Introduction:To evaluate pediatric tracheostomies performed at a tertiary care pediatric intensive care unit (PICU) before and after the Coronavirus disease-2019 (COVID-19) pandemic.Methods: A total of 57 pediatric tracheostomy patients performed at a tertiary care PICU were included.Prognostic scores including pediatric risk of mortality 2, pediatric index of mortality 2 and pediatric logistic organ dysfunction scores, the family education process and time to home discharge were evaluated according to time of tracheostomy (pre-pandemic vs. after pandemic) and responsible surgeon (pediatric surgeon vs. otolaryngologist).MedCalc ® Statistical Software version 19.7.2 (MedCalc Software Ltd, Ostend, Belgium; https: //www.medcalc.org;2021) was used for statistical analysis.Results: A non-significant tendency for higher rate of pediatric surgery-based tracheostomies was noted after the pandemic (76.0 vs. 24.0%,p=0.134).No significant difference was noted between tracheostomies performed before vs. after the COVID-19 pandemic and those performed by otolaryngologists vs. pediatric surgeons in terms of prognostic scores and time to home discharge. Conclusion:Our findings emphasize the maintenance of high quality patient care for pediatric tracheostomy patients in accordance with standardized tracheostomy protocols and policies during the pandemic period with no significant difference between tracheostomies performed before and after the COVID-19 pandemic and those performed by pediatric surgeons vs. otolaryngologists in terms of prognostic scores and time to home discharge.

Pandemic

2019-20 coronavirus outbreak

10.4274/cayd.galenos.2021.21033

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Bir Dahili Cerrahi Çocuk Yoğun Bakım Birimi’nde çocuk ölüm riski I ve çocuk ölüm endeksi II’nin karşılaştırılması Özgün Araştırma

Türk Pediatri Arşivi (2010)

Ayşe Berna Anıl Murat Anıl Nevin Çetin Münevver Yıldırımer Alkan Bal

Amac: Calismanin amaci Turkiye’deki bir dahili cerrahi Cocuk Yogun Bakim Birimi’ne CYBB basvuran hastalarin olum oranlarini ongormede Cocuk Olum Riski I PRISM I ve Cocuk Olum Endeksi II PIM II derecelendirmelerinin ayirt etme yeteneklerini ve ayarlamalarini karsilastirmaktir Gerec ve Yontem: Toplam 277 hasta 1 Eylul 2007 ile 31 Agustos 2008 tarihleri arasinda ileriye donuk olarak incelenmistir Bu hastalarin 39’u 14 7 CYBB’deki izlemleri sonunda kaybedilmistir Her bir derecelendirme ornegin olum ve yasami ayirt etme yetenegi ROC egrisinde egri altinda kalan alanin hesaplanmasi ile yapilmistir Standardize olum orani SOO da saptanmistir Ayarlama Hosmer Lemeshow testi ile degerlendirilmistir Bulgular: Analizlerimizin sonucunda PRISM I ROC egrisinde egri altinda kalan alan: 0 884; SOO: 1; Hosmer Lemeshow ki kare p degeri: 0 09 ve PIM II’nin ROC egrisinde egri altinda kalan alan: 0 912; SOO: 1; Hosmer Lemeshow ki kare p degeri: 0 30 olum ve yasami ayirt etmede yeterli ve ayarlamalarinin iyi oldugu saptanmistir Cikarimlar: Sonuc olarak PRISM I ve PIM II CYBB’deki hastalarin seyirlerini ongormede guvenilir iki yontemdir Ancak ayirt etme yeteneginin daha yuksek ayarlama ve kullanim kolayliginin olmasi PIM II’nin daha yararli olabilecegini dusundurmustur Turk Ped Ars 2010; 45: 18 24 Anahtar kelimeler: Cocuk olum endeksi skoru II cocuk olum riski seyir cocuk yogun bakim birimi

10.4274/tpa.v45i1.5000002154

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Serum Vitamin D Levels in Relation to Development of Multisystem Inflammatory Syndrome in Pediatric COVID-19

Journal of Pediatric Infectious Diseases (2022)

