Dincer Yildizdas

Cukurova University | CU · Department of Pediatric Surgery

Background. Pain and sedation management is an integral part of pediatric intensive care practice. Sedoanalgesia management must be balanced in order to optimize comfort and avoid complications. In order to achieve this balance, sedoanalgesia management needs to be clarified in pediatric intensive care units (PICU). With this study, we aimed to inv...

High-flow nasal cannula oxygen therapy (HFNC) is increasingly used in the treatment of acute respiratory failure. It has important effects in patients with respiratory distress. In our study, we planned to share our HFNC experiences in our newly established pediatric intensive care unit. All children between the ages of 1 month and 18 years were in...

Objectives The aim was to evaluate the current status of point-of-care ultrasound (POCUS), perceptions, education, training, and barriers to using POCUS in pediatric emergency departments (PEDs) and pediatric intensive care units (PICUs) in Turkey. Methods A descriptive, multicenter, cross-sectional study through an online survey was developed usi...

Background Continuous kidney replacement therapy (CKRT) has recently become the preferred kidney replacement modality for children with acute kidney injury (AKI). We hypothesise that CKRT technical parameters and treatment settings in addition to the clinical characteristics of patients may influence the circuit lifetime in children. Methods The s...

Objective: The aims of this study were to compare the results of ultrasound (US) guidance and the landmark (LM) technique for central venous catheter (CVC) placement in pediatric intensive care units (PICUs) as performed by clinicians. Material and Methods: The patients were divided into two groups according to the technique used: an LM group (459...

Objective To identify urinary catheter (UC)–associated urinary tract infection (CAUTI) incidence and risk factors. Design A prospective cohort study. Setting The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries. Participants The study included...

Introduction Traumatic brain injury (TBI) has become a significant cause of death and morbidity in childhood since the elucidation of infectious causes within the last century. Mortality rates in this population decreased over time due to developments in technology and effective treatment modalities. Aim of the study This retrospective cohort stud...

Crush syndrome due to traumatic rhabdomyolysis is one of the most significant problems to occur following earthquakes. On February 6, 2023, millions of people in Turkey were affected by two consecutive Kahramanmaraş earthquakes. The present study reports the analysis of clinical and laboratory findings of crush syndrome in pediatric earthquake vict...

Background Central venous catheterization is performed for such reasons as hemodynamic monitoring, parenteral nutrition, drug and fluid administration, and extracorporeal treatment. This study aimed to retrospectively review the indications for central venous catheter (CVC) insertion for vascular access and removal by pediatric intensive care unit...

Purpose: The aim of this study was to determine the drug-drug interactions that are frequently encountered in critically ill patients and the factors that predict these interactions. Materials and Methods: All patients who were admitted to the pediatric intensive care unit (13 bed) of a university hospital and used more than one drug in their treat...

Objective: Prevention and management of malnutrition are important in critically ill children. Parenteral nutrition (PN) is considered for patients who cannot tolerate enteral feeding. There are many reasons why PN cannot be delivered in the prescribed amount. We aimed to evaluate whether PN is delivered as prescribed in the pediatric intensive car...

Introduction: Malnutrition is defined as a pathological condition arising from deficient orimbalanced intake of nutritional elements. Factors such as increasing metabolic demandsduring the disease course in the hospitalized patients and inadequate calorie intakeincrease the risk of malnutrition. The aim of the present study is to evaluate nutrition...

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritio...

Purpose The aim of this study was to determine the clinical, laboratory, and radiological factors related with posttraumatic epilepsy (PTE). Methods The study is a multicenter descriptive cross-sectional cohort study. Children who followed up for TBI in the pediatric intensive care unit between 2014 and 2021 were included. Demographic data and cli...

Pregabalin is a drug used to treat neuropathic pain, epilepsy, and fibromyalgia. However, the number of reported cases of pregabalin abuse is steadily growing. This case showed dystonia, an effect not previously documented as a consequence of pregabalin administration. A 16-year-old male patient with no known pre-existing medical conditions was adm...

