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Öğe Can High Average Oxygen Saturation be a Risk Factor for Necrotizing Enterocolitis in VLBW Infants?(Wolters Kluwer Medknow Publications, 2019) Gokce, Ismail Kursad; Oguz, Serife SunaBackground: Avoiding hyperoxia with oxygen saturation monitoring is important in the follow-up of very low birth weight (VLBW) infants. Role of oxygen-derived free radicals in the pathogenesis of necrotizing enterocolitis (NEC) has been well defined. However, a great majority of the evidence supporting the role of hyperoxia in NEC development are data from experimental studies and there are very few clinical studies. In this study, the association between NEC and average oxygen saturation (SpO(2)) levels in VLBW infants was researched. Methods: Average SpO(2) values of VLBW infants in the last 24 h were recorded prospectively with pulse oximeter. Average SpO(2) records were continued at least for 10 days starting from the first day after birth. In the follow-up, the average SpO(2) values of the patients who developed NEC and those who did not were compared. Results: A total of 127 VLBW infants were followed up. Thirteen patients developed NEC (Bell's classification >= stage II). No differences were found between the average SpO(2) levels (94.9 and 94.8%) of the patients who developed NEC and those who did not. It was found that average SpO(2) value higher than 93 or 95 was not a risk for NEC development (P = 0.693 and P = 0.771). Conclusions: In this study, no association was found between average SpO(2) values recorded in the first weeks of VLBW infants and NEC.Öğe Demographic characteristics of cases diagnosed with cleft palate(2020) Kaya, Huseyin; Guliyeva, Lale; Ozdemir, Ramazan; Gokce, Ismail Kursad; Deveci, Mehmet FatihAim: The aim of this study is to retrospectively evaluate the cleft palate cases in our neonatal clinic and to examine the associated clinical features, predisposing factors, accompanying anomalies, additional findings, treatment approaches and follow-up results.Material and Methods: The study included babies that were diagnosed with cleft palate in our Neonatal Intensive Care Unit between January 2014 and December 2018. The etiological risk factors, demographic characteristics, clinical features and concomitant malformations of the patients included in the study were retrospectively recorded from the patient files and the database system of our hospital.Results: A total of 70 cleft palate patients were observed over a five year period. Of these, 30 (42.9%) were female and 40 (57.1%) were male. The mean gestational age was 38 ± 2.9 weeks and the mean birth weight was 2845 ± 700 grams. 77.1% of the patients were found to additionally have cleft lips. 27 patients (38.5%) had cardiac defects, 18 (25.7%) had central nervous system anomalies and 4 (5.7%) had hypothyroidism. 24 (34.3%) of the parents were consanguineous. The median age at the time of the initial operation was 13 months for cleft palate cases and 5 months for cleft lip cases.Conclusion: As a result, treatment and follow-up of patients with cleft palate defect requires a multidisciplinary approach. These patients should undergo a thorough examination and evaluation. Since many syndromes or malformations may accompany the palate defects, these cases should be investigated with respect to genetic disease and other system anomalies.Öğe Development of severe hyponatremia due to cerebrospinal fluid leakage following meningomyelocele surgery in a newborn(Amer Assoc Neurological Surgeons, 2018) Gokce, Ismail Kursad; Turgut, Hatice; Ozdemir, Ramazan; Onal, Selami CagatayCerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.Öğe Development of severe hyponatremia due to cerebrospinal fluid leakage followingmeningomyelocele surgery in a newborn(Amer assoc neurologıcal surgeons, 5550 meadowbrook drıve, rollıng meadows, ıl 60008 usa, 2018) Gokce, Ismail Kursad; Turgut, Hatice; Ozdemir, Ramazan; Onal, Selami CagatayCerebrospinal fluid leakage following meningomyelocele surgery is a frequent complication in the wound healing period and is associated with wound dehiscence. CSF loss can cause severe hyponatremia, especially in the newborn and early infancy periods when dietary sodium content is relatively low. Hyponatremia in the newborn period can result in adverse neurodevelopmental outcomes. In addition, hyponatremia's cerebral effects can increase complications in neurosurgery patients. The authors present the case of a newborn in whom CSF leakage from the operative site and severe hyponatremia developed following meningomyelocele surgery. To the best of their knowledge, severe hyponatremia caused by CSF leakage after meningomyelocele surgery has not been previously reported in the literature.