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    Retrospective Analysis of Demographic, Epidemiologic, and Clinical Characteristics of Poisoning in Pediatric Intensive Care Unit
    (BEZMIALEM VAKIF UNIV, 2020-01-01) Sik, Guntulu; Demirbuga, Asuman; Annayev, Agageldi; Deliceo, Elif; Tufan, Ali Evren; Citak, Agop
    Objective: Poisonings are significant causes of preventable morbidities and mortalities in pediatric patients hospitalized in pediatric intensive care units. In this study, we aimed to evaluate demographic and epidemiologic features, interventions, treatments, clinical course, and prognosis of patients hospitalized in pediatric intensive care unit for poisoning retrospectively. Methods: The recordings of 172 patients admitted to the pediatric intensive care unit with acute poisoning between 2015 and 2019 were evaluated retrospectively. Results: A total of 172 patients were admitted to our pediatric intensive care unit with the diagnosis of poisoning. Eighty-eight of them (51.2\%) were girl. The average age was 5.8 +/- 5.6 years, and mean length of stay was 2.9 days. It was noted that 72.1\% of patients with poisoning were accidental, whereas 27.9\% of them were suicidal. Majority of suicidal patients were girls (89.5\%), and the mean age was 13.1 +/- 4.9 years. However, only 36.2\% of patients with accidental poisoning were girls and the mean age was 3.1 +/- 2.6 years. Patients with poisoning were most commonly seen during spring. The most common cause of poisoning was drugs (76.7\%). Poisoning with multiple drugs were seen in 36 patients (20.9\%). Central nervous system drugs were the most common cause (32.7\%). Nausea-vomiting (17.4\%), altered mental status (12.7\%), and abdominal pain (7.5\%) were the most common symptoms. Thirteen patients required invasive mechanical ventilation. Five patients were treated with hemodialysis and eight patients treated with plasma exchange. Conclusion: Poisonings are important part of pediatric intensive care unit hospitalization. Accidental poisoning is common especially in children under five years of age. Taking preventive measures, educating parents about home accidents, storing medications in safe and locked places and keeping them out of reach of children can reduce the rate of accidental poisoning.
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    Extracorporeal membrane oxygenation for the support of pediatric patients with acute fulminant myocarditis
    (TURKISH J PEDIATRICS, 2019-01-01) Sik, Guntulu; Annayev, Agageldi; Demirbuga, Asuman; Deliceo, Elif; Aydin, Selim; Erek, Ersin; Demir, Halil Ibrahim; Citak, Agop
    Acute fulminant myocarditis, is a severe, rapidly progressive disease. The clinical outcomes of children with severe acute myocarditis who are resist to medical treatment is not well known. We studied the clinical courses of patients with acute fulminant myocarditis supported by extracorporeal membrane oxygenation (ECMO). We performed a retrospective chart review of six children with acute fulminant myocarditis who were treated with ECMO. Demographic information, clinical and vital signs, as well as laboratory results were investigated. The median age of 63 months (13-140 months), the mean ECMO duration was 164 hours (79-402 hours), and median intensive care unit stay was 24 days. The most common symptoms were chest pain (66\%) and fever (66\%). Severe arrhythmia were seen in two patients. One patient received extracorporeal cardiopulmonary resuscitation. In two patients, right femoral arteries and right femoral veins were used, in others, right common carotid artery and right internal jugular veins were used. Five patients (83.3 \%) survived to discharge. ECMO can be used effectively in pediatric patients with acute fulminant myocarditis to support the circulation while awaiting myocardial recovery. Timely use of ECMO can improve the survival rate and may be associated with better outcomes.