Background: The aim of this study was to analyze the characteristics of pediatric posterior reversible encephalopathy syndrome (PRES) to determine clinical and radiologic differences between younger and older age groups, and to identify risk factors for development of any neurologic sequelae. Methods: The study cohort consisted of confirmed pedi...

Microbiota composition might play a role in the pathophysiology and course of sepsis, and understanding its dynamics is of clinical interest. Invasive meningococcal disease (IMD) is an important cause of community-acquired serious infection, and there is no information regarding microbiota composition in children with meningococcemia. In this study...

Objective: To identify central-line (CL)-associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs). Design: From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms. Setting: T...

The limited energy stores and fast metabolism of sick children in the intensive care unit, as well as the intense stress caused by the critical illness, reveal the importance of nutrition. Adequate and balanced nutritional care for critically ill children improves the clinical course and prognosis. In order to provide appropriate nutritional suppor...

Background: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population...

Objective: Factors such as increased metabolic needs and inadequate calorie and protein intake increase the risk of malnutrition in critically ill children admitted to the pediatric intensive care unit. This study aimed to determine the risk of malnutrition and associated clinical outcomes. Materials and methods: Data from all patients aged 1 mo...

Purpose The International Nosocomial Infection Control Consortium (INICC) found a high mortality rate in ICUs of the Middle East (ME). Our goal was to identify mortality risk factor (RF) in ICUs of the ME. Materials From 08/01/2003 to 02/12/2022, we conducted a prospective cohort study in 236 ICUs of 77 hospitals in 44 cities in 10 countries of ME...

Background: A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm...

Incidence of diabetes during pregnancy is increasing worldwide, and intrauterine hyperglycemia exposure may have long-term adverse effects on the cardiovascular health of children. We investigated prospectively the risk of atherosclerosis and carotid intima-media thickness (CIMT) in infants born macrosomic and in infants of diabetic mothers (IDM) a...

Introduction:The aim of this study was to determine the caregiver burden of mothers of patients who were treated in a university hospital pediatric intensive care unit and had tracheostomy.Methods:The mothers of 41 patients who were hospitalized and received tracheostomy at Çukurova University Medical Faculty Pediatric Intensive Care Unit between 1...

Background The diagnosis of brain death is a clinical condition in which it is difficult to perform confirmatory tests due to the ineligible clinical status of the patient. Prior to confirmatory tests, the use of a BIS monitor to determine the time of brain death is important for organ transplants, cost-effectiveness and reducing stressful wait of...

Epidemiology of paediatric severe sepsis and septic shock

Objective: In patients with severe traumatic brain injury, it is possible to obtain a good long- term prognosis, prevent secondary injury, and decrease morbidity and mortality with the administration of appropriate treatments in the acute period. This study aims to evaluate the approaches of the pediatric intensive care specialists in Turkey towar...

Aim: This study was aimed at characterizing the prevalence, management, and outcomes of pediatric severe sepsis and septic shock in tertiary pediatric intensive care units (PICUs) in Turkey. Methods: A point prevalence study was conducted on five days over the course of one year in 29 PICUs in Turkey. Outcomes included severe sepsis and septic s...

Introduction: There have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (...

Objective: To evaluate the safety and functionality of the transhepatic approach as an alternative route for central venous catheterization in pediatric patients with chronic critical illness. Methods: The study included data of 12 chronic critically ill pediatric patients who underwent central venous catheterization with transhepatic approach....

Low cardiac output syndrome is a clinical picture insourcing from insufficient oxygen sup- ply to tissues so as to meet the metabolic demand, myocardial dysfunction, and cardiovas- cular insufficiency. Low cardiac output syndrome is seen in nearly 25% of pediatric patients who underwent corrective or palliative surgery due to congenital heart defec...

Purpose: Incidence of diabetes during pregnancy is increasing worldwide, and intrauterine hyperglycemia exposure may have long-term adverse effects on the cardiovascular health of children. We investigated risk of atherosclerosis and carotid intima-media thickness (CIMT) in infants born macrosomic and in infants of diabetic mothers (IDM) at the age...

Background The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. Methods This was a mu...

