Search

Etkin Piyasa Hipotezi, finans literatüründe bir süredir geçerliliği tartışılan bir görüş haline gelmiştir. Bu tartışmaların sebeplerinden birinin takvim anomalileri konusunda yapılan çalışmalarda elde edilen bulgular olduğu söylenebilir. İlk çalışmalarda sıkça görülen bu anomaliler, zamanla tespit edilememeye başlanmıştır. Takvim anomalilerinin daha seyrek görülmeye başlaması, akıllara “Piyasalar etkin hale mi geliyor?” sorusunu getirse de bunun cevabı henüz kesin bir şekilde verilebilmiş değildir. Bu çalışmada Haftanın Günü, Hafta Sonu, Ocak Ayı, Yılın Ayı, Ay İçi, Ay Dönüşü ve Tatil Anomalisinin zaman içindeki gelişimi altı farklı Borsa İstanbul endeksi üzerinde araştırılmıştır. 03.01.1999–01.01.2019 dönemi beş alt döneme ayrılarak incelenmiş, Borsa İstanbul’da ilk alt dönem olan 1999–2003 döneminde takvim anomalilerinin yoğun olarak görüldüğü, ancak ilerleyen yıllarda varlıklarının önemli ölçüde azaldığına dair bulgular elde edilmiştir., The Efficient Market Hypothesis has become controversial in the finance literature for some time. It can be said that one of the reasons for these discussions is the findings reached from the research on calendar anomalies. These anomalies, which were frequently seen in the first studies, began to be undetected over time. The fact that calendar anomalies are seen less often brings to mind the question: “Are the markets becoming efficient?” However, the answer to this question has not been given definitively yet. In this study, the presence of Day of the Week, Weekend, January, Month of the Year, Intra-Month, Turn-of the Month and Holiday anomalies over time were investigated on six different Borsa Istanbul indices. The period of 03.01.1999–01.01.2019 was analysed by dividing it into six sub-periods. The evidence about the presence of calendar anomalies in Borsa Istanbul is reached for the first sub-period, 1999–2003, however their presence is significantly decreased in the following years.

Objectives: We present the short-term results of an alternative method in stage 1 surgery for hypoplastic left heart syndrome. Methods: Data of 16 consecutive patients who were treated with the novel method in our clinic between February 2019 and March 2021 were analysed retrospectively. Preoperative data and postoperative follow-up were recorded. Results: Of the 16 operated patients, 12 were diagnosed with hypoplastic left heart syndrome, while four were diagnosed with hypoplastic left heart syndrome variants. Seven patients died during early postoperative period. One patient died at home waiting stage 2 surgery. Three patient underwent stage 2 surgery. Pulmonary artery reconstruction was performed in one patient due to left pulmonary artery distortion. Conclusions: We believe that our method can be an effective alternative in the surgery of hypoplastic left heart syndrome and its variants. It is hoped that with increasing number of studies and more experience better outcome will be achieved.

We compared transatrial closure, tricuspid valve septal detachment, and tricuspid valve chordal detachment techniques for ventricular septal defect (VSD) closure.Patients who had VSD closure with three different techniques in our clinic between September 2016 and December 2020 were retrospectively reviewed. A total of 117 patients were included in the study. The patients were divided into three groups: group 1, classical transatrial closure; group 2, closure with tricuspid valve septal detachment; and group 3, closure with tricuspid valve chordal detachment. The groups were evaluated by serial transthoracic echocardiography (preoperative, postoperative 1st day, postoperative 1st month). Cardiac rhythm checks and recordings were performed.No residual VSD was observed in early or late periods in any of the groups whose VSD closure was performed with the three different techniques. No severe tricuspid regurgitation (TR) was detected during the early and late postoperative periods of all operating procedures. When the groups were compared in terms of early/late TR after the operation (without TR+trace amount of TR and mild TR+moderate TR were compared), no statistically significant difference was found (P0,05; P=0,969 and P0,05; P=0,502).In this study, we found no statistically significant difference between three VSD closure techniques in terms of early TR, late TR, residual VSD, and permanent atrioventricular complete block during postoperative period. We hope that our results will be supported by the results of researches that are being made about this subject in large series.

This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs (p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations (p = 0.001, p = 0.012, and p = 0.027). Conclusion: To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.

Objective: Few cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in children compared with the total number of cases in the general population. No pediatric studies (or cases) have evaluated extracorporeal techniques in severe coronavirus disease 2019 (COVID-19) patients. In this article, we aimed to describe the clinical features, treatments, and outcomes of four children with COVID‐19 who were treated with therapeutic plasma exchange (TPE) and continuous renal replacement therapy (CRRT) in our pediatric intensive care unit (PICU). Materials and Methods: The children with COVID 19 pneumonia admitted to the PICUs from March 23, and May 6, 2020 were collected. Demographic data and reason for hospitalization were recorded. Vital and laboratory findings were examined in children with extracorporeal treatments. Results: Noninvasive mechanical ventilation, antiviral and antibacterial therapy, supportive antioxidant treatments were administered for 11 children. Respiratory failure and vital signs were more serious in four patients than in other patients. Therefore, we performed extracorporeal support treatments, TPE and CRRT. The patients showed a rapid clinical response to these treatments. Conclusion: TPE and CRRT can use for severe COVID-19 infection receiving other supportive and medical treatments in children.

OBJECTIVE The present study aimed to compare the rate of wound site infection in patients

Acute fulminant myocarditis (AFM) is a clinical condition that can lead to sudden onset of rapidly progressing cardiogenic shock with significant arrhythmia and possible cardiac arrest. Mechanical circulation support has been reported to provide effective cardiac support in patients with AFM. In this article, we aimed to present the case of a 14-year-old girl with AFM who experienced a cardiogenic shock and resistant ventricular tachycardia unresponsive to medical treatment; however, she could be successfully treated with veno-arterial extracorporeal membrane oxygenation and discharged without neurological sequelae from the hospital.

