Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life‐threatening mucocutaneous reactions characterized by necrosis and detachment of the epidermis. Drugs and bacterial or viral infections are the most common causes of SJS/TEN. Although cases of SJS/TEN have been reported after hydroxychloroquine, vaccine (mRNA [Biontech], and inactivated vaccine [Sinovac]) administration and during the clinical course of active Coronavirus disease 2019 (COVID‐19), limited data is indicating the COVID‐19 disease as a triggering factor. Also, there are no pediatric cases of SJS/TEN associated with COVID‐19 in the literature. Herein we reported two pediatric cases with a diagnosis of TEN related to COVID‐19. Therapeutic plasma exchange therapy was applied to both of our patients. Although there are a few adult cases in the literature, our article is the first pediatric case report about patients diagnosed with TEN related to COVID‐19 and successfully treated with plasma exchange.
Brucellosis is a multisystemic disease that can present with multiple signs and symptoms. Rarely, brucellosis can manifest as neurobrucellosis, with central or peripheral nervous system involvement. Guillain-Barré syndrome (GBS) is a post-infectious autoimmune disease that progresses rapidly, causing ascending muscle weakness, and is accompanied by areflexia/hyporeflexia. Regarding GBS etiology, it is thought to be an autoimmune disease, triggered by a previous bacterial or viral infection. There are a few Brucella-associated GBS case reports in the literature and in our opinion, only one of them is a pediatric patient. Herein we reported a case of GBS associated with neurobrucellosis, who was successfully treated with therapeutic plasmapheresis (TP) due to poor response to IVIG treatment.
Aims: The aim of this study was to present a comprehensive overview of the clinical spectrum and outcomes of critically ill pediatric patients admitted to a tertiary-level pediatric intensive care unit (PICU). Furthermore, we aimed to assess potential factors that could influence the requirement for PICU admission. The findings of this study may aid in the prompt identification and management of critically ill pediatric patients, thereby reducing the likelihood of PICU admission.
Methods: This descriptive study investigated the presentation of critical illness among pediatric patients aged between 1 month-18 years old admitted to the PICU was conducted in Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital, from February 2022 to January 2023. Demographic data, clinical variables, and outcome data (alive/expired) were analyzed.
Results: A total of 456 patients were analyzed, of which 258 (56.6%) were males and 198 (43.4%) were females. The median length of stay in the PICU was 5 days (1-114). Respiratory diseases (43.2%) were the most common reasons for admission to the PICU, followed by sepsis (13.2%), and neurological diseases (13.8%). We observed a mortality rate of 6.1%, with no association with age or sex. Variables found to be risk factors for mortality were PRISM III score, presence of sepsis and acute renal failure, the requirement for mechanical ventilation, use of inotropic agents, continuous renal replacement therapy and therapeutic plasma exchange requirement, and length of stay (p < 0.001).
Conclusion: The profile of patients admitted to the PICU can serve as a basis for developing dedicated protocols for critical care and redistributing the PICUs’ resources.
BackgroundThe aim of this study is to characterize the clinical indications, outcomes, and complications of therapeutic plasma exchange (TPE) in pediatric intensive care unit.MethodsA retrospective study was conducted on critically ill patients who received TPE. A dataset of 672 treatments administered to 102 patients was analyzed.ResultsThe most common indication for TPE was COVID‐19‐related clinical conditions, followed by sepsis (24.5%), neurological diseases (9.8%) and renal diseases (6.9%). None of our patients died due to TPE‐related complications, and the most common complication during and after the TPE was hypotension (21.7%).ConclusionAlthough TPE is riskier to provide to critically ill children, our experience indicates that it can be performed relatively safely in critically ill children with appropriate treatment indications. In particular, indications, onset time, number of sessions and other procedures should be standardized for the pediatric age group.
Aim: Due to the rapid development in pediatric critical care medicine, some past studies suggested that pediatric trauma patients have better outcomes such as lower mortality and lower length of hospital stay in the pediatric intensive care unit (PICU). In this study, we aim to describe the demographic, clinical features, mechanisms of injury, and outcomes of children hospitalized in our pediatric intensive care unit due to trauma.
Material and Method: We performed a retrospective evaluation of 60 pediatric trauma patients (between 0 and16 years of age) admitted to the PICU at University of Health Science, Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital from August 2020 to February 2022.
Results: A total of 60 pediatric trauma patients were followed up in our PICU. The median age of patients was 17 (0-724) months with a preponderance of male cases (n:38, 63.3%). The median duration of hospitalization in PICU was 6 (1-46) days. According to the trauma type, the majority of the injuries were falling from a height (n:37, 61.7%).
Conclusion: We would like to draw attention to the fact that head traumas due to falling were so common and also affect mortality. The lactate and the lactate/albumin ratio of patients who developed mortality were significantly higher. Although there are studies on the association of lactate/albumin ratio with mortality in critically ill pediatric patients, we could not find any data on this issue in pediatric trauma patients in the literature. Our study will contribute to the literature on the relationship between lactate/albumin ratio and mortality in pediatric trauma patients. We suggest that the relationship between lactate/albumin ratio and mortality should be investigated in pediatric trauma patients with larger case numbers.
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