Çocuk Yoğun Bakım Ünitelerinde Meningokoksemi: Demografik, Epidemiyolojik ve Klinik Özellikler

Amaç: Meningokoksemi tanısıyla çocuk yoğun bakım ünitelerinde (ÇYBÜ) izlenen hastaları demograk, epidemiyolojik, klinik ve laboratuvar özellikleri açısından değerlendirmektir. Yöntemler: Dört farklı ÇYBÜ'de takip ve tedavisi yapılan, menenjitin eşlik ettiği veya tek başına meningokosemi tanısı almış 1 ay-18 yaş arası çocukların tıbbi kayıtları değerlendirildi. Bulgular: Çalışmaya toplam 33 hasta dahil edildi ve ortalama yaş 3.4±2.1 yıldı. Hastaların 22 (%67)'si erkekti. Hastaların %84'ünde ateş ilk semptomdu ve %97'sinde tanı anında meningokoksemiye ait döküntü saptandı. Lomber ponksiyon hastaların %45'ine yapıldı ve 7 (%21)'sinde eşlik eden menenjit olduğu görüldü. N. meningitidis 7 hastanın kan kültüründe ve 2 hastanın BOS kültüründe üretilebildi. Hastaların %93'ü hastaneye başvurduktan sonraki ilk 1 saat içerisinde ortalama 60 ml/kg sıvı bolusu aldı. İnotropik ve vazopressör tedavi olarak 18 (%54.5) hastaya dopamin, 9 (%27.2) hastaya dobutamin ve 4 hastaya (%12.1) epinefrin infüzyonu verildi. Hastaların %58'inde steroid, %12'sine ise dissemine intravasküler koagülasyon ve purpura fulminans nedeniyle heparin infüzyonu uygulandı. Ortalama yoğun bakım yatış süresi süresi 6 gün (1-29 gün), mortalite oranı %21'di. Sonuç: Çalışmamızdaki hastaların demograk, epidemiyolojik, klinik ve laboratuvar özellikleri daha önce yapılan çalış- malarla benzer olmakla birlikte, mortalite oranı yüksek olarak bulunmuşturCAYD 2015;2(1):7-12.

Meningococemia in Pediatric Intensive Care Units:Demographic, Epidemiological and Clinical Features

Objective: The aim of this study was to review demographic, epidemiological, clinical, and laboratory characteristics of meningococcemia patients in pediatric intensive care units (PICU). Methods: Investigators from 4 dierent PICUs reviewed the medical records of children aged between 1 month to 18 years and diagnosed with meningococcemia with or without meningitis. Results: There were a total of 33 patients in the study period. The median age at admission was 3,4±2.1 years. In all, 22 (67%) were male. Fever was the rst symptom in 84% of the patients and 97% of them had meningococcemic rashes at admission. Lumbar puncture was performed to 45% of the patients and 7 (21%) of them had meningitis with meningococcemia. N. meningitidis was cultured from 7 blood and 2 cerebrospinal uid samples. An average of 60 mL/kg uid bolus was given to 93% of the patients within the rst hour of hospital admission. Dopamine, dobutamine, and epinephrine were given to patients who required inotropic and vasopressor infusions (54.5%, 27.2%, 12.1% of the patients,respectively). Fifty-eight percent of the patients received steroid therapy and 12% of them received heparin infusion for disseminated intravascular coagulation and purpura fulminans. The mean length of PICU stay was 6 days (1 to 29 days) and the overall mortality rate was 21% (7 patients). Conclusion: Although demographic, epidemiological, clinical, and laboratory characteristics of our patients were similar to previous reports, mortality rate was higher CAYD 2015;2(1):7-12.

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Çocuk Acil ve Yoğun Bakım Dergisi
  • ISSN: 2146-2399
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 2014

5.7b3.1b

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