Introduction:Transfusion of blood components, including red blood cells (RBC), platelets and plasma, is the fastest way to improve the haematological state of critically ill patients and can be a lifesaving intervention. Although transfusion is a common practice in paediatric intensive care units (PICUs), its adverse effects are not clearly defined. Therefore, we aimed to evaluate the incidence and predictors of RBC transfusion in mechanically ventilated children.Methods:Data of patients admitted to PICUs from January 2014 to April 2019 were extracted. The mechanically ventilated patients were categorised into two groups, and the relationship between transfusion and prognostic factors was examined.Results:This study investigated 373 children with a mean age of 3.86±4.86 years. Among these children, 239 received RBC transfusion (64.1%). Inotropic drug usage, acute kidney injury, continuous renal replacement therapy (CRRT), mortality, length of mechanical ventilation, and duration of PICU stay were associated with RBC transfusion. Logistic regression analysis revealed that inotropic drug usage increased the RBC transfusion requirement by 5.168 fold, and CRRT increased it by 2.804 fold.Conclusion:Blood transfusion is an associated adversity in critically ill children. Therefore, patients who need transfusion should be followed up more carefully and closely.

Objective: Early diagnosis of sepsis is important for effective treatment and improved prognosis. C-reactive protein (CRP) and procalcitonin (PCT) are the most commonly used biomarkers for sepsis. However, their routine usage is not cost-effective. Complete Blood Count (CBC) parameters including red cell distribution width (RDW), neutrophil to lymphocyte ratios (NLR), platelet to lymphocyte ratios (PLR), mean platelet volume (MPV), and hemoglobin are simple and easily calculated. The aim of this study was to determine the CBC parameters in patients with sepsis on admission and compare with those of the control group. Material and Methods: The medical records of 115 eligible patients (68 sepsis, 47 control patients) who were hospitalized in PICU between January 2014 and March 2019 were retrospectively investigated. Demographic, prognostic and laboratory findings of the patients admitted with sepsis were compared with those of the control patients. Results: Sixty-eight (59.1%) of the patients were admitted with sepsis, severe sepsis or septic shock. In sepsis patients, CRP (p

Introduction Thrombocytopenia is a common haematological finding in critically ill patients. Studies have shown that decreased platelet counts are associated with prolonged hospitalisation, increased costs, and mortality in adult populations. However, not enough studies have investigated the incidence of thrombocytopenia and the relationship between thrombocytopenia and the prognoses of paediatric patients who require treatment in the intensive care unit. We evaluated the effects of initial platelet counts on the outcomes of.pediatric intensive care unit patients. Material and Methods We performed a retrospective analysis of the records of all patients admitted to the pediatric intensive care unit between October 2016 and December 2017. The relationship between the initial thrombocyte counts and the need of invasive mechanical ventilation and non-invasive mechanical ventilation,inotropic drug use, continuous renal replacement need, duration of hospitalization and mortality rate were investigated. Results Totally 387 patients were included in the study. Age distributions ranged from 1 month to 17 years, and the mean patient age was 3.95±4.80 years. The most frequent diagnoses of patients were respiratory disorders (144 patients; 37.2%). There was a statistically significant relationship between thrombocyte levels of the first complete blood count performed during admission and invasive mechanical ventilation, non- invasive mechanical ventilation , inotropic drug use, mortality, acute kidney injury, and continuous renal replacement therapy. Analyses of receiver-operator characteristic (ROC) curves for the thrombocyte counts showed that with a cutoff value of 102,000, mortality had 92.7% sensitivity and 53.1% specificity. The odds ratios (ORs) and relationship between prognostic factors and thrombocytopenia were calculated using logistic regression models. ORs were 4.616 for continuous renal replasman therapy, 6.682 for inotropic drug use, and 3.649 for mortality. Conclusion A low platelet count at the time of admission to the pediatric intensive care unit should be considered an independent risk factor that increases mortality and morbidity and prolongs hospitalisation. Extensive care should be provided to this group of patients.

Giriş: Kritik hastaçocukların prognozunu ve mortalitesini değerlendirmek için birçok öngörücübiyobelirteç geliştirilmiştir. Hiperlaktateminin kritik hastalarda mortalite ileilişkili olması nedeniyle serum laktat seviyesi yaygın bir biyobelirteçtir.Önceki çalışmalar, serum albümin seviyesinin de faydalı bir biyobelirteçolduğunu göstermiştir. Bazı yeni makaleler, serum laktat ve albüminkombinasyonunun kritik hastalardaki ölüm oranlarını daha etkili birbelirleyicisi olduğunu ileri sürdü. Bu çalışmada laktat / albümin (L / A)oranının tek başına serum laktat seviyesinden daha iyi bir prognostik faktörolup olmadığını belirlemeyi amaçladık. Gereç ve yöntemler: Bunedenle bu biyobelirteçler ile invaziv mekanik ventilasyon, invaziv olmayanmekanik ventilasyon desteği, inotropik ilaç ihtiyacı, akut böbrek hasarı,sürekli renal replasman tedavisi, mortalite ve hastanede kalış süresiarasındaki ilişkiyi geriye dönük olarak inceledik. Bulgular: Çalışmayayaş ortalamaları 4.8 ± 5.3 yıl (1 ay ile 18 ay arasında değişen) 379 hastadahil edildi. Pediatrik yoğun bakım ünitesinde ortalama kalış süresi 7.4 ± 11.5gün, ortanca L / A oranı 0.46 (dağılım, 0.11-10.0) idi. Bulgularımız kritikhasta çocuklarda L / A oranı ve serum laktat seviyesinin mortalite ile ilişkiliolduğunu göstermektedir. Bununla birlikte, analiz sonuçlarımız > 0.5 L / Aoranının genel olarak daha iyi bir mortalite belirleyicisi olduğunu düşündürmektedir.Sonuç: L / A oranının kritik hasta çocuklardamortalitenin yararlı ve etkili bir belirleyicisi olduğu sonucuna vardık., Introduction: Many predictive biomarkers were developed to evaluatethe prognosis and mortality of critically ill children. Serum lactate level isone common biomarker because hyperlactatemia is associated with mortality in thesepatients. Previous studies have shown that serum albumin level is also a usefulbiomarker. Several recent articles suggested that the combination of serumlactate and albumin is a more effective predictor of mortality in criticallyill patients. This study aimed to determine whether the lactate/albumin (L/A) ratiowas a better prognostic factor than serum lactate level alone. Material and Methods: Thus, we retrospectively investigated the relationship between these biomarkers and theirrelationship with invasivemechanical ventilation, noninvasive mechanical ventilation support, inotropicdrug need, acute renal kidney injury, continuous renal replacement therapy,mortality, and hospitalisation period. Results: A total of 379 patients with a mean age of 4.8±5.3 years (range,1 month to 18 years) were included in this study. The average duration of stayin the paediatric intensive care unit was 7.4±11.5days, and the median L/A ratiowas 0.46 (range, 0.11–10.0). Our findings indicate that the L/A ratio and serumlactate level were associated with mortality in critically ill children.However, our analysis also suggested that an L/A ratio of >0.5 uponadmission is an overall better predictor of mortality. Conclusion:We conclude that the L/A ratio is a useful andeffective predictor of mortality in critically ill children.

