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Covid-19 Pandemisinin Çocuk Yoğun Bakım Ünitesi Yatışlarına