14 results on '"Ulgen Tekerek N"'
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2. PP117 [Infections » Sepsis]: NASOPHARYNGEAL MICROBIOTA ANALYSIS OF CHILDREN WITH MENINGOCOCCEMIA IN PEDIATRIC INTENSIVE CARE UNIT: INMACS-PICU STUDY
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Bozan, G., primary, Aslan, K., additional, Kiral, E., additional, Perez Brocal, V., additional, Sevketoglu, E., additional, Uysal Yazici, M., additional, Azapagasi, E., additional, Kendirli, T., additional, Emeksiz, S., additional, Dursun, O., additional, Yildizdas, D., additional, Anil, A. B., additional, Akcay, N., additional, Kihtir, H. S., additional, Havan, M., additional, Ekinci, F., additional, Ulgen Tekerek, N., additional, Kilic, O., additional, Moya, A., additional, and Dinleyici, E. C., additional
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- 2022
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3. P0558 / #1804: EVALUATION OF PERFORMANCES OF PRISM III AND PIM II SCORING SYSTEMS IN PEDIATRIC INTENSIVE CARE PATIENTS WITH MALIGNANCY
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Dursun, O., primary, Uzunay Gundogan, B., additional, Ulgen Tekerek, N., additional, and Dönmez, L., additional
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- 2021
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4. P0565 / #1955: THE VALUE OF ALBUMIN CORRECTED ANION GAP AND LACTATE CLEARANCE IN PREDICTING PEDIATRIC INTENSIVE CARE MORTALITY
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Dursun, O., primary, Uzunay Gundogan, B., additional, Ulgen Tekerek, N., additional, and Dönmez, L., additional
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- 2021
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5. ABSTRACT 864
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Ulgen Tekerek, N., primary, Akyildiz, B.N., additional, Ozcan, A., additional, Gurel, A.B., additional, and Turan, C., additional
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- 2014
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6. Relationship between fluid overload and mortality and morbidity in pediatric intensive care unit.
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Bayirli H, Ulgen Tekerek N, Koker A, and Dursun O
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Objective: The relationship between fluid overload and clinical outcomes was investigated., Design: This study is an observational and analytic study of a retrospective cohort., Settings: Pediatric intensive care units., Patients or Participants: Between 2019 and 2021 children who needed intensive care were included in the study., Interventions: No intervention., Main Variable of Interest: Early, peak and cumulative fluid overload were evaluated., Results: The mortality rate was 11.7% (68/513). When fluid overloads were examined in terms of mortality, the percentage of early fluid overload was 1.86 and 3.35, the percent of peak fluid overload was 2.87 and 5.54, and the percent of cumulative fluid overload was 3.40 and 8.16, respectively, in the survivor and the non-survivor groups. After adjustment for age, severity of illness, and other potential confounders, peak (aOR = 1.15; 95%CI 1.05-1.26; p: 0.002) and cumulative (aOR = 1.10; 95%CI 1.04-1.16; p < 0.001) fluid overloads were determined as independent risk factors associated with mortality. When the cumulative fluid overload is 10% or more, a 3.9-fold increase mortality rate was calculated. It is found that the peak and cumulative fluid overload, had significant negative correlation with intensive care unit free days and ventilator free days., Conclusions: It is found that peak and cumulative fluid overload in critically ill children were independently associated with intensive care unit mortality and morbidity., (Copyright © 2024 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)
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- 2024
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7. How significant is the BIG score in childhood traumatic brain injury?
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Ulgen Tekerek N, Cebisli E, Erkan M, Koker A, and Dursun O
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- Humans, Female, Male, Child, Child, Preschool, Retrospective Studies, Infant, Adolescent, Reproducibility of Results, Intensive Care Units, Pediatric, Glasgow Coma Scale, Brain Injuries, Traumatic mortality, Brain Injuries, Traumatic diagnosis
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Background: This study aims to evaluate the reliability of the BIG score in predicting mortality in children with traumatic brain injury (TBI) and to compare it with the literature and other scoring systems., Methods: Patients who were followed up in the Pediatric Intensive Care Unit (PICU) for TBI between 2014 and 2019 in a tertiary reference hospital were evaluated retrospectively., Results: One hundred fifty-nine patients met the inclusion criteria. The most common injury mechanisms were falling from a height (39.6%). The mortality rate was 12.6% (n = 20). The mean BIG score, ISS, and PRISM III were statistically significantly higher in the mortality group (p < 0.001). The AUC values found in the ROC analysis in the whole study group, respectively, 0.962 (CI 0.920-0.986) for the BIG score, 0.952 (CI 0.906-0.979) for the ISS, 0.957 (CI 0.913-0.983) for the GCS, and 0.981 (CI 0.946-0.996) for the PRISM III. In the patients with isolated TBI, the AUC value for the BIG score was 0.988 (0.967-1.000) and higher than the ISS and PRISM 3 [0.983 (0.956-1.000), 0.969 (0.932-1.000) respectively]). The cut-off point for the BIG score in the whole group was 19 (sensitivity 95%, specificity 88%, positive predictive value 0.58, negative predictive value 0.99). In logistic regression model, we found that BIG score is an independent variable for mortality (AOR:1.4, 95%CI 1.22-1.63)., Conclusion: In children with traumatic brain injury, the BIG score is simple, quickly calculated, and a good predictor of mortality and disease severity. Prospective studies with more extensive series are needed on this subject., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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8. Posttraumatic epilepsy in critically ill children with traumatic brain injury.
