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Earthquake-induced crush syndrome and subsequent acute kidney injury are important issues that affect morbidity and mortality. Fasciotomies prolong the length of stay in intensive care unit in patients with compartment syndrome due to the complications it causes. Infections and delayed wound healing are two common complications among these. Therefore, early closure of fasciotomy wounds is recommended. Although different treatments can be applied for treatment of wounds, data on this subject in pediatric patients are insufficient. We report the case of a 15-year-old girl who developed acute renal failure due to crush syndrome after being trapped in the wreckage for 9 hours and undergoing fasciotomy procedures for four locations, in the left extremity, two in the thigh and two in the cruris. Hemodialysis, antihypertensive, and antibiotic treatment were administered during the intensive care follow-up due to acute kidney injury, hypertension, and sepsis. With negative pressure therapy, silver alginate wound dressing, and hyperbaric oxygen therapy, all wounds epithelialized within two months. However, rehabilitation for drop foot syndrome caused by nerve cuts in the left extremity continues. [ABSTRACT FROM AUTHOR]

Objectives: Hyponatremia is known to increase mortality and morbidity in adult patients. However, the significance of hyponatremia in critically ill pediatric patients is unknown, unlike in adults. We tried to determine the prevalance of hyponatremia in critically ill children and whether the severity of hyponatremia contributes to hospital stay and mortality. Methods: The results of 190 patients who met the inclusion criteria and were admitted to the pediatric intensive care unit between April 2014 and April 2017 were analyzed. Results: Eighty-six (45.3%) patients developed hyponatremia at the time of hospitalization, and Hospital-Acquired Hyponatremia (HAH) developed in 46 (24.2%) patients during the hospitalization. Fifty-eight (30.5%) patients were normonatremic. The patients in the HAH group were significantly more septic (p = 0.015). The duration of intensive care hospitalization was significantly longer in the HAH group (p < 0.001) and significantly less in the normonatremic group (p = 0.008). Total mortality was 41% (n = 78). There was no difference between the groups regarding mortality (p = 0.4). However, the degree of hyponatremia was associated with mortality. Mortality was 24.1% in mildly hyponatremic patients, 45.6% in moderate patients, and 58.8% in severe patients (OR: 2.636, 95% CI: 1.189-5.842; OR: 4.490, 95% CI:1.439-14.008, p = 0.01). We discovered that as hyponatremia severity increased, so did the length of stay in the intensive care unit, the need for invasive ventilation, and the need for vasoactive drugs (p = 0.009, p = 0.018, and p = 0.006, respectively). Conclusions: Unlike adults, the prognostic value of hyponatremia in terms of mortality has not been determined in critically ill children. However, as the severity of hyponatremia increased, it was seen that the length of stay in the intensive care unit and mortality increased. [ABSTRACT FROM AUTHOR]

Objectives: Very few studies have been conducted to identify the conditions that cause poisoning in pediatric patients needing intensive care, both by age group and toxic agent factor. This study will support the development of strategies for poisoning prevention measures by comparing the data in our region with other data in the world. Methods: This study is a single-centered, retrospective study. The baseline status of acute poisoning was defined in pediatric patients aged one month to 18 years who required intensive care hospitalization between November 2017 and March 2022. Results: There were 148 patient admissions due to acute poisonings (5.2% of all admissions, 69.6% females, median age: 13.6 months). Our study revealed that acute poisoning in children is caused mainly by pharmacological (88.5%), oral intake (97.3%) and at home (85.8%). It was observed that intoxication peaked at two different ages; the first peak was at preschool (33.1%), and the second peak was at adolescence (58.7%). In the univariate analysis, females (odds ratio [OR] = 4.1), adolescents (OR = 167.6), psychiatric drug users (OR = 55.5), and multiple drug intoxications (OR = 3.6) were associated with more suicides. Being adolescents and using psychiatric medication contributed significantly to suicide attempts in multivariate analysis (OR = 145.3 and OR = 37.9). None of our patients died. Conclusions: Preventing both poisoning and suicide attempts is the most critical priority. However, we suggest prevention strategies should be strengthened even if mortality is not observed. Furthermore, our study shows that suicide attempts are very likely to be repeated, especially if an underlying psychiatric illness exists. [ABSTRACT FROM AUTHOR]