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    The Effect of Aminoglycosides on Colistin-Containing Regimens in the Treatment of Carbapenem-Resistant Gram-Negative Infections in Pediatric Intensive Care Units: A Two-Center Experience
    (Erciyes Univ Sch Medicine, 2019) Bal, Zumrut Sahbudak; Kamit, Fulya; Duyu, Muhterem; Yazici, Pinar; Anil, Ayse Berna; Yilmaz, Dilek Ciftdogan; Yilmaz, Nisel Ozkalay; Cilli, Feriha; Karapinar, Bulent
    Objective: This study aimed to assess the outcomes including morbidity and mortality of carbapenem-resistant gram-negative (CRGN) infections in pediatric critical care setting. The second aim was to investigate the impact of aminoglycosides on colistin-containing regimen in CRGN-infected pediatric critical care patients. Materials and Methods: We retrospectively evaluated medical records of 82 patients who had received colistin in combination with an aminoglycoside (CA group) or another antibiotic (CO group) at two reference pediatric intensive care units (PICUs) between February 2011 and February 2016. Results: We enrolled 82 CRGN-infected patients who were admitted to PICUs of two hospitals. The median age of the patients was 24 (25th-75th percentile; 8-78.75) months, and the median duration of hospital stay was 30 days (25th-75th percentile; 16.7-57.7). No statistical difference was observed in the variables, including microbiological response, attributable mortality, crude mortality, and the duration of achieving first negative culture (p>0.05). Clinical response was significantly more observed in the CA group (85.5% vs. 63.2; p=0.048), and attributable mortality was higher in the CO group (12.7% vs. 31.6%; p=0.055). Nephrotoxicity did not show statistical difference between groups (p=0.357), and neurotoxicity was not observed. Conclusion: Colistin-containing regimen in combination with an aminoglycoside may be an effective and safe antimicrobial agent without a significant increase in side effects.
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    Increasing suction pressure during endotracheal suctioning increases the volume of suctioned secretions, but not procedure-related complications: A comparative study in open system endotracheal suctioning
    (Elsevier Sci Ltd, 2020) Maras, Gul Bulbul; Eser, Ismet; Senoglu, Nimet; Yilmaz, Nisel Ozkalay; Derici, Yeser Karaca
    Objectives: To compare the effect of three different suction pressures (80 mmHg, 150 mmHg, 250 mmHg) with the open system suction method in terms of the volume of secretions and complications development in intubated intensive care patients. Research methodology/design: This study was planned as a prospective, experimental, self-controlled design. The study sample included 47 patients. Data were collected using a data collection and patient follow-up form from patient records. Setting: Single adult intensive care unit in a university hospital. Results: Fifty five percent of the patients were male, 61.7% were older than 65 years and 38.32% had lung infection. The amount of suctioned secretions tended to increase significantly with increasing negative pressure and there was a significant difference between the pressures in terms of the median volume of suctioned secretions (p < 0.001). There was no significant difference between the suction pressures in terms of oxygen desaturation, hypertension rates (p > 0.05). Tachycardia, bradycardia, hypoxaemia, tracheal mucosal damage or mucosal bleeding were not observed during suctioning with three different suction pressures. Conclusion: It may be assumed that 250 mmHg suction pressure, via compliance with open system suction method related procedures, is being more effective and equally safe for secretion cleaning in comparison to the 80 and 150 mmHg suction pressures. (C) 2020 Elsevier Ltd. All rights reserved.