Neslihan Zengın Alkan Bal Tugba Aysun Goren Semra Şen Fatoş Alkan

Abstract Objective The aim of the study is to evaluate vitamin D (vit D) levels in children with and without development of multisystem inflammatory syndrome in children (MIS-C) after coronavirus disease 2019 (COVID-19) and also between those with severe and moderate MIS-C. Methods This comprises retrospective data of 68 patients including 34 patients with MIS-C and admitted into the pediatric intensive care unit (MIS-C group) and 34 patients without MIS-C (non-MIS-C group) were analyzed for their presenting characteristics, serum vit D levels, ventilatory needs, and prognostic scores. Results Vit D levels were significantly lower in patients with versus without MIS-C [9 (2–18) vs. 19 (10–43) ng/mL, p <0.001], and also in patients with severe versus moderate MIS-C [7.5 (2–17) vs. 9 (5–18) ng/mL, p = 0.024]. Vit D deficiency (levels <12 ng/mL) was more common in the MIS-C versus non-MIS-C group (79.4 vs. 11.8%, p <0.001) and in severe versus moderate MIS-C (92.9 vs. 70.0%, p <0.001). The severe versus moderate MIS-C was associated with significantly higher levels of procalcitonin [7.6 (0.9–82) vs. 1.7 (0.2–42) ng/mL, p = 0.030] and troponin [211 (4.8–4,545) vs. 14.2 (2.4–3,065) ng/L, p = 0.008] and higher likelihood of reduced ejection fraction (75.0 vs. 15.4%, p = 0.004). Conclusion Our findings indicate the higher prevalence of vit D deficiency in pediatric COVID-19 patients with versus without MIS-C, as well as in those with severe versus moderate MIS-C. Higher troponin and procalcitonin levels and dyspnea at presentation seem also to be risk factors for severe MIS-C, more pronounced cardiac dysfunction, and poorer prognosis.

Procalcitonin

10.1055/s-0042-1756713

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Comparison of early characteristics of multisystemic inflammatory syndrome and Kawasaki disease in children and the course of Kawasaki disease in the pandemic

BMC Pediatrics (2024)

Fatoş Alkan Onur BİRCAN Alkan Bal Semra Şen Neslihan Zengın

Abstract Introduction Multisystemic inflammatory syndrome (MIS-C) is a newly described disease manifestation in children associated with the novel coronavirus SARS-CoV-2 infection and can be easily confused with Kawasaki disease with its clinical and laboratory findings. In this study, the clinical findings, organ involvements, similarities, and differences in laboratory and imaging of the children with MIS-C and KD at the time of admission will be revealed in detail, and the treatment methods and follow-up results will be revealed. Material and method Our study was a single-center study and included pediatric patients who were treated with a diagnosis of MIS-C between March 2020 and July 2023 in the pediatric cardiology, pediatric emergency, pediatric infection, and pediatric intensive care clinics at Celal Bayar University and who were treated with a diagnosis of KD (complete/incomplete) between January 2015 and July 2023. MIS-C diagnosis was made according to the Turkish Ministry of Health COVID-19 guidelines. Sociodemographic characteristics, clinical, laboratory, and echocardiography findings, treatments given, and clinical course of all patients included in the study were evaluated. Results The median age was 30 months (7–84) in KD and 96 months (6-204) in MIS-C, and it was significantly higher in the MIS-C group ( p = 0.000). Symptom duration was significantly longer in the MIS-C group ( p = 0.000). In terms of clinical features, gastrointestinal syndrome findings (nausea, vomiting, abdominal pain) and respiratory findings (dyspnea) were significantly higher in the MIS-C group ( p = 0.007, p = 0.000, p = 0.002, respectively). Regarding cardiovascular system involvement, coronary involvement was significantly higher in the KD group. However, valvular involvement, left ventricular systolic dysfunction, and pericardial effusion were significantly higher in the MIS-C group ( p = 0.000, p = 0.001, p = 0.003, p = 0.023, respectively). In terms of laboratory findings, white blood cell count was higher in KD ( p = 0.000), absolute lymphocyte count, platelet level, blood sodium, and albumin levels were lower in MIS-C group ( p = 0.000, p = 0.000, p = 0.000, p = 0.000, p = 0.003, respectively), ferritin and troponin levels were significantly higher in MIS-C group. These results were statistically significant ( p = 0.000, p = 0.000, respectively). D-dimer and fibrinogen levels were high in both groups, and no significant statistical difference was detected between the two groups. There was no significant difference between the two groups regarding the length of hospitalization and mortality, but steroid use was significantly higher in the MIS-C group ( p = 0.000). Conclusion In conclusion, this study has demonstrated the similarities and differences between MIS-C and KD regarding clinical findings, organ involvement, and laboratory and imaging results. The results of our study have important implications in terms of contributing to the data in the existing literature on these two diseases and for the correct diagnosis and better management of pediatric patients presenting with these disorders. What is known Multisystemic inflammatory syndrome (MIS-C) is a newly described disease manifestation in children associated with the novel coronavirus SARS-CoV-2 infection and can be easily confused with Kawasaki disease with its clinical and laboratory findings. What is new Although MIS-C and KD have many similarities, their symptoms, disease processes, possible complications, and treatment regimens may differ.

10.1186/s12887-024-04966-x

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Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study

Pediatric Research (2023)

Güntülü Şık Aysegul Inamlık Nihal Akçay Selman Kesici Fatih Aygün

Procalcitonin

10.1038/s41390-023-02518-0

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Citations (9)