Objective We aimed to evaluate and compare the prognostic performance of common pediatric mortality scoring systems (the Pediatric Index of Mortality 2 [PIM2], PIM3, Pediatric Risk of Mortality [PRISM], and PRISM4 scores) to determine which is the most applicable score in our pediatric study cohort. Methods This prospective observational multicent...

Background: Assessment of intravascular volume status is important in pediatric patients admitted to the emergency departments and pediatric intensive care units. Inferior vena cava (IVC) diameter and collapsibility index are used to evaluate the intravascular volume status in adults. The normal range of IVC diameter is available for adults and th...

Rapid assessment of cerebral dysfunction is crucial for the management of patients in intensive care units. The Glasgow Coma Scale (GCS) evaluates eye, verbal, and motor responses, but is insufficient to effectively evaluate patients on mechanical ventilation, or who are unable to speak. The Full Outline of Unresponsiveness (FOUR) score includes ad...

Central venous catheterization interventions are used in various clinics for diagnostic and treatment purposes. Establishing vascular access is a difficult and critical step, especially in critically ill pediatric patients. Complications include ventricular arrhythmia, air embolism, carotid artery puncture, cardiac tamponade, pneumothorax, hemoth...

Background: Candida urinary tract infections (UTIs) are common nosocomial infections among critically ill patients hospitalized in pediatric intensive care Units (PICU). We aimed to report outcomes of critically ill pediatric patients who received micafungin for hospital acquired Candida UTIs. We analyzed treatment success rates and success rates a...

Objective: This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units. Materials and methods: This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus d...

Objective The objective of this study was to detect variables associated with burnout syndrome (BS) in pediatric intensive care units (PICUs) and pediatric emergency medicine departments (PEDs) in high-volume centers from different parts of Turkey. Methods An observational, cross-sectional multicenter study was performed. The Maslach Burnout Inven...

The management and monitoring of sedoanalgesia are important measures in improving the efficacy of procedures and mechanical ventilation, as well as reducing adverse effects and preventing withdrawal syndrome, and delirium in pediatric intensive care units (PICUs). As there is an ongoing need to clarify the best approach to sedoanalgesia in PICUs,...

Background The increased intracranial pressure (ICP) syndrome may emerge depending on many different neurological factors and the early diagnosis and treatment are important for the prevention of neurologic damage and related mortality. In recent years, the follow-up of increased ICP with non-invasive methods has been rising. In this study, our obj...

Meningococcal infections that have high mortality and morbidity in childhood and progress rapidly are an important health problem. It is one of the most important emergent diseases of the infectious diseases. Neisseria meningitidis has 13 serogroups. A, B, C, Y and W135 are the most common cause of invasive diseases among these serogroups. The outc...

Objective: We aimed to investigate the rate of brain death (BD) determinations and organ donations (OD) in our tertiary pediatric intensive care unit (PICU), and to report the data on the demographic pattern and supplementary descriptive data on BD declarations. Methods: The study was designed as a retrospective, single-center, descriptive cohort s...

Yatakbaşı ultrasonografi kullanımı çocuk yoğun bakım uzmanları için artan bir popülariteye sahiptir. Çocuk yoğun bakımlarda tedavi gören kritik hasta çocuklar için yatakbaşı ultrasonografinin farklı kullanım alanlarında sağladığı pek çok avantajı mevcuttur. Bu teknik yatakbaşında tekrarlanabilir ölçümlere olanak sağlar, noninvazivdir ve radyasyon i...

Sürekli renal replasman tedavisi yavaş ve sürekli sıvı uzaklaştırması ve asit-baz dengesini koruması avantajları nedeni ile son yıllarda çocuk yoğun bakım ünitelerinde tedavi gören kritik hasta çocuklarda hemodiyaliz ve periton diyalizine göre daha sıklıkla tercih edilen bir yöntem olarak öne çıkmıştır. Ancak bu ekstrakorporeal yöntemin optimal çal...

Although the number of studies evaluating methods to predict fluid overload is increasing, the assessment of fluid status in children on dialysis is still fraught with inaccuracies. We aimed to evaluate the predictive capability of lung ultrasounds and the inferior vena cava collapsibility index (cIVC) in predialysis overhydration in children with...

