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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 Colchicine Protects against Hyperoxic Lung Injury in Neonatal Rats(Karger, 2012) Ozdemir, Ramazan; Yurttutan, Sadik; Talim, Beril; Uysal, Bulent; Erdeve, Omer; Oguz, Serife Suna; Dilmen, UgurBackground: Bronchopulmonary dysplasia (BPD) is characterized by inflammation, fibrosis and mucosal necrosis, which leads to emphysematous coalescence of alveoli. Objective: We tested whether prophylaxis with colchicine, an anti-inflammatory, antioxidant and antifibrotic drug, would decrease the severity of lung injury in an animal model of BPD. Methods: Twenty-five rat pups were divided into three groups: control (n = 8), hyperoxia (n = 7), and hyperoxia + colchicine (n = 10). The hyperoxia groups were exposed to >95% oxygen from day 1 to 10 of life. On day 10, the animals were sacrificed and the lungs were processed for histology and biochemical analysis. Lung morphology was assessed by the mean linear intercept (MLI), a measure of alveolar size. The degree of lung inflammation and antioxidant capacity were assessed by quantifying lung homogenate tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), malondialde-hyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels. Results: Colchicine significantly decreased lung damage as determined by the MLI in the c groups (p < 0.01). The median level of lung MDA was significantly higher in the hyperoxia group compared with the control group (p < 0.05) and the colchicine-treated group (p < 0.05). Lung homogenate SOD and GSH-Px activities in the colchicine-treated group were significantly higher than in the hyperoxia group (p < 0.05). Furthermore, colchicine-treated pups had lower lung homogenate TNF-alpha and IL-1 beta levels compared with the hyperoxia group (p < 0.05). Conclusions: Colchicine has favorable effects on alveolarization as well as inflammation and oxidative stress markers in an animal model of BPD. Copyright (C) 2012 S. Karger AG, BaselÖğe 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 Mean Platelet Volume in Neonatal Sepsis(Wiley, 2012) Oncel, Mehmet Yekta; Ozdemir, Ramazan; Yurttutan, Sadik; Canpolat, Fuat Emre; Erdeve, Omer; Oguz, Serife Suna; Uras, NurdanBackground The aim of this study was to investigate any changes in mean platelet volume (MPV) in patients with neonatal sepsis (NS). Methods Subjects were stratified into two groups: proven sepsis (Group 1a) and clinical sepsis (Group 1b). The control group (Group 2) consisted of healthy newborns matched for gestational age and birth weight. Results A total of 100 patients with NS (35 with proven sepsis and 65 with clinical sepsis) and 50 healthy controls were enrolled. A comparison of markers of sepsis obtained at baseline revealed white blood cell count (WBC), C-reactive protein (CRP), interleukin-6 (IL-6), and MPV levels to be significantly higher in newborns with sepsis compared to healthy controls (P = 0.01, <0.001, <0.001, and 0.001, respectively). Mean baseline serum levels of CRP and MPV were significantly higher in Group 1a compared to Group 1b (P = 0.003, P = 0.007, respectively), whereas the difference between group with regards to baseline serum levels of IL-6 and platelet count was statistically insignificant (P = 0.14, P = 0.28, respectively). Conclusion This is the first study to demonstrate a statistically significant difference with regard to baseline MPV values between patients with sepsis (proven or clinical) and healthy controls. J. Clin. Lab. Anal. 26:493-496, 2012. (C) 2012 Wiley Periodicals, Inc.Öğe Postnatal hydrocortisone therapy for the treatment of bronchopulmonary dysplasia in very low birth weight infants(2019) Buyuktiryaki, Mehmet; Alyamac Dizdar, Evrim; Okur, Nilufer; Sari, Fatmanur; Bezirganoglu, Handan; Canpolat, Fuat Emre; Uras, Nurdan; Oguz, Serife SunaAim: Corticosteroids are widely used to prevent and treat bronchopulmonary dysplasia (BPD) due to their strong anti-inflammatory effects. We aim to evaluate the outcomes of late onset systemic hydrocortisone (HC) therapy in very low birth weight infants with BPD.Material and Methods: The medical records of 706 preterm infants with gestational age ≤ 30 weeks over a 4-year period were retrospectively reviewed. Infants who required invasive/noninvasive respiratory support or ≥ 30% oxygen due to BPD and were treated with HC after the third postnatal week were included. The infants were divided into 3 groups according to respiratory support at the beginning of the HC treatment: mechanical ventilation (MV), noninvasive ventilation (NIV), and free oxygen.Results: Seventy-six (11.9%) infants in our cohort received HC therapy. In the MV group, 83.3% of the infants were successfully extubated after a median of 4 days (interquartile range [IQR], 2-8 days). In the NIV group, 83.9% of the infants required no longer respiratory support after a median of 6 days (IQR, 3-16 days). In the free oxygen group, none of the infants needed supplemental oxygen after a median of 8 days (IQR, 6-12 days). Conclusion: Late HC therapy facilitates extubating without adverse short-term effects, reduces the need of invasive and noninvasive ventilation, and facilitates discharge without supplemental oxygen.Öğe Renal and mesenteric tissue oxygenation in preterm infants treated with oral ibuprofen(Taylor & Francis Ltd, 2014) Guzoglu, Nilufer; Sari, Fatma Nur; Ozdemir, Ramazan; Oguz, Serife Suna; Uras, Nurdan; Altug, Nahide; Dilmen, UgurBackground: Hemodynamically significant patent ductus arteriosus (PDA) is a common problem in preterm infants which often causes significant morbidities. Although PDA induces alterations in various tissue perfusion, there is scarce information about the effect of oral ibuprofen on hemodynamics of regional tissues. Objective: To investigate, using near-infrared spectroscopy, the effect of oral ibuprofen on renal and mesenteric tissue oxygenation and oxygen extraction in preterm infants with a diagnosis of hemodynamically significant PDA. Patients and methods: Fifteen infants (gestational age <32 weeks) with the diagnosis of hemodynamically significant PDA treated with oral ibuprofen were monitored for near-infrared spectroscopy - determined renal and mesenteric oxygenation. The infants with PDA were matched for gestational age, postnatal age with infants without PDA, who served as control subjects. Results: In infants with PDA, mean arterial blood pressure was significantly lower compared with the control infants [39.3 (range: 36-54) versus 51 (range: 43-66) mmHg, respectively; p < 0.001)]. There were no significant differences in regional oxygen saturation and fractional oxygen extraction of renal and mesenteric tissues in PDA and control infants (p > 0.05). And ibuprofen treatment did not negatively influence renal and mesenteric oxygenation and extraction in infants with PDA (p > 0.05). Conclusion: Renal and mesenteric tissue oxygenation and oxygen extraction were preserved in preterm infants with a diagnosis of hemodynamically significant PDA treated with oral ibuprofen.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).