AMAÇ: Sepsis, yoğun bakım hastalarında önemli mortalite ve morbidite nedenidir. Sepsisin erken tanısı, tedavi ve prognoz için önemlidir. Sepsis için en yaygın kullanılan biyobelirteçler C-reaktif protein (CRP) ve prokalsitonindir (PKT). Bununla birlikte, rutin olarak istendiğinde özellikle PKT belirgin hastane maliyeti oluşturmaktadır ve her merkezde bakılamamaktadır. Bu düşünce ile rutin hemogram parametrelerinden olan eritrosit dağılım genişliği (RDW) ve ortalama trombosit volümünün (OTH) sepsis tanısındaki değerliliğini incelemeyi amaçladık.GEREÇ VE YÖNTEM: Ekim 2016 ile Mart 2018 tarihleri arasında Okmeydanı Eğitim ve Araştırma Hastanesine yatırılan 2 yaş üstü 173 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Çalışmaya alınan tüm hastaların demografik bilgileri ve yatışı sonrası ilk laboratuvar değerleri kaydedildi. Hastalar başvuru tanısına göre sepsisi olanlar ve olmayanlar olarak iki gruba ayrıldı. Gruplar arasındaki prognostik ve laboratuvar farklılıklar karşılaştırıldı. Sepsis biyobelirteçleri için receiver operating characteristic (ROC) eğrileri kullanıldı.BULGULAR: Hastaların 38’i (% 16.8) sepsis ve septik şok ile başvurdu. Sepsis ile CRP (p%16 ile mekanik ventilatör (p=0.014)ve eritrosit transfüzyonu (p=0.009) gereksiniminin arttığı, yoğun bakım yatış süresinin uzadığı gösterilmiştir (p=0.044).SONUÇ: Bu çalışma ile RDW ve OTH’nin sadece anemi ve trombositopeni ayrımında kullanılmayacağını, aslında bir akut faz reaktanı gibi, sepsis ve inflamasyon ile ilişkili birer belirteç olduğu gösterilmiştir. Ayrıca RDW>%16 olması mekanik ventilatör ve eritrosit transfüzyonu gereksinimini artıran, yoğun bakım yatış süresini uzatan bir belirteç olarak gösterilmiştir.

Aygun, Fatih/0000-0001-6519-6583 WOS:000561254100006 PubMed ID: 32129197 Acute kidney injury (AKI) is one of the most common causes of increased mortality and morbidity in the pediatric intensive care unit (PICU). Continuous renal replacement therapy (CRRT) is the mainstay treatment for AKI in children as it allows continuous and programmed removal of fluids, which is tolerated better hemodynamically. Defining the risk factors of CRRT related to mortality and morbidity will help improve the outcomes of patients in the PICU. In this study, we aimed to determine the prognostic factors and outcomes of patients who received CRRT. This was a single-center, retrospective study on PICU patients requiring CRRT. Patients with a history of chronic renal failure and PICU stay duration of

Predictors of early diagnosis and severe infection in children with coronavirus disease 2019 (COVID-19), which has killed more than 4 million people worldwide, have not been identified. However, some biomarkers, including cytokines and chemokines, are associated with the diagnosis, pathogenesis and severity of COVID-19 in adults. We examined whether such biomarkers can be used to predict the diagnosis and prognosis of COVID-19 in pediatric patients. Eighty-nine children were included in the study, comprising three patient groups of 69 patients (6 severe, 36 moderate and 27 mild) diagnosed with COVID-19 by real-time polymerase chain reaction observed for 2–216 months and clinical findings and 20 healthy children in the same age group. Hemogram, coagulation, inflammatory parameters and serum levels of 16 cytokines and chemokines were measured in blood samples and were analyzed and compared with clinical data. Interleukin 1-beta (IL-1β), interleukin-12 (IL-12) and interferon gamma-induced protein 10 (IP-10) levels were significantly higher in the COVID-19 patients (p = 0.035, p = 0.006 and p < 0.001). Additionally, D-dimer and IP-10 levels were higher in the severe group (p = 0.043 for D-dimer, area under the curve = 0.743, p = 0.027 for IP-10). Lymphocytes, C-reactive protein and procalcitonin levels were not diagnostic or prognostic factors in pediatric patients (p = 0.304, p = 0.144 and p = 0.67). Increased IL-1β, IL-12 and IP-10 levels in children with COVID-19 are indicators for early diagnosis, and D-dimer and IP-10 levels are predictive of disease severity. In children with COVID-19, these biomarkers can provide information on prognosis and enable early treatment.

Novel coronavirus disease 2019 is a viral infectious disease which commonly involve the lungs with primarily radiologic manifestations of atypical or organizing pneumonia. It can cause multisystemic involvement including central nervous system symptoms. One of these neurologic manifestations is posterior reversible encephalopathy syndrome (PRES). It is suggested that the increased levels of cytokines and inflammatory mediators in the course of the disease are responsible for cerebrovascular endothelial dysfunction and disruption of the blood-brain barrier. To the best of our knowledge, no pediatric PRES has been reported related to coronavirus disease 2019. Here, we present a pediatric PRES case associated with severe acute respiratory syndrome coronavirus 2 infection.

