Gülşen KESKİN, Mine AKIN, Sibel SAYDAM, Yeşim ŞENAYLI, Devrim Tanıl KURT, Sengül ÖZMERT, Feyza SEVER, Atilla ŞENAYLI

CENTRAL VENOUS CATHETERIZATION IN PEDIATRIC BURN PATIENTS: SIX-YEAR CLINICAL OUTCOMES IN A SINGLE CENTER EXPERIENCE

Objective: There is a limited number of studies in which the central venous catheterization practices in pediatric burn patients is discussed. The aim of this study is to share 6 years of experience of central venous catheterization practices performed by the department of anesthesia in a pediatric burn intensive care unit. Method: Anesthesia forms and laboratory records of 84 pediatric patients, who underwent central venous catheterization by the anesthesiologists in the pediatric burn intensive care unit of Ankara Child Health and Diseases Hematology-Oncology Training and Research Hospital between January 2009-December 2015, were retrospectively analyzed. Results: Between January 2009-December 2015, 122 central venous catheters were inserted in 84 pediatric burn patients aged between 15 days and 17 years. In 73 patients (59.8%) the internal jugular vein and in 49 patients (40.2%) femoral vein were preferred for catheterization. 63.9% of the patients were aged 4 years or under. No major complications were encountered during and after the catheterization. Acinetobacter species was the most isolated organism from the catheter cultures. Conclusion: Burn injury more than 40% of total burn surface area is responsible for the mortality regardless of the localization of the catheter and the cause of burn. Although not statistically significant, infection rates were high in the catheterization of the femoral vein.

PED‹YATR‹K YANIK HASTALARINDA SANTRAL VENÖZ KATETER‹ZASYON: TEK B‹R MERKEZ DENEY‹M‹N‹N ALTI YILLIK KL‹N‹K SONUÇLARI

Amaç: Çocuk yan›k hastalar›ndaki santral venöz kateter uygulamalar› az say›da çal›flma vard›r. Bu çal›flmada ciddi yan›k yüzdesi ve derecesine sahip hastalar›n takip edildi¤i 10 yatakl› çocuk yan›k ünitesinde anestezi bölümü taraf›ndan tak›lan santral venöz kateter uygulamalar› ile ilgili 6 y›ll›k deneyimin paylafl›lmas› amaçland›. Yöntem: Ocak 2009- Aral›k 2015 tarihleri aras›nda Ankara Çocuk Sa¤l›¤› ve Hastal›klar› Hematoloji-Onkoloji E¤itim Araflt›rma Hastanesi, çocuk yan›k yo¤un bak›m ünitesinde anestezi bölümü taraf›ndan santral venöz kateter uygulanan 84 pediyatrik hastan›n anestezi formlar›, laboratuvar kay›tlar› retrospektif olarak analiz edildi. Bulgular: Ocak 2009- Aral›k 2015 tarihleri aras›nda 15 gün-17 yafl aral›¤›nda 84 çocuk yan›k hastas›na 122 santral venöz kateter tak›ld›. 73 (59.8 %) internal juguler ven, 49 (40.2 %) femoral ven kullan›ld›. Hastalar›n %63.9’u 4 yafl ve alt›nda idi. Kateterizasyon s›ras›nda ve sonras›nda major komplikasyon ile karfl›lafl›lmad›. Kateter kültürlerinde en çok Acinetobacter izole edildi. Sonuç: Çocuk yan›k hastalar›nda, %40 ve üzeri yan›k alan›na sahip olmak kateter yeri ve yan›k nedeninden ba¤›ms›z olarak mortaliteden sorumludur. Femoral ven kateterizasyonlar›nda enfeksiyon oranlar› istatiksel olarak anlaml› olmasa da yüksektir.

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