Presenter of 3 Presentations
EVALUATION OF HEALTHCARE CANDIDEMIA AND TREATMENT PROTOCOL IN PEDIATRIC INTENSIVE CARE
Abstract
Background
In recent years, a clear increase has been observed in the incidence of nosocomial fungal infections.
Objectives
The aim of this study is to assess the candida species, treatment approaches and outcomes of candida infections were identified in the pediatric intensive care unit.
Methods
The study was performed from March 2018-March 2019 in a 14-bed tertiary pediatric intensive care in a city hospital. The patients with invasive candidiasis were detected from microbiology laboratary records and medical records were examined retrospectively.
Results
Within one year, a total of 176 patients were treated in the intensive care unit. Of these patients, 28 (15.7%) had candida isolated species . The most common isolated species was C. albicans in 35.7%. Among non-albican species, C. tropicalis was most commonly isolated in 25%, followed by C. parapsilosis observed in 10.7%.
In 5 patients, antifungal treatment was not started because of no systemic findings.
Mortality occurred in 6 of these patients (21%). In 5 patients, the cause of mortality was considered to be candida sepsis. There was no correlation identified between candida species and mortality.
Some of the Candida species were observed to be resistant to fluconazole, flucytosine and caspofungin. Proliferation in patients with mortal progression were resistant species. However, all candida species were susceptible to micafungin.
Conclusion
In this study, duration of intensive care stay and invasive medical proocedures are associated with an increased risk of invasive candidiasis. Additionally, it is confirmed that micafungin is a more appropriate agent that can be chosen for administration of antifungal treatment.
ASSESSMENT OF PIM3 AND PELOD2 SCORES OF CHILDREN WHO CAME FROM THE WAR IN SYRIA
Abstract
Background
Since the civil war in Syria began, millions of Syrians have left the country and been forced to migrate to other countries. Turkey is the country with most migration hosting 3.6 million refugees.
Objectives
The aim of this study was to compare the PIM-3, PELOD-2, PELOD-2 PDR, mortality rates and outcomes of patients who were admitted to the pediatric intensive care unit.
Methods
This was a retrospective study performed between February 2018 and February 2019 at Hatay State Hospital, very close to the Syrian border. The study included 158 patients. Patients were divided into 3 groups as Turkish citizens, those living in Turkey as refugees and those brought from the border.
Results
Of patients, 57 were Turkish citizens, 33 were refugees and 68 were brought from the border. For patients, the mean PIM-3 score was 25.62±27.70, PELOD-2 score was 8.03±4.72 and PELOD2-PDR was 16.07±23.45. The median scores for PIM-3, PELOD-2, and PELOD2-PDR of patients brought from the Syrian border were evaluated to be higher compared to Turkish citizens and refugees. There was no significant difference observed between refugees and Turkish citizens(Table1). Of patients who died, 59.20% comprised patients brought from the border(Table2)
Conclusion
It is considered that the source of the difference between patients brought from the border and living within Turkey may be associated with the continuing war beyond our borders and children experiencing insufficient care conditions.
In conclusion, war doesn't just cause death due to weapons but also due to many different causes and unfortunately, children suffer most because of this situation.
THE COMPARISON OF THE CARDIAC INDEX VALUES MEASURED BY CRITICAL CARE ECHOCARDIOGRAPHY WITH THE VALUES MEASURED BY PICCO IN THE PEDIATRIC INTENSIVE CARE UNIT
Abstract
Background
Pulse index Contour Cardiac Output (PiCCO) monitoring is an invasive, hemodynamics monitor and provides continuous cardiac output (CO) and cardiac index (CI), preload, systemic vascular resistance index measurements. Use of critical care echocardiography by the pediatric intensivists has been increased. Cardiac output and CI can be measured with echocardiography.
Objectives
In this study we aimed to compare the CO and CI values which were measured by pediatric intensivists with critical-care echocardiography and measured by PiCCO monitor in critically ill pediatric patients.
Methods
A total of 49 echocardiographic measurements were performed and recorded from 15 patients with diagnosis of septic shock, cardiogenic shock, acute respiratory distress syndrome, pulmonary edema. Echocardiographic measurements were performed by two pediatric intensive care fellows. The distance of left ventricle outflow tract (LVOT) in parasternal longer axis and LVOT-Velocity Time Integral (LVOT-VTI) measurement was performed in the apical five chamber image. Cardiac output_echocardiography (CO_echo) and CI_echocardiography (CI_echo) was calculated with these measurements. PiCCO monitoring was performed.
Results
Cardiac output (CO_picco) and CI (CI_picco) measured by PiCCO simultaneously with echocardiographic measurements were recorded another researcher who blind to echocardiographic measurements. We detected strong positive correlation between CO_echo and CO_picco measurements (p<0.001, r=0.985) and a strong positive correlation between CI_echo and CI_picco measurements (p<0.001, r=0.943).
Conclusion
According to our study results we suggested that echocardiographic CO measurements which will be performed by an experienced pediatric intensive care team with critical care echocardiography may be as valuable as PiCCO measurements in the management of the fluid and vasoactive-inotropic treatment of critically ill pediatric patients.
Video on Demand
Presenter of 1 Presentation
EVALUATION OF HEALTHCARE CANDIDEMIA AND TREATMENT PROTOCOL IN PEDIATRIC INTENSIVE CARE
Abstract
Background
In recent years, a clear increase has been observed in the incidence of nosocomial fungal infections.
Objectives
The aim of this study is to assess the candida species, treatment approaches and outcomes of candida infections were identified in the pediatric intensive care unit.
Methods
The study was performed from March 2018-March 2019 in a 14-bed tertiary pediatric intensive care in a city hospital. The patients with invasive candidiasis were detected from microbiology laboratary records and medical records were examined retrospectively.
Results
Within one year, a total of 176 patients were treated in the intensive care unit. Of these patients, 28 (15.7%) had candida isolated species . The most common isolated species was C. albicans in 35.7%. Among non-albican species, C. tropicalis was most commonly isolated in 25%, followed by C. parapsilosis observed in 10.7%.
In 5 patients, antifungal treatment was not started because of no systemic findings.
Mortality occurred in 6 of these patients (21%). In 5 patients, the cause of mortality was considered to be candida sepsis. There was no correlation identified between candida species and mortality.
Some of the Candida species were observed to be resistant to fluconazole, flucytosine and caspofungin. Proliferation in patients with mortal progression were resistant species. However, all candida species were susceptible to micafungin.
Conclusion
In this study, duration of intensive care stay and invasive medical proocedures are associated with an increased risk of invasive candidiasis. Additionally, it is confirmed that micafungin is a more appropriate agent that can be chosen for administration of antifungal treatment.