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Ulgen Tekerek N, Dursun O, Asilioglu Yener N, Yildizdas D, Anıl AB, Kendirli T, Koker A, Karalok S, Aksoy A, Kinik Kaya E, Ekinci F, Incecik F, Olgac Dundar N, Durak F, Botan E, Havan M, Sahin S, Duman O, and Haspolat S
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- Child, Female, Humans, Male, Cross-Sectional Studies, Intracranial Hemorrhages, Seizures, Child, Preschool, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic diagnostic imaging, Critical Illness
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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 clinical and radiological parameters were recorded from electronic case forms. All patients who were in the 6-month posttraumatic period were evaluated by a neurologist for PTE., Results: Four hundred seventy-seven patients were included. The median age at the time of trauma was 66 (IQR 27-122) months, and 298 (62.5%) were male. Two hundred eighty (58.7%) patients had multiple traumas. The mortality rate was 11.7%. The mean duration of hospitalization, pediatric intensive care unit hospitalization and mechanical ventilation, Rotterdam score, PRISM III score, and GCS at admission were higher in patients with epilepsy (p < 0.05). The rate of epilepsy was higher in patients with severe TBI, cerebral edema on tomography and clinical findings of increased intracranial pressure, blood transfusion in the intensive care unit, multiple intracranial hemorrhages, and intubated patients (p < 0.05). In logistic regression analysis, the presence of intracranial hemorrhage in more than one compartment of the brain (OR 6.13, 95%CI 3.05-12.33) and the presence of seizures (OR 9.75, 95%CI 4.80-19.83) were independently significant in terms of the development of epilepsy (p < 0.001)., Conclusions: In this multicenter cross-sectional study, intracranial hemorrhages in more than one compartment and clinical seizures during intensive care unit admission were found to be independent risk factors for PTE development in pediatric intensive care unit patients with TBI., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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9. Analysis of Intestinal and Nasopharyngeal Microbiota of Children with Meningococcemia in Pediatric Intensive Care Unit: INMACS-PICU Study.
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Bozan G, Pérez-Brocal V, Aslan K, Kiral E, Sevketoglu E, Uysal Yazici M, Azapagasi E, Kendirli T, Emeksiz S, Dursun O, Yildizdas D, Anil AB, Akcay N, Kihtir HS, Havan M, Ulgen Tekerek N, Ekinci F, Kilic O, Moya A, and Dinleyici EC
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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, we aimed to evaluate the intestinal and nasopharyngeal microbiota composition of children with IMD. Materials and Methods: In this prospective, multi-center study, 10 children with meningococcemia and 10 age-matched healthy controls were included. Nasopharyngeal and fecal samples were obtained at admission to the intensive care unit and on the tenth day of their hospital stay. The V3 and V4 regions of the 16S rRNA gene were amplified following the 16S Metagenomic Sequencing Library Preparation. Results: Regarding the alpha diversity on the day of admission and on the tenth day at the PICU, the Shannon index was significantly lower in the IMD group compared to the control group ( p = 0.002 at admission and p = 0.001, on the tenth day of PICU). A statistical difference in the stool samples was found between the IMD group at Day 0 vs. the controls in the results of the Bray-Curtis and Jaccard analyses ( p = 0.005 and p = 0.001, respectively). There were differences in the intestinal microbiota composition between the children with IMD at admission and Day 10 and the healthy controls. Regarding the nasopharyngeal microbiota analysis, in the children with IMD at admission, at the genus level, Neisseria was significantly more abundant compared to the healthy children ( p < 0.001). In the children with IMD at Day 10, genera Moraxella and Neisseria were decreased compared to the healthy children. In the children with IMD on Day 0, for paired samples, Moraxella , Neisseria , and Haemophilus were significantly more abundant compared to the children with IMD at Day 10. In the children with IMD at Day 10, the Moraxella and Neisseria genera were decreased, and 20 different genera were more abundant compared to Day 0. Conclusions: We first found alterations in the intestinal and nasopharyngeal microbiota composition in the children with IMD. The infection itself or the other care interventions also caused changes to the microbiota composition during the follow-up period. Understanding the interaction of microbiota with pathogens, e.g., N. meningitidis , could give us the opportunity to understand the disease's dynamics.