Background Acute kidney injury (AKI), particularly that requiring dialysis, is a severe complication in hospitalized children associated with high morbidity and mortality. A prospective European AKI registry (EurAKId registry, NCT02960867) was created to describe the epidemiology and outcomes of pediatric patients treated with acute dialysis. Meth...

Aim:In this retrospective study, our objective was to evaluate children with arterial or venous thromboembolism, who were treated with tissue plasminogen activator (tPA) in our hospital.Materials and Methods:The medical records of 56 tPA treatments administered to 53 patients with thrombosis in the paediatric intensive care unit and paediatric clin...

OBJECTIVE: Acute respiratory distress syndrome (ARDS) is a clinical picture that indicates severe acute hypoxemic respiratory insufficiency. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are convenient, uncomplicated, and inexpensive parameters that can be used in detecting the severity of the disease. The prognostic r...

We report a case of an acquired Bartter-like syndrome (BLS) after 3 days of treatment initiation and improved after discontinuation of colistin therapy in pediatric intensive care unit. A 2-month-old girl with spinal muscular atrophy type 1 who had respiratory distress received colistin therapy with a dose of 5 mg/kg/day for Acinetobacter baumannii...

Purpose: The aim of this study was to evaluate the lung-protective mechanical ventilation strategy, early enteral nutrition, negative fluid balance, and adequacy of hospital resources in our pediatric intensive care unit. Materials and Methods: This study included 32 patients who developed acute respiratory distress syndrome (ARDS) during their mon...

Introduction:The causes of intoxication can vary from country to country, from region to region within the same country and even in the same region over the years. In this study, the patients with intoxication diagnosis were evaluated in terms of their demographic characteristics, intoxication reasons and also the factors causing intensive care hos...

This study was aimed to evaluate the success rate of high-flow nasal cannula (HFNC) oxygen therapy and factors causing therapy failure. This prospective observational study included 131 children who received HFNC oxygen and followed-up in the pediatric emergency department, pediatric clinics, and pediatric intensive care unit between March 2018 and...

Background: The number of studies evaluating delirium and its frequency in critically ill infants, children, and adolescents is increasing day by day. The primary objective of this study was to evaluate all patients hospitalized in our pediatric intensive care unit (PICU) in terms of pediatric delirium, to determine the frequency and risk factors...

Objectives: Guidelines for the pediatric severe traumatic brain injury were published in 2003, 2012, 2019 in order to establish a common treatment approach. In this study, our aim is to evaluate the approaches of the pediatric intensive care specialists in Turkey, towards the follow-up and treatment of severe traumatic brain injury through a survey...

Background: Measurement of the optic nerve sheath diameter (ONSD) with point-of-care ultrasound (POCUS) is a non-invasive and radiation-free technique that can be used to assess increased intracranial pressure (ICP). Ophthalmic artery and central retinal artery Doppler indices can be used like transcranial Doppler to evaluate increased ICP. This s...

Rapid assessment of cerebral dysfunction is crucial for the management of patients in intensive care units. The Glasgow Coma Scale (GCS) evaluates eye, verbal, and motor responses, but is insufficient to effectively evaluate patients on mechanical ventilation, or who are unable to speak. The Full Outline of Unresponsiveness (FOUR) score includes ad...

The primary objective of this study was to evaluate whether pediatric respiratory rate-oxygenation index (p-ROXI) and variation in p-ROXI (p-ROXV) can serve as objective markers in children with high-flow nasal cannula (HFNC) failure. In this prospective, single-center observational study, all patients who received HFNC therapy in the general pedia...

Introduction:Providing support for early enteral nutrition reduces the severity and complications of the disease, shortening the length of stay in the intensive care unit and affecting the patients positively. Although there is not enough evidence about when to start feeding in intensive care patients, it is recommended to start feeding within 24-4...

Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinica...

ABSTRACT Objective: In this study, we have planned to present the results of a national survey performed to evaluate the last situation of pediatric intensive care specialty and pediatric intensive care units in Turkey. Material and Methods: We have sent an electronic survey which includes 47 questions about the characteristics of pediatric intensi...