Magnezyum, insan vücudunda dördüncü en çok bulunan esansiyel elementtir. Esas olarak kemik dokuda yer alan magnezyum özellikle nöroendokrin yolakların düzgün çalışması için gereklidir. Beslenme sorunları, malnütrisyon, altta yatan kronik hastalıklar ve ilaç kullanımı gibi hazırlayıcı nedenlerden dolayı magnezyum eksikliği yoğun bakım hastalarında sık görülmektedir. Yetişkin yoğun bakım hastalarında yapılan çalışmalarda hasta prognozu ile hipomagnezeminin ilişkili olduğuna dair birçok çalışma olmasına rağmen çocuk yoğun bakım hastalarında yeterli çalışma ve kanıt bulunmamaktadır. Bu nedenle biz de bu çalışmada çocuk yoğun bakım hastalarında başvuru sırasındaki magnezyum düzeyi ile prognoz arasındaki ilişkiyi araştırmayı ve böylece Mg ile ilgili farkındalık oluşturmayı amaçladık. Çocuk Yoğun Bakım Ünitesi’ne Ekim 2016-Şubat 2018 tarihleri arasında yatırılan tüm hastaların verileri geriye dönük olarak toplandı. Hastalar magnezyum düzeyi 1.8mg/dl olarak iki gruba ayrıldı. Gruplar arasındaki demografik ve prognostik faktörler karşılaştırıldı. Toplam 302 hastanın 50’sinde (%16,6) magnezyum düzeyi

Hiponatremi çocuk acil ve yoğun bakım ünitelerinde sık görülen bir elektrolit bozukluğudur. Yetişkin hastalarda hiponatreminin mortalite için bağımsız bir risk faktörü olduğu gösterilmesine karşın özellikle çocuk yoğun bakım (ÇYB) hastalarında hiponatreminin klinik önemi ve prognoza etkisi yeterince irdelenmemiştir. Bu çalışmada çocuk yoğun bakım ünitesi’nde (ÇYBÜ) yatırılan hastalarda ilk gün hiponatremi sıklığı ve erken dönem prognoz ile olan ilişkisinin araştırılması planlanmıştır. Ekim 2016 ile Mart 2018 tarihleri arasında yatırılan tüm hastaların verileri geriye dönük olarak incelenmiştir. Çalışmaya alınan 435 hastanın 22’sinde orta ve ağır düzeyde hiponatremi saptandı. Hastaların 12’si (%54,5) erkek, 10’u (%45,5) kızdı. Yaş dağılımları 1,5 ay ile 17 yaş arasında olup ortalama hasta yaşı 3,67±2,00 yıldı. Hiponatremi saptanan hastaların ortalama yatış süresi 14,91±22,17 gündü. Serum sodyum (Na) düzeyinin düşüklüğü (Na

Objectives: Multi-system inflammatory syndrome in children (MIS-C) is a less understood and a rare complication of coronavirus disease-2019 (COVID-19). Given the scarce data regarding this novel disease, we aimed to describe the clinical features and outcomes of our patients with MIS-C and to evaluate the associated factors for the pediatric intensive care unit (PICU) admission. Methods: The MIS-C patients under 18 years old diagnosed and treated in three referral centers between July 2020 and March 2021 were included. Data of the patients were retrospectively obtained from their medical records. Results: Overall, 76 subjects (24 females) with a mean age of 8.17 ± 4.42 years were enrolled. Twenty-seven (35.5%) patients were admitted to the PICUs. The two most common systemic involvement patterns were cardiac and gastrointestinal. There was only one lethal outcome in a patient with underlying acute lymphoblastic leukemia. Those with higher procalcitonin levels at admission were found to stay longer in the hospital (r = 0.254, p = 0.027). The risk of PICU admission increased with age (aOR: 1.277; 95% CI: 1.089–1.498; p = 0.003) and with decreased initial serum albumin levels (aOR: 0.105; 95% CI: 0.029–0.378; p = 0.001). Conclusion: Although there is a wide clinical variability among the patients with MIS-C, we suggest that those with older age and lower initial serum albumin levels merit close monitoring due to their higher risk for PICU admission.Key Points• Although there is a wide variability regarding the management process among clinicians, MIS-C is a rare, severe, less understood complication of COVID-19 that may cause rapid clinical deterioration in the patients.• Clinicians should be aware of this condition in children with persistent fever and a family history of COVID-19.• Older age and low serum albumin levels are the independent predictors for the pediatric intensive care unit admission among MIS-C patients. © 2021, International League of Associations for Rheumatology (ILAR).

Background The severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has been causing a serious epidemic in our country and all over the world since December 2019 and has become a global health problem. The disease caused by the SARS‐CoV‐2 virus has been named as coronavirus disease 19 (COVID‐19). Methods We report on the epidemiological and clinical features of 37 children diagnosed with COVID‐19. Results The median age was 10 years, and 57.1% of the children were male. In addition, 78.3% of the children had histories of contact with adult patients who had been diagnosed with COVID‐19, and 27.0% of our patients had coexisting medical conditions. We found that 40.5% of our patients had mild infection, while 32.4% had moderate infection, and 27.1% had developed severe or critical illness. The most common abnormal laboratory findings in our patients were decreased lymphocytes (45.9%) and increased D‐dimer values (43.2%), while abnormal radiological findings were detected in 56.7% of the children. In addition, 64.8% of the patients had received azithromycin, 59.4% of the patients had received oseltamivir, and hydroxychloroquine was used in combination with azithromycin in 35.1% of the children. Non‐invasive mechanical ventilation was required in 27.0% of the children. Conclusions Although COVID‐ 19 infection is usually mild in childhood, severe clinic can be seen in children with comorbidities or even in children who were previously healthy.