Öğe The effect of defect size on mortality and morbidity in patients with neural tube defect(2022) Turgut, Hatice; Ozdemir, Ramazan; Gokce, Ismail Kursad; Kaya, Huseyin; Onal, Selami CagatayAim: Neural tube defects (NTD) occur due to errors in the closing of neural canal in embryo. All over the world, the incidence of all forms of NTD varies between 1.4 and 2 in every 1000 live births. The aim of the present study was to investigate the short term prognosis, accompanying anomalies and complications in patients with NTD and to evaluate the relation between defect sizes. Material and Methods: Patients who applied to Inonu University Neonatology Department between January 2010 and December 2017 with the diagnosis of NTD and were operated on were included in the study. Babies who died within the first 24 hours were excluded from the study. Patients were divided into two groups according to the size of NTD; < 5 cm (Group 1) and ≥ 5 cm (Group 2). Approval for the study was obtained from local ethics committee. Results: Overall 133 infants were included in the study. Mean birth weight was 3155 ± 531 g and mean duration of pregnancy was on 38.1 ± 1.8 weeks. Of NTD’s 82% was located in lumbosacral region. 90.2% of the patients underwent operation within the first 24 hours. Parameters such as hydrocephalus, need for shunt, need for flap in tissue defects, the rate of postoperative complications, duration of hospitalization, mortality and the use of antibiotics were found to be at a higher rate in cases whose defect size was ≥5 cm than in those whose defect size was < 5 cm (p < 0.005). Postoperative complications developed in 48.1% of the patients. The most common complications were observed to be cerebrospinal fluid (CSF) leakage (24.1%) and bladder dysfunction (7.5%). Conclusion: In patients with NTD, as the size of the defect increases, additional interventions, complications, hospitalization rates and mortality increase as well. Therefore, it is recommended that health care personnel should take care against problems in the management of this group of patients and inform familes beforehand on these issues.Öğe The effect of feeding with own mother’s milk on bronchopulmonary dysplasia in very low birth weight infants(2019) Gokce, Ismail Kursad; Deveci, Mehmet FatihAim: This study aimed to evaluate the effect of feeding with own mother’s milk on the incidence of bronchopulmonary dysplasia (BPD) and other preterm morbidities in very low birth weight (VLBW) infants.Materials and Methods: VLBW infants followed in our unit were divided into three groups according to their predominantly feeding type such as own mother’s milk group (MM), preterm formula group (PF) and mix fed group (MxF) in the first postnatal month. Groups were compared regarding demographic and clinical features including BDP. Results: The mean birth week of 117 VLBW infants was 29.3 ± 2.1 weeks and the mean birth weight was 1115 ± 265 g. Seventy seven infants were in the MM group, 17 infants were in the PF group and 23 infants were in the MxF group. There was a significant decrease in BPD incidence in the MM group compared to infants in the PM group (p=0.03). The frequency of necrotizing enterocolitis, late-onset sepsis and severe intraventricular hemorrhage (IVH) were found to decrease in the MM group when compared with other infants.Conclusion: The incidence of BPD decreases in VLBW infants fed with their own mother’s milk compared to VLBW infants fed with formula. Also besides feeding with mother’s milk may contribute to a decrease in the frequency of severe IVH.Keywords: Breastfeeding; bronchopulmonary dysplasia; intracranial hemorrhages; mother’s milk; newbornÖğe Evaluation of Patients with Ichthyosis Followed in a Neonatal Intensive Care Unit: A Single Center Experience(Erciyes Univ Sch Medicine, 2023) Deveci, Mehmet Fatih; Ates, Kubra; Alagoz, Meral; Tekedereli, Ibrahim; Gokce, Ismail Kursad; Aslan, Mehmet; Ozdemir, RamazanObjective: Ichthyosis is a keratinization disorder that is characterized by a defective skin barrier and inability to retain water in the skin. Ichthyosis is extremely rare and mostly hereditary, and its manifestations typically involve dryness, scaling, and hyperkeratosis. Moreover, different clinical findings may be observed depending on the concomitant anomalies. Patients with ichthyosis should be protected from infection and hypernatremic dehydration during the neonatal period. After diagnosis, patients with ichthyosis should be screened for concomitant genetic disorders and their families should be referred to genetic counseling. Materials and Methods: In this study, ichthyosis cases observed in our neonatal intensive care unit were retrospectively evaluated. We analyzed the genetic analyses and demographic and clinical data of patients hospitalized in our unit over the past 9 years. Results: Three of the 24 patients evaluated expired during the neonatal period. Genetic analysis was performed on 10 patients, with 8 exhibiting a pathogenic variant. Four of these cases were diagnosed with syndromic ichthyosis, whereas four were nonsyndromic. Conclusion: Patients with ichthyosis need to be diagnosed early and subsequently screened for accompanying anomalies. In managing this disorder, genetic analysis and counseling are as important as proper skin care, hydration, and infection prevention and should not be overlooked.Öğe Extensively drug-resistant acinetobacter baumannii meningitis which successfully treated with tigecycline; a case report of preterm newborn(2021) Deveci, Mehmet Fatih; Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanAcinetobacter baumannii (A. baumannii) meningitis is a state difficult to treat with a high mortality rate, since antibiotics have low CSF penetration level and antibiotic resistance is frequently encountered. Multidrug-resistance is common in hospital-acquired A. baumannii infections, and in these cases, colistin treatment is frequently used as the last option. Colistin-resistant A. baumannii infections are reported in recent years. We present a case of preterm newborn who developed extensively drug-resistant (carbapenem and colistin resistance) A. baumannii meningitis after ventriculoperitoneal shunt operation. Although not approved in children, combined intravenous treatment including tigecycline, meropenem and colistin provides clinical and bacteriological recovery in colistin and carbapenem-resistant A. baumannii meningitis.Öğe Extensively drug-resistant acinetobacter baumannii meningitis which successfully treated with tigecycline; a case report of preterm newborn(2021) Deveci, Mehmet Fatih; Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanAcinetobacter baumannii (A. baumannii) meningitis is a state difficult to treat with a high mortality rate, since antibiotics have low CSF penetration level and antibiotic resistance is frequently encountered. Multidrug-resistance is common in hospital-acquired A. baumannii infections, and in these cases, colistin treatment is frequently used as the last option. Colistin-resistant A. baumannii infections are reported in recent years. We present a case of preterm newborn who developed extensively drug-resistant (carbapenem and colistin resistance) A. baumannii meningitis after ventriculoperitoneal shunt operation. Although not approved in children, combined intravenous treatment including tigecycline, meropenem and colistin provides clinical and bacteriological recovery in colistin and carbapenem-resistant A. baumannii meningitisÖğe Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, MehmetCongenital diaphragmatic hernia (CDH) is an anomaly characterized by a defect in the diaphragm, leading to the passage of intra-abdominal organs into the thoracic cavity. Herein, the presented work analyzes the global gene expression profiles in nine CDH and one healthy newborn. All of the patients had left posterolateral (Bochdalek) diaphragmatic hernia, operated via an abdominal approach, and stomach and bowels in the thorax cavity. Some patients also had additional anomalies. A total of 560 differentially regulated genes were measured. Among them, 11 genes showed significant changes in expression associated with lung tissue, vascular structure development, and vitamin A metabolism, which are typical ontologies related to CDH etiology. Among them, SLC25A24 and RAB3IL1 are involved in angiogenesis, HIF1A and FOXC2-AS1 are related with the alveolus, MAGI2-AS3 is associated with the diaphragm, LHX4 and DHH are linked with the lung, and BRINP1, FZD9, WNT4, and BLOC1S1-RDH5 are involved in retinol. Besides, the expression levels of some previously claimed genes with CDH etiology also showed diverse expression patterns in different patients. All these indicated that CDH is a complex, multigenic anomaly, requiring holistic approaches for its elucidation.