens and 4 (7.2%) of the refugee patients, with the difference being statistically significant (p = 0.011). The rate of non-vehicle traffic accident in the refugee patients was higher than that in the Turkish citizens (23.2% and 10%, respectively) (p = 0.035). Ten patients died due to trauma, of which 7 (5.8%) patients were Turkish citizens and 3 (5.3%) were refugee patients.Conclusion: In our study, we found that non-vehicle traffic accidents were more common in refugee patients, but there was no clinical difference between Turkish citizens and refugee patients. We think that more careful evaluation of immigrant problems, projects, and studies focused on the child population, improvement of socioeconomic conditions, and regular participation in the education system can reduce injury rates.

Objectives: the aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children.Methods: a retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: there were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4 degrees C (38.0-38.7 degrees C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: to the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution., NA

In this chapter, we described high-flow nasal cannula therapy (HFNC) and noninvasive ventilation treatment (NIV) modalities and told about their usage in pediatric intensive care unit (PICU). We discussed articles published within the last 2 years comparing NIV, especially continuous positive airway pressure (CPAP) and HFNC therapies in pediatric patients of different health situations as hypoxemic respiratory failure (RF), severe asthma exacerbations, acute bronchiolitis, pneumonia, and acute respiratory failure (ARF) after cardiac surgery. We paid special attention to choose the systematic reviews and meta-analysis and original articles with the largest study population issued in years between 2017 and 2019. However, our search for some of these topics resulted in only one or a few studies in childhood, and the issue dates were earlier than 2017. To ensure the integrity of the subject, we included some of the earlier studies and some of the adult studies where pediatric studies were not found.

Background and Aims: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. Materials and Methods: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT. During the study period of 3 years, venous cannula of ECMO circuit before pump was used for CRRT access for both the filter inlet and outlet of CRRT machine to minimize the thromboembolic complications. The common indication for CRRT was fluid overload. Results: CRRT was used in 3.68% of a total number of patients admitted and 43% of patients on ECMO. The patients have undergone renal replacement therapy for periods of time ranging between 24 h and 25 days (260 h mean). The survival rate of this group of patients with multiorgan failure was 33%. Renal recovery occurred in all of the survivors. Complications such as electrolyte imbalance, hypothermia, and bradykinin syndrome were easily managed. Conclusions: Adding a CRRT device on ECMO circuit is a safe and effective technique. The major advantages of this technique are easy to access, applying CRRT without extra anticoagulation process, preventing potential hemodynamic disturbances, and increased clearance of solutes and fluid overload using larger hemofilter.

OTO, ARZU/0000-0003-0229-2759; Sevketoglu, Esra/0000-0002-8330-2877, WOS: 000496521400006, PubMed: 31435144, Objectives:To analyze the course of seasonal viral infections of respiratory tract in patients hospitalized in pediatric intensive care units (PICU) of 16 centers in Turkey. Materials and methods: It is a retrospective, observational, and multicenter study conducted in 16 tertiary PICUs in Turkey includes a total of 302 children with viral cause in the nasal swab which required PICU admission with no interventions. Results: Median age of patients was 12 months. Respiratory syncytial virus (RSV) was more common in patients over one year of age whereas influenza, human Bocavirus in patients above a year of age was more common (p = 60 mm Hg. Conclusion: Our findings demonstrate that patients with neurological symptoms, tachycardia, hypoxia, hypotension, acidosis, impaired liver, and renal function at the time of admission exhibit more severe mortal progressions. Presence of acidosis and multiorgan failure was found to be predictor for mortality. Knowledge of clinical presentation and age-related variations among seasonal viruses may give a clue about severe course and prognosis. By presenting the analyzed data of 302 PICU admissions, current study reveals severity of viral respiratory tract infections and release tips for handling them.