Background:Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods:This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results:Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion:Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

Objectives: To investigate conventional mechanical ventilation weaning characteristics of patients requiring conventional mechanical ventilation support for greater than 48 hours within the PICU. Design: the prospective observational multicenter cohort study was conducted at 15 hospitals. Data were being collected from November 2013 to June 2014, with two designated researchers from each center responsible for follow-up and data entry. Setting: Fifteen tertiary PICUs in Turkey. Patients: Patients between 1 month and 18 years old requiring conventional mechanical ventilation for greater than 48 hours were included. A single-center was not permitted to surpass 20% of the total sample size. Patients with no plans for conventional mechanical ventilation weaning were excluded. Interventions: Conventional mechanical ventilation Measurements and Main Results: Pertinent variables included PICU and patient demographics, including clinical data, chronic diseases, comorbid conditions, and reasons for intubation. Conventional mechanical ventilation mode and weaning data were characterized by daily ventilator parameters and blood gases. Patients were monitored until hospital discharge. of the 410 recruited patients, 320 were included for analyses. A diagnosis of sepsis requiring intubation and high initial peak inspiratory pressures correlated with a longer weaning period (mean, 3.65 vs 1.05-2.17 d; p < 0.001). Conversely, age, admission Pediatric Risk of Mortality III scores, days of conventional mechanical ventilation before weaning, ventilator mode, and chronic disease were not related to weaning duration. Conclusions: Pediatric patients requiring conventional mechanical ventilation with a diagnosis of sepsis and high initial peak inspiratory pressures may require longer conventional mechanical ventilation weaning prior to extubation. Causative factors and optimal weaning for this cohort needs further consideration., National Institutes of HealthUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA, Drs. Sik, Yaman, and Kendirli disclosed government work. Drs. Yaman and Davutoglu received support for article research from the National Institutes of Health. the remaining authors have disclosed that they do not have any potential conflicts of interest.

Purpose/Aim: Ventricular septal defect VSD which is the most common cause of congenital heart defects in children, can lead to heart failure 6–8 weeks after birth due to the decrease in the pulmonary vascular resistance. The clinical features of cardiac failure can be subtle during the infant period, so the laboratory parameters can help the diagnosis and the follow-up. The relation between gamma-glutamyl transferase GGT and cardiac failure is reported in adults. Herein, we aimed to evaluate the relationship between liver enzymes especially GGT levels and cardiac failure developing due to VSD in pediatric patients

The Chiari network (CN) is a mobile, net-like structure occasionally present in the right atrium, near the opening of the inferior vena cava and coronary sinus. While typically asymptomatic, it may contribute to thromboembolism or right atrial pathologies. Here, we hypothesized that existing differences in P-wave morphology on electrocardiograms (ECG) may be associated with atrial conduction changes. Seventy-one children with a CN were recruited and matched to 60 healthy controls. P-wave duration, P-wave amplitude, P dispersion (Pd), QRS, PR, QT, and QTc (calculated with Bazett formula) intervals were measured and compared. Between the control and the patient groups, the mean P-wave duration was 78.1 ms and 88.7 ms, P amplitude was 1.3 mm and 1.1 mm, and Pd was 18.9 and 35.5 ms, respectively. These differences were statistically significant across all measurements (p

Introduction:Thisstudy investigated the mortality rates during the postoperative early period(one month) in patients who underwent on- or off-pump coronary artery bypassgrafting (CABG) and explored the effects of cardiopulmonary bypass (CPB) onearly mortality and cerebral accident.Patientsand Methods: This study comprises a total of 260 subjects thatunderwent CABG surgery in our clinic. Patients who underwent CABG were groupedaccording to two different surgical techniques: the first group (Group 1)consisted of patients who underwent CABG using CPB and cross-clamp (on-pump);the second group (Group 2) consisted of patients who underwent CABG by beatingheart (off-pump) technique. Proximal anastomoses were performed using sideclamps in all cases.Results: Postoperativefollow-up was conducted on patients until Day 30 for mortality. We encounteredfour dead cases and six cerebrovascular accidents.Conclusion: The rates of cerebralaccidents (2.4% vs. 2.1%) and deaths (1.8% vs. 1%) have the same ratios and arenot statistically significant in on-pump CABG surgeries compared with off-pumpCABG surgeries., Giriş: Bu çalışma, son gelişmelerle pompalı/pompasız koroner arter baypas grafting(KABGO) uygulanan hastalarda, postoperatif erken dönemde (bir ayda), kardiyopulmonerbaypas (KPB)'ın erken mortalite ve serebral olay üzerine etkileri araştırıldı.Hastalar veYöntem: Çalışmamız, kliniğimizde koroner arter baypas greftlemeameliyatı yapılan toplam 260 olguyu içermektedir. KABGO uygulanan hastalar ikifarklı cerrahi tekniğe göre gruplandırıldı. Birinci grup (Grup 1), CPB ve Xklemp (on-pump) kullanılarak KABGO uygulanan hastalardan oluştu. İkinci grup(Grup 2), atan kalp (off-pump) tekniği ile KABGO uygulanan hastalardan oluştu.Proksimal anastomozlar tüm olgularda yan klemp kullanılarak yapıldı.Bulgular: Hastalar postoperatif otuzuncu güne kadar mortalite açısından takip edildi.Dört ölüm olgusu ve altı serebrovasküler olayla karşı karşıya kaldık.Sonuç: On-pump KABGOameliyatlarında off-pump KABGO ameliyatlarına kıyasla serebral kaza oranları(%2.4’e karşı %2.1) ve ölüm (%1’e karşı %1.8) benzer oranda görülürkenistatistiksel olarak anlamlı değildir.

Background While Continuous Renal Replacement Therapy (CRRT) is a well established treatment modality for patients with acute kidney insufficiency (AKI), it is now also being used for the management of various illnesses such as acute metabolic disorders presenting with hyperammonemia and elevated leucine levels. Herein, we aimed to describe our experience with CRRT in treatment of acute decompensation of 14 patients with a diagnosis of metabolic disorder who has been admitted to our pediatric intensive care unit (PICU) in the last year. Methods Patients who have had life threatening acute metabolic crisis due to various metabolic disorders and were treated with continuous renal replacement therapy (CRRT) were evaluated retrospectively. Results Between November 2014 and December 2015, 14 patients were found to have received CRRT for various metabolic disorders in the PICU. Ten patients had hyperammonemia and four patients had elevated leucine levels. Nine patients were male and five were female. The age interval was between 2 days and 18 months, with a mean of 5.5 ± 7.4 months. The weight distribution was between 2.5 and 18 kg, with a mean of 7.3 ± 5.6 kg. Eleven patients received continuous veno-venous hemodiafiltration (CVVHDF), and 3 patients with MSUD received continuous veno-venous hemodialysis (CVVHD). All patients have received high throughput hemodialysis and hemofiltration. The dialyzate rate was set to be minimum 4042 ml/h/1.73 m2, and maximum 12,900 ml/h/1.73 m2. Hemofiltration was performed with a replacement rate of 40–76 ml/kg/h. The average CRRT duration was 16.6 ± 15.6 h. Conclusions We suggest that CRRT is an efficient method that can be used in hyperammonemia and elevated leucine levels which are metabolic emergencies.