Öğe Global gene expression profiling in congenital diaphragmatic hernia (CDH) patients (vol 22, pg 359, 2022)(Springer Heidelberg, 2022) Gurunluoglu, Kubilay; Dundar, Muhammed; Unver, Turgay; Akpinar, Necmettin; Gokce, Ismail Kursad; Gurunluoglu, Semra; Demircan, Mehmet[Abstract Not Available]Öğe Late onset hyponatremia in preterm newborns: is the sodium content of human milk fortifier insufficient?(Taylor & Francis Ltd, 2020) Gokce, Ismail Kursad; Oguz, Serife SunaIntroduction: In this study, we aimed to define the incidence and time to detection of late onset hyponatremia (LOH) as well as factors affecting its development in preterm newborns. We also aimed to determine the daily sodium requirement of these patients. Methods: We studied a total of 145 very low birth weight infants with a full or nearly full enteral diet and followed them up until discharge. We recorded demographic and clinic characteristics. We measured serum sodium (SNa) levels at least once a week after the second week. We compared infants with LOH with other infants to analyze possible risk factors. Results: Twenty-nine (20%) infants developed LOH in an average of 23.4 +/- 7.8 days. The mean SNa level of these infants was 124.6 +/- 5.6 mmol/L. Logistic regression analysis showed that a birth weight of less than 1000 g, preterm early membrane rupture, and nutrition with fortified human milk alone were risk factors for LOH. The mean daily amount of sodium added to the nutrition of hyponatremic preterm infants was 3.6 +/- 2.1 mmol/L. Subgroup analysis showed that the incidence of LOH was two times higher (39.2%) in infants with a birth weight of less than 1000 g. Conclusion: We observed the development of LOH within three to four weeks in nearly half of preterm infants fed with fortified human milk, especially those with a birth weight of less than 1000 g. We believe that the sodium content of currently used human milk fortifiers should be increased.Öğe Neonatal COVID-19 case from Turkey; a Case report of neonatal(2020) Deveci, Mehmet Fatih; Gokce, Ismail Kursad; Ozdemir, RamazanThe coronavirus disease 2019 (COVID-19) is a disease caused by a new type of coronavirus that the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has affected nearly all countries worldwide. More than 5 million global cases have been reported to date. As first the case was identified in China in December 2019; then Turkey started reporting cases in March 2020. SARS-CoV-2 is highly infectious and especially leads to morbidity and mortality in elderly and chronically ill patients. In children, fewer and milder infections have been reported. There are 3 cases reported in the neonatal period so far in the literature. We have observed that the literature does not contain any newborn cases reported from our country. We report the first neonatal case of COVID-19 from Turkey.Öğe Neurodevelopmental evaluation of newborns who underwent hypothermia with a diagnosis of hypoxic ischemic encephalopathy based on the Bayley-III scale(Tubitak Scientific & Technological Research Council Turkey, 2023) Deveci, Mehmet Fatih; Baysal, Senay Guven; Alagoz, Meral; Gokce, Ismail Kursad; Dogan, Derya Gumus; Ozdemir, RamazanBackground/ aim: Hypoxic ischemic encephalopathy (HIE) is one of the common causes of mortality and morbidity in newborns. Despite therapeutic hypothermia, an important treatment with proven efficacy, the morbidity and mortality rates remain high. The aim of this study was to neurodevelopmentally evaluate patients who underwent therapeutic hypothermia.Material and method: Included herein were patients who underwent hypothermia between 2018 and 2020. Their medical files were reviewed retrospectively, and their demographic and clinical information was recorded. Patients whose contact information was available were called