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Aim: Hyperchloremia is related to the risks of several morbidities and mortality in seriously sick cases. The effect of hyperchloremia on the incidence of acute kidney injury (AKI) in trauma patients is not well known. Association of hyperchloremia and AKI within the first 72 hour of pediatric intensive care unit (PICU) admission in pediatric trauma patients was investigated. Materials and Methods: A total of 137 patients with major trauma were investigated retrospectively from tertiary hospital. Serum chloride levels = 110 mmol/L described as hyperchloremia. Clinical and laboratory data were compared between AKI and non-AKI. A multivariate logistic regression analysis was used to determine the association between hyperchloremia and AKI. Results: Totally 109 children were favorable for evaluation following the application of suitability criteria. On admission and at 72 hours, electrolyte measurements were similar between two groups, however chloride level was significantly higher in AKI group (112.33 ± 4.74 vs. 109.07 ± 4.90 mmol/L; p<0.01) at 72 hours. Ratio of hyperchloremia was remarkably more common in AKI group (p<0.01). Hyperchloremia at 72 hours was ensured as an independent risk factor for AKI of pediatric patients with major trauma in the multivariate logistic analysis. Conclusion: Hyperchloremia frequently seen among major trauma patients adopted to the PICU, and appear to be related to an increased risk for AKI within the first 72 hour of admission. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to compare the mechanical, thrombotic, and infectious complication ratio of the internal jugular vein with those of femoral vein catheterization. Materials and Methods: It is a single-center retrospective study. One hundred seventynine pediatric patients undergoing central venous catheter insertion in the intensive care unit were selected from February 2020 to August 2021. The patients were divided into 2 groups based on catheter type; internal jugular versus femoral venous catheterization. Procedure complications rates were assessed. However, jugular catheterization was performed under ultrasound guidance, and femoral venous catheterization was inserted via an original landmark-based technique. Thromboprophylaxis was performed on all patients without coagulopathy. Results: The overall rate of procedural complications was 20%. The subcutaneous hematoma was the most common mechanical complication and higher in femoral attempts (p= 0.001), followed by arterial injury (p= 0.002). Thrombotic complications were similar between the two groups (p= 0.053). Infections complications were higher in femoral venous catheterization (p= 0.016). Conclusion: Femoral venous catheterization is associated with a greater risk of mechanical and infectious complications than internal jugular venous catheterization. Usage of ultrasound during catheterization procedures decreases mechanical complications. [ABSTRACT FROM AUTHOR]

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Objectives: The aim of the present study was to determine the prognostic value of thrombocytopenia, platelet indices (MPV/PLT and PDW/PLT) in children with septic shock., Background: Septic shock is one of the major causes of mortality among children worldwide., Methods: A retrospective analysis was made of children admitted to the pediatric intensive care unit between November 2010 and December 2019. Two hundred four children were included; they were diagnosed with septic shock according to the international pediatric sepsis consensus conference criteria. The MPV/platelet ratio and PDW/platelet ratios were estimated as the MPV and PDW values divided by the platelet count on the first three days of hospitalization. The clinical outcome was 28-day mortality., Results: MPV/PLT and PDW/PLT ratios were found to be significantly higher in the non-survivors than survivor (p≤0.001). In the multivariate logistic regression analysis, higher MPV/platelet ratios at 72h (OR: 7.41; 95% CI: 1.25-43.7; p=0.027) and PDW/platelet ratios at 72h (OR: 2.9; 95% CI: 1.13-7.50; p=0.027) were significant risk factors for mortality., Conclusions: Platelet indices are useful laboratory parameters in septic shock. MPV/PLT and PDW/PLT ratios can be promising reliable markers for 28-day mortality in children with septic shock (Tab. 4, Fig. 1, Ref. 29).

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 disease 2019, treatment modalities, and loss of workdays were recorded., Results: Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 ± 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died., Conclusion: Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients.

Brucella infections have a wide spectrum of symptoms especially in children, making the diagnosis a complicated process. The gold standard for the final diagnosis for brucellosis is to identify the Brucella spp. isolated from blood or bone marrow cultures. The main purpose of this work was to evaluate the factors affecting the isolation of Brucella spp. from blood cultures. In our study, the ratio of fever, presence of hepatomegaly, and splenomegaly were found to be higher in the bacteremic group. In addition, C-reactive protein levels and liver function enzymes were found to be higher in the bacteremic group. In our opinion, while evaluating the febrile child with suspected Brucella infection, we highly recommend sampling blood cultures regardless of the history of previous antimicrobial therapy and duration of the symptoms.