Varicella is a common, highly contagious viral infection of childhood. Varicella is a usually benign and self-limited disease, but it can be complicated by severe bacterial infections, especially in immunocompromised hosts. In this study, we describe a previously healthy 3-months-old infant who was admitted with high fever, cough, and respiratory distress, who had a history of varicella infection three weeks before, with exposure from her adolescent, unvaccinated sister. A lung abscess caused by Staphylococcus aureus complicating the varicella infection was discovered. The patient was aggressively treated with drainage of the abscess and intravenous antibiotics and had a good recovery. Keywords: Varicella, Lung abscess, Infant

Introduction: Peritoneal dialysis and continuous renal replacement therapy (CRRT) are the most frequently used treatment modalities for acute kidney injury. CRRT is currently being used for the treatment of several non-renal indications, such as congenital metabolic diseases. CRRT can efficiently remove toxic metabolites and reverse the neurological symptoms quickly. However, there is not enough data for CRRT in children with metabolic diseases. Therefore, we aimed a retrospective study to describe the use of CRRT in metabolic diseases and its associated efficacy, complications, and outcomes. Materials and Methods: We performed a retrospective analysis of the records of all patients admitted in the pediatric intensive care unit (PICU) for CRRT treatment. Results: Between December 2014 and November 2018, 97 patients were eligible for the present study. The age distribution was between 2 days and 17 years, with a mean of 3.77 &plusmn, 4.71 years. There were 13 (36.1%) newborn with metabolic diseases. The patients were divided into two groups: CRRT for metabolic diseases and others. There was a significant relationship between the groups, including age (p &le, 0.001), weight (p = 0.028), blood flow rate (p &le, 0.001), dialysate rate (p &le, 0.001), and replacement rate (p &le, 0.001). The leucine reduction rate was 3.88 &plusmn, 3.65 (% per hour). The ammonia reduction rate was 4.94 &plusmn, 5.05 in the urea cycle disorder group and 5.02 &plusmn, 4.54 in the organic acidemia group. The overall survival rate was 88.9% in metabolic diseases with CRRT. Conclusion: In particularly hemodynamically unstable patients, CRRT can effectively and quickly reduce plasma ammonia and leucine.

Children in paediatric intensive care units (PICUs) are vulnerable to infections because invasive devices are frequently used during their admission. We aimed to determine the prevalence, associated factors, and prognosis of infections in our PICU. This retrospective study evaluated culture results from 477 paediatric patients who were treated in the PICU between January 2014 and March 2019. Ninety patients (18.9%) had bacterial infections, with gram-negative bacteria being the predominant infectious agents. Culture-positive patients were younger than culture-negative patients, and age was related to mortality and various clinical factors. Culture-positive bacterial infections in the PICU were associated with increased use of invasive mechanical ventilation (odds ratio(OR), 2.254), red blood cell (RBC) transfusions (OR:2.624), and inotropic drugs (OR:2.262). Carbapenem resistance was found in approximately one-third of gram-negative bacteria, and was most common in tracheal aspirate specimens and cases involving Klebsiella spp. Total parenteral nutrition was a significant risk factor (OR:5.870). Positive blood culture results were associated with poorer patient survival than other culture results. These findings indicate that infections, especially those involving carbapenem-resistant bacteria, are an important issue when treating critically ill children.

Amac: Cocuk kardiyoloji poliklinigine senkop yakinmasi ile basvuran olgularin tani ve etiyolojiler inin aydinlatilmasi, bu dogrultuda yapilan laboratuvar calismalari, oz-soygecmis anamnezi ve fizik muayene bulgularinin etiyoloji ile iliskisinin incelenmesi. Gerec ve Yontem: Calismaya senkop yakinmasiyla Mart 2017-Ekim 2017 tarihleri arasinda poliklinigimize basvuran 67 olgu dahil edildi. Olgularin detayli anamnezleri, fizik muayene bulgulari kaydedildi. Ayrica, tum olgularin elektrokardiyografi ve ekokardiyografileri degerlendirilerek, sonuclar kayit edildi. Gerekli gorulen hastalarda kraniyal goruntuleme ve EEG yapildi. Bu verilerle olgulara vazovagal senkop, postural ortostatik tasikardi sendromu, ortostatik hipotansiyon, epilepsi, histerik nobet, katilma nobeti, egzersizle iliskili senkop tanilari konuldu. Analizlerde SPSS 22.0 programi kullanildi. Bulgular: Toplam 67 olgunun, 41’i (%61,2) kiz, 26’si (%38.8) erkek, yas ortalamasi 11,7±2,5 yil (2.5 - 17 yas arasi) olarak bulundu. Olgularin %64.2’sinde atak sirasinda veya sonrasinda solukluk, %34.3’unde bulanti, %32.8’inde ekstremitelerde uyusma ve karincalanma, %31.3’unde nefes kesilmesi, %20.9’unda eslik eden carpinti, %20.9’unda epigastrik huzursuzluk, %17.9’unda terleme ve %7.5’inde eslik eden gogus agrisi prodromal semptomlari goruldu. Vakalarin %68.7’sine vazovagal senkop (VVS), %9’una postural ortostatik tasikardi sendromu (POTS), %7.5’ine epilepsi, %4.5’ine histerik nobet, %4.5’ine ortostatik hipotansiyon (OH), %3’une egzersizle iliskili senkop ve %3’une katilma nobeti tanisi konuldu. Vazovagal senkop tanisi konan olgularin yakinmalari onlemler ile geriledi. Vakalarin hicbirinin fizik muayenesinde patolojik bulguya rastlanmadi. Bu vakalarin %6’sinda ilac kullanma oykusu, %14.9’unda EKO'da pozitif bulgu, %3’unde kranial MR bulgusu, %1.5'inde EEG’de anormallik saptandi. Cinsiyet faktorunun senkop etiyolojisine etkisi gozlenmedi. Sonuc: Cocukluk cagi vazovagal senkop hastalarinda oncelikli tedavi yontemi egitim ve tavsiyeler ile sivi ve tuz aliminin arttirilmasidir. Etiyolojide siklikla vazovagal senkop gozlense de diger senkop yapabilecek sebepler dikkatlice degerlendirilmelidir. Yineleyen senkop ataklari olan hastalarda beta bloker tedavisi denenmekle birlikte etkisi sinirlidir. Bu nedenle; egitim ve onerilerle kontrol altina alinamayan yineleyen vazovagal senkoplu hastalarda ilac tedavisi denenebilir.

Introduction:Thisprospective study investigated the effect of the valves of saphenous veins,which were used as conduits, on patency and the 2-year rate of remainingpatency of saphenous vein with valve, saphenous vein without valve, and radialart ery (RA) via multislice computerized tomography (MSCT) angiography.Patientsand Methods: Between 2014 and 2015, the patients that underwentcoronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) andcross-clamp (on-pump with cross-clamp) in our clinic were grouped into threegroups depending on the graft type. The first group (Group 1) was RA group, thesecond group (Group 2) was great saphenous vein with valve group, and the thirdgroup (Group 3) was great saphenous vein without valve group. Results: The 2-yearrates of the remaining patency of these grafts in the decreasing order was asfollowing: RA (87.5%), great saphenous vein without valve (82.4%), and greatsaphenous vein with valve (78.8%).Conclusion: The rate of remainingpatency was not statistically significant among the RA, saphenous vein withoutvalve, and saphenous vein with valve conduits (p> 0.05; RA vs. vein withoutvalve, p= 0.737; RA vs. saphenous vein with valve, p= 0.321; and saphenous veinwithout valve vs. saphenous vein with valve, p= 0.465)., Giriş: Çalışmamız prospektif bir çalışma olup yalnızca konduit olarak kullanılmışsafen venlerin kapakçıklarının açık kalma üzerine etkisi değil, aynı zamandakapaklı safen venin, kapaksız safen venin, radyal arterin iki yıllık açık kalmaoranı çok kesitli bilgisayarlı tomografi (ÇKBT) anjiyografi kullanılarakaraştırılmıştır.Hastalar veYöntem: Kliniğimizde 2014-2015 yılları arasında koroner arterbaypas greft operasyonu (KABGO) yapılmış hastalar üç farklı grefte göregruplandı. Gruplar kalp akciğer makinası ve X-klemp (On-Pump X-klempli)kullanılarak KABGO yapılan hastalarda kullanılan greftlere göre oluşturuldu.Birinci grup (Grup 1); radiyal arter grubu, ikinci grup (Grup 2); valvli safenven grubu, üçüncü grup (Grup 3); valv içermeyen safen ven grubu olarakbelirlendi.Bulgular: Greftlerde iki yıllık açık kalma oranı, radiyal arter için %87.5, kapaksız safen ven için %82.4 ve kapaklı safen ven için%78.8 bulunmuştur.Sonuç: Radiyal arter, kapaksızsafen ven, kapaklı safen ven arasında iki yıllık açık kalma oranları,istatistiksel olarak anlamlı değildir (p> 0.05; radiyal arter vs. valvsizven için p= 0.737; radiyal arter vs. valvli ven için p= 0.321; valvsiz ven vs.vavli ven için p= 0.465).

Giriş: Obstriktif uykuapnesi (OSA) şiddeti ile elektrokardiyogramdaki PR süresinin genişlemesiarasındaki ilişki ve PR süresini etkileyebilecek OSA şiddet indeksleri ileilişkisi araştırılmıştır.Hastalar ve Yöntem: Bu çalışma;kliniğimizde Ocak 2013 ve Ağustos 2014 tarihleri arasında, OSA tanısı almış 85kişiyi içermektedir. Polisomnografi (PSG) raporları alanında uzman hekimtarafından değerlendirildi. Şiddetli uyku apne hastalığı olan bireyler grup 1olarak adlandırılırken, orta, hafif uyku apne hastalığı olan bireyler grup 2olarak belirlendi.Bulgular: Çalışmayakatılan tüm bireylerin yaş dağılımı; minimum 20 yıl, maksimum 85 yıldır(ortalama ± standart sapma 45.5 ± 13.2 y). Bu kişilerin 51’i (%60) erkek, 34’ü(%40) kadındır. Polisomnografi şiddetli OSA tanısı alan bireyleri içeren grup1’de PR süresi 163.1 ± 35.2 milisaniye (ms) iken grup 2’de 147.8 ± 29.3milisaniye olduğu görüldü.Sonuç: Şiddetli OSA tanısı alanbireylerin, hafif ve orta şiddette OSA tanısı alan bireylere göre PRsürelerinin yüksek olduğu görüldü. Sonucun istatiksel olarak anlamlı olduğutespit edildi (p< 0.05, p= 0). OSA şiddeti göstergesi vehipoksi-reoksijenizasyon parametreleri olan AHI (apne-hipopne indeksi), ODI(oksijen desaturasyon indeksi); arousal değerleri PR uzamasında katkısağladığına inanmaktayız., Introduction:Relationship between obstructive sleep apnea (OSA)and electrocardiogram and OSA severity index relationship that may affect thePR interval were studied.Patientsand Methods: This study included 85 people who had OSAdiagnosed at our clinic between January 2013 and August 2013. Theirpolysomnography (PSG) reports were evaluated by physicians who are expert intheir fields. Individuals with severe OSA diseases were categorized as group 1,and individuals with mild to moderate OSA were categorized as group 2.Results: Agedistribution of individuals who participated to the study ranged from 20 yearsto 85 years (mean ± standard deviation, 45.5 ± 13.2 years). Fifty-one (60%) ofthose individuals were men, and 34 (40%) of them were women. The PR intervalfor the group who had severe OSA on PSG (group 1) was 163.1 ± 35.2 ms, and it was147.8 ± 29.3 in group 2.Conclusion: It was observed thatindividuals having severe OSA had higher PR intervals than individuals who hadmild to moderate OSA. It was determined that results were statisticallysignificant (p< 0.05, p= 0.032). We believe that apnea-hypopnea index,oxygen desaturation index, and arousal values, which are indications of OSAseverity and parameters of hypoxia-reoxygenation, contribute to PRprolongation.

Introduction: In our study COPD and non-COPD patients who underwent CABG were compared in terms of prolonged mechanical ventilation and lower respiratory tract infektion. Patients and Methods: A total of 233 patients without valvular pathology and connective tissue disorders, such as Marfan syndrome, who underwent isolated on-pump CABG in the Department of Cardiovascular Surgery were retrospectively studied. Preoperative laboratory tests and respiratory system test (Spirobank Spirometry, Medical International Research Product) were applied in patients who had pathology in respiratory system query or examination were performed at our clinic during the preoperative period. The severity of COPD in COPD patients was evaluated according to the COLD guideline. All patients were divided in two groups. The group including COPD patients was named group 1 and the other group including non-COPD patients was named gruop 2. Results: UMSD rates in groups 1 and 2 were 4.8% and 1.8%, respectively. Lower respiratory tract infection rates in groups 1 and 2 were 6.3% and 1.7%, respectively. Conclusion: According to our study, we can say that the rate of UMSB and lower respiratory tract infection occuring in treated COPD patients after CABG is statiscally indifferent according to non-COPD patient. (p= 0.348 for UMSD, p= 0.088 for lower respiratory tract infection).

Objective: The present study consisted of patients who underwent on-pump coronary artery bypass grafting (CABG) and off-pump CABG and investigated effect of using cardiopulmonary bypass (CPB) on the amount of postoperative drainage and blood products, red blood cell (RBC), free frozen plasma (FFP) given in the intensive care unit in 60-80-year-old patients who underwent CABG. Methods: The present study comprises a total of 174 patients who have undergone coronary artery bypass graft (off-pump or on-pump CABG) surgery in our clinic in between 2012-2015 year. Results: It was observed that the amount of drainage in the first 24 postoperative hours was lower in the on-pump CABG group (Group 1) when compared to off-pump group (Group 2) (Group 1 vs. Group 2; 703.5 +/- 253.8 ml vs. 719.6 +/- 209.4 ml; P=0.716). However, the amount of drainage in the second 24 hours was statistically significantly lower in the off-pump CABG group (Group 1 vs. Group 2; 259.8 +/- 170.6 ml vs. 190.1 +/- 129.1 ml; P=0.016). With regard to the amount of overall drainage, no statistically significant difference was observed between the two groups. Group 1 needed RBC transfusion higher than Group 2 (Group 1 vs. Group 2; 2.2 +/- 1.3 bag vs. 1.2 +/- 0.9 bag; P

Introduction: Gamma glutamyl transferase (GGT) and uric acid (UA) are reported to be predictive markers in various disorders. It has been reported that these biomarkers can be used to indicate increased risk of mortality in critically ill patients. Herein, we aimed to evaluate the effects of the initial serum GGT and UA levels on the outcomes of patients in the pediatric intensive care unit (PICU) and to investigate if these biomarkers can be used to predict pediatric mortality. Materials and Methods: The relationship between the initial GGT and UA levels and invasive mechanical ventilation (IMV) and noninvasive mechanical ventilation (NIV) support, inotropic drug need, acute renal kidney injury (AKI), continuous renal replacement therapy (CRRT), presence of sepsis, mortality, and hospitalization period were investigated retrospectively. Results: In all, 236 patients (117 males and 119 females) were included in the study. The age distribution of the patients was 1&ndash, 12 years. There was a statistically significant relationship between GGT levels in the first biochemical analysis performed during admission and inotropic drug use, AKI, duration of hospitalization in intensive care unit, and sepsis. There was a statistically significant relationship between initial UA levels and inotropic drug use, AKI, CCRT, and sepsis. Conclusion: We suggest that initial GGT and UA levels during admission could be used to predict the outcomes of patients in PICU.

Introduction. Procalcitonin (PCT) and C-reactive protein (CRP) are already known predictive markers in serious bacterial infections, and it is emphasized that these biomarkers can be used as a marker of increased mortality in critically ill patients. Herein, we aimed to evaluate the initial serum PCT and CRP levels on the outcome of patients in pediatric intensive care units (PICUs) and find out if these biomarkers can be used to predict mortality. Materials and Methods. The relationship between the initial serum PCT and CRP levels and invasive mechanical ventilation (IMV) and noninvasive mechanical ventilation (NIV) support, inotropic drug need, acute renal kidney injury (AKI), continuous renal replacement therapy (CRRT), mortality, and hospitalization period was investigated retrospectively. Results. In total, 418 suitable patients (226 males and 192 females) were included in the study. Age distributions of patients ranged from 1 month to 17 years. There was a statistically significant relationship between PCT levels in the first biochemical analysis performed during admission and MV support, inotropic drug use, mortality, ARF, hospitalization in the intensive care unit, CRRT and blood component transfusion. There was a statistically significant relationship between CRP levels and MV support, NIV, inotropic drug use, mortality, AKI, hospitalization in the intensive care unit, CRRT, and blood component transfusion. Conclusion. We suggest that the initial PCT and CRP levels during admission can be used to predict the outcome of patients in PICU.

Background: Acute kidney injury (AKI) is a serious clinical condition in children admitting to the pediatric intensive care unit. Beside having the risk of significant morbidity and mortality, AKI has also increased the risk for chronic kidney disease. However, there is paucity of data regarding AKI epidemiology in children. Herein, we aimed to describe the incidence, risk factors, and outcome of AKI in critically ill children. Methods: The records of patients, who were hospitalized in our pediatric intensive care unit between October 2016 and March 2018 were investigated retrospectively. The relationship between AKI and the need of invasive mechanical ventilation and non-invasive mechanical ventilation, inotropic and nephrotoxic drug use, initial laboratory findings, continuous renal replacement need, pediatric risk of mortality-III score (PRISM-III), duration of hospitalization, and mortality rate were investigated. Results: Totally, 447 patients were found to have been included in the study. The AKI developed in 111 patients. The sepsis was the most common underlying disease with 27 patients (24.3 %). There was a statistical significance between development of AKI and the need of invasive mechanical ventilation, inotropic and nephrotoxic drug use, PRISM-III score, continuous renal replacement need, plasma exchange, blood component transfusion, duration of hospitalization, and mortality. Conclusions: The AKI is associated with prolonged hospitalization and increased mortality. AKI should be considered as a medical emergency that should be diagnosed and managed accurately.