to the developmental pediatrics outpatient clinic for a neurodevelopmental evaluation. The Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) was used as the evaluation tool. Laboratory values and clinical parameters of the patients were further analyzed.Results: It was found that 42 patients underwent hypothermia in 3 years, of whom 14 (33.3%) had died. Of the 28 patients who were discharged, 20 children could be reached, and a neurodevelopmental evaluation was performed. Developmental delay in the cognitive area was detected in 11 (55%) patients, delay in the language area was found in 9 (45%) patients, and delay in the motor area was found in 11 (55%) patients. The correlation and regression analysis results determined that the time to start cooling was the most effective common factor in all 3 fields of scoring. Conclusion: The time to start cooling is related to the neurodevelopmental outcomes of patients with HIE. The earlier cooling is started, the better the neurodevelopmental results. Despite therapeutic hypothermia, the neurodevelopmental development of infants may be adversely affected. These patients should be followed-up neurodevelopmentally for a long time.Öğe A newborn with gastric hemangioma treated using propranolol(Korean soc pedıatrıc gastroenterology & nutrıtıon, 301 dongsung-dong 25-ı, jongno-gu, seoul, 301 dongsung, south korea, 2018) Kaya, Huseyin; Gokce, Ismail Kursad; Gungor, Sukru; Turgut, Hatice; Ozdemir, RamazanGastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.Öğe A Newborn with Gastric Hemangioma Treated Using Propranolol(Korean Soc Pediatric Gastroenterology & Nutrition, 2018) Kaya, Huseyin; Gokce, Ismail Kursad; Gungor, Sukru; Turgut, Hatice; Ozdemir, RamazanGastric hemangiomas are rare benign vascular tumors that can cause severe gastrointestinal system bleeding. We presented the case of a neonate with fresh bleeding and melena from the orogastric tube and detected gastric hemangioma in esophagogastroduodenoscopic examination. Propranolol is widely used in treatment of cutaneous hemangiomas and non-gastric gastrointestinal system hemangiomas. However, the surgical approach is preferred for treating gastric hemangiomas, and there are few reports of gastric hemangiomas associated with non-surgical treatment. Gastric hemorrhage decreased with antacid and somatostatin treatment. Propranolol treatment was initiated before the surgery decision. After three weeks of treatment, we observed regression in the hemangioma with endoscopic evaluation. During the course of treatment, the patient's gastrointestinal system bleeding did not recur, and there were no side effects associated with propranolol.Öğe An Observational, Prospective, Multicenter, Registry-Based Cohort Study Comparing Conservative and Medical Management for Patent Ductus Arteriosus(Frontiers Media Sa, 2020) Okulu, Emel; Erdeve, Omer; Arslan, Zehra; Demirel, Nihal; Kaya, Huseyin; Gokce, Ismail Kursad; Ertugrul, SabahattinNo consensus has been reached on which patent ductus arteriosus (PDAs) in preterm infants require treatment and if so, how, and when they should be treated. A prospective, multicenter, cohort study was conducted to compare the effects of conservative approaches and medical treatment options on ductal closure at discharge, surgical ligation, prematurity-related morbidities, and mortality. Infants between 24(0/7)and 28(6/7)weeks of gestation from 24 neonatal intensive care units were enrolled. Data on PDA management and patients' clinical characteristics were recorded prospectively. Patients with moderate-to-large PDA were compared. Among the 1,193 enrolled infants (26.7 +/- 1.4 weeks and 926 +/- 243 g), 649 (54%) had no or small PDA, whereas 544 (46%) had moderate-to-large PDA. One hundred thirty (24%) infants with moderate-to-large PDA were managed conservatively, in contrast to 414 (76%) who received medical treatment. Eighty (62%) of 130 infants who were managed conservatively did not receive any rescue treatment and the PDA closure rate was 53% at discharge. There were no differences in the rates of late-onset sepsis, necrotizing enterocolitis (NEC), retinopathy of prematurity, intraventricular hemorrhage (>= Grade 3), surgical ligation, and presence of PDA at discharge between conservatively-managed and medically-treated infants (p> 0.05). Multivariate analysis including perinatal factors showed that medical treatment was associated with increased risk for mortality (OR 1.68, 95% Cl 1.01-2.80,p= 0.046), but decreased risk for BPD or death (BPD/death) (OR 0.59, 95%Cl 0.37-0.92,p= 0.022). The preferred treatment options were ibuprofen (intravenous 36%, oral 31%), and paracetamol (intravenous 26%, oral 7%). Infants who were treated with oral paracetamol had higher rates of NEC and mortality in comparison to other treatment options. Infants treated before postnatal day 7 had higher rates of mortality and BPD/death than infants who were conservatively managed or treated beyond day 7 (p= 0.009 and 0.007, respectively). In preterm infants born at <29 weeks of gestation with moderate-to-large PDA, medical treatment did not show any reduction in the rates of open PDA at discharge, surgical or prematurity-related secondary outcomes. In addition to the high incidence of spontaneous closure of PDA in the first week of life, early treatment (<7 days) was associated with higher rates of mortality and BPD/death.Öğe A randomized trial comparing the short binasal prong to the RAM cannula for noninvasive ventilation support of preterm infants with respiratory distress syndrome(Taylor & Francis Ltd, 2021) Gokce, Ismail Kursad; Kaya, Huseyin; Ozdemir, RamazanPurpose: In this study, we compared the efficacy of the RAM cannula and the short binasal prong (SBP) as noninvasive ventilation (NIV) interfaces in preterm infants with respiratory distress syndrome (RDS). Materials and Methods: Premature infants with RDS who required NIV were randomized in the RAM cannula and SBP groups within the first half hour. The groups were compared in terms of their need for invasive ventilation, their surfactant use, and their morbidities. Results: We assessed 126 patients (62 SBPs and 64 RAM cannulas). Clinical and demographic features of the groups were similar. Within the first 72 hours, the RAM cannula group showed a higher need for invasive ventilation (32.8 and 9.6%, p = .002, respectively), surfactant (42.1 and 19.3%, p = .007, respectively), and rate of pulmonary hemorrhage was also higher. There were no differences between the groups in terms of other morbidities. Conclusions: In preterm infants with RDS, RAM cannula use as an interface for NIV results in increased invasive ventilation and surfactant use.Öğe Successful Implementation of a Bundle Strategy to Prevent Ventilator-Associated Pneumonia in a Neonatal Intensive Care Unit(Oxford Univ Press, 2018) Gokce, Ismail Kursad; Kutman, Hayriye Gozde Kanmaz; Uras, Nurdan; Canpolat, Fuat Emre; Dursun, Yasemin; Oguz, Serife SunaBackground: We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit. Methods: This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods. Results: Throughout the study period, 13 VAP episodes were observed. Full adherence to all six components of the bundle doubled in the active-bundle period (12.8 vs. 24.3%, p<0.01). The mean VAP rate decreased from 7.33/1000 to 2.71/1000 ventilator days following intervention (p = 0.083). Conclusion: This study showed that reliable implementation of a neonate-specific VAP prevention bundle can produce sustained reductions in VAP rates.Öğe Successful ımplementation of a bundle strategy to prevent ventilator-associated pneumonia in aneonatal ıntensive care unit(Oxford unıv press, great clarendon st, oxford ox2 6dp, england, 2018) Gokce, Ismail Kursad; Kutman, Hayriye Gozde Kanmaz; Uras, Nurdan; Canpolat, Fuat Emre; Dursun, Yasemin; Oguz, Serife SunaBackground: We aimed to investigate the effectiveness of evidence-based bundle that we developed to reduce ventilator-associated pneumonia (VAP) rates and to assess the degree of compliance rates to this strategy in a tertiary neonatal intensive care unit. Methods: This before-after prospective cohort trial divided into two periods was conducted. All neonates requiring ventilation were enrolled in the study. VAP incidence, compliance rates to bundle components and the contribution of each bundle component to VAP rates were compared between the periods. Results: Throughout the study period, 13 VAP episodes were observed. Full adherence to all six components of the bundle doubled in the active-bundle period (12.8 vs. 24.3%, p<0.01). The mean VAP rate decreased from 7.33/1000 to 2.71/1000 ventilator days following intervention (p = 0.083).