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- 2023
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10. Long-term results of liver transplantation for maple syrup urine disease: A single-center experience in Turkey.
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Aras A, Avanaz A, Inan Aydemir N, Kayaalp E, Ulgen Tekerek N, Kisaoglu A, Demiryilmaz I, Soyucen E, Dursun O, Yilmaz A, Artan R, and Aydinli B
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- Humans, Living Donors, Retrospective Studies, Turkey, Quality of Life, Maple Syrup Urine Disease surgery, Liver Transplantation methods
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Objectives: Maple syrup urine disease (MSUD) is an autosomal recessive inherited disorder. Despite the advances in medical nutrition therapies, classical phenotype causes severe neurological disorders and sudden death. It is known that MSUD patients do not experience metabolic attacks despite their free diet after liver transplantation (LT). This study aims to reveal the long-term results, development, mental, motor, intellectual and nutritional status of MSUD patients who underwent LT., Methods: The data of 12 patients who underwent deceased donor (5 recipients) and living donor liver transplantation (7 recipients) were retrospectively analyzed. The age, genotype, psychometric and mental status, development, BCAA values, type of LT, donor-recipient proximity, complications, and survival were assessed., Results: There were 4 (33%) girls and 8 (67%) boys. The mean current age was 9.33 ± 4.58 years. The mean follow-up time was 3 ± 2.5 years. The repeated measures of leucine and isoleucine values revealed that there were no significant differences from the pre-LT to post-LT 1-year. The protein-restricted nutrition was switched to a free diet when oral intake was opened after LT. None of the recipients experienced metabolic attacks after the living donor or deceased donor LT. The 1-, 3-, and 5-year survival rate of the patients is 83.3%. There was no significant difference in survival between living and deceased donor liver transplantation., Conclusions: Liver transplantation is a treatment option for MSUD in proper conditions to save the patient life, increase the quality of life, and provide essential amino acids with free diet intake for growth and development., (© 2022 Wiley Periodicals LLC.)
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- 2023
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11. Intestinal Mucormycosis in a Child With Maple Syrup Urine Disease After Orthotopic Liver Transplant.
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Cebisli E, Ulgen-Tekerek N, Dursun O, Koker A, Kisaoglu A, Artan R, Soyucen E, and Elpek GO
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- Female, Humans, Child, Child, Preschool, Tissue Donors, Necrosis complications, Liver Transplantation adverse effects, Liver Transplantation methods, Mucormycosis diagnosis, Mucormycosis drug therapy, Maple Syrup Urine Disease diagnosis, Maple Syrup Urine Disease surgery, Maple Syrup Urine Disease complications
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Mucormycosis can result in serious morbidity and mortality, especially in transplant recipients. In this case report, we present a 3-year-old female patient with maple syrup urine disease who developed mucormycosis infection after deceased donor split liver transplant. Progressive segmental necrosis of the small intestines and new ischemic areas were observed after repeated abdominal surgeries. Microscopic examination of biopsy material revealed mucormycosis. Early recognition is crucial for treatment, and patients with clinical suspicion can be treated empirically with antifungal medicine. However, diagnostic tests with accurate and fast results are needed and more effective therapeutic methods should be developed for better outcomes.
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- 2023
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12. Determinants of Quality of Life after Pediatric Traumatic Brain Injury.
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Ulgen Tekerek N, Dursun O, Karalok S, Koker A, Duman O, and Haspolat S
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Introduction Pediatric traumatic brain injury (TBI) is a significant cause of death and long-term disability. There is a paucity of data on quality of life in survivors of pediatric TBI. The aim of this study is to determine the factors affecting the quality of life after TBI in children. Methods Consecutively admitted 104 of 156 patients to the pediatric intensive care unit (PICU) with TBI between 1 month and 18 years were included in the study. Demographics were obtained from electronic records. Injury severity and mortality scores were calculated. The Pediatric Quality of Life Inventory (PedsQL) scale and Glasgow Outcome Scale (GOS) score were evaluated by interview with patient or the caregiving parents. The Rotterdam computed tomography (CT) score was calculated from the radiology images taken within the first 24 hours after admission to the emergency service. Results Severe TBI, multiple trauma, intracranial hemorrhage from multiple sites, convulsions, high intracranial pressure, emergency operation on admission, and hypotension on admission were associated with low PedsQL values according to results of univariate analysis ( p < 0.05). There was a negative correlation between PedsQL and GOS, mechanical ventilation duration, PICU length of stay (LOS), and hospital LOS. In the linear regression model made by considering the univariate analysis results, it was shown that Rotterdam CT score and PICU LOS are independent variables that determine low PedsQL score. PedsQL scores were lower in children ≥ 8 years of age and in those evaluated within the first year after discharge ( p = 0.003). Conclusion In pediatric TBI, Rotterdam CT score and PICU LOS were found as independent variables determining PedsQL score after discharge., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)
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- 2022
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13. Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey.
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Kiral E, Kirel B, Havan M, Keskin M, Karaoglan M, Yildirim A, Kangin M, Talay MN, Urun T, Altug U, Kesici S, Tufan E, Kacmaz E, Bozan G, Azapagasi E, Uysal Yazici M, Ozturk Z, Yesilbas O, Karaguzel G, Kaya G, Barlas U, Duyu M, Boyraz M, Sevketoglu E, Akcay N, Hancili S, Guven A, Dursun O, Ulgen Tekerek N, Ozcifci G, Yazici P, Turanli E, Kendirli T, Kahveci F, Yetimakman AF, Citak A, Şik G, Bingol I, Aygun F, Durak C, Yilmaz R, Bugrul F, Sari Y, Tekguç H, Albayrak H, Yener N, Agin H, Soydan E, Yildizdas D, Dilek SO, Yalindag N, Incekoy-Girgin F, Alacakir N, Tutunculer F, Arslanaoglu MO, Aydin C, Bilgin M, Simsek E, and Dinleyici EC
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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 (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection., Methods: This is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year., Results: The percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic ( p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic ( p < 0.0001) and also higher among children with new onset Type 1 diabetes ( p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission., Discussion: The frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemic; however, need to evaluate the potential effects of SARS-CoV-2 on the increased percentage of new onset Type 1 diabetes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kiral, Kirel, Havan, Keskin, Karaoglan, Yildirim, Kangin, Talay, Urun, Altug, Kesici, Tufan, Kacmaz, Bozan, Azapagasi, Uysal Yazici, Ozturk, Yesilbas, Karaguzel, Kaya, Barlas, Duyu, Boyraz, Sevketoglu, Akcay, Hancili, Guven, Dursun, Ulgen Tekerek, Ozcifci, Yazici, Turanli, Kendirli, Kahveci, Yetimakman, Citak, Şik, Bingol, Aygun, Durak, Yilmaz, Bugrul, Sari, Tekguç, Albayrak, Yener, Agin, Soydan, Yildizdas, Dilek, Yalindag, Incekoy-Girgin, Alacakir, Tutunculer, Arslanaoglu, Aydin, Bilgin, Simsek and Dinleyici.)
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- 2022
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14. Comprehensive Analysis of Liberal and Restrictive Transfusion Strategies in Pediatric Intensive Care Unit.
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Akyildiz B, Ulgen Tekerek N, Pamukcu O, Dursun A, Karakukcu M, Narin N, Yay M, and Elmali F
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- Cardiac Output physiology, Child, Child, Preschool, Female, Hematocrit statistics & numerical data, Hemodynamics physiology, Hemoglobins analysis, Humans, Intensive Care Units, Pediatric statistics & numerical data, Male, Oximetry methods, Oxygen blood, Prospective Studies, Critical Illness therapy, Erythrocyte Transfusion methods
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Background: We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters., Methods: A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger < 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion. Oxygen saturation, noninvasive total hemoglobin, noninvasive total oxygen content, perfusion index (PI), heart rate and systolic and diastolic blood pressures were assessed via the Radical-7 Pulse co-oximeter (Masimo, Irvine, CA, USA) with the Root monitor, initially and at 4 h., Results: In all, 160 children were eligible for final analysis. The baseline hemoglobin level for the PRBC transfusion was 7.38 ± 0.98 g/dL for all patients. At the end of the PRBC transfusion, cardiac output decreased by 9.9% in Group 1 and by 24% in Group 2 (p < 0.001); PI increased by 10% in Group 1 and by 45% in Group 2 (p < 0.001). Lactate decreased by 9.8% in Group 1 and by 31.68% in Group 2 (p < 0.001)., Conclusion: Restrictive blood transfusion strategy is better than liberal transfusion strategy with regard to the hemodynamic and laboratory values during the early period. PI also provides valuable information regarding the efficacy of PRBC transfusion in clinical practice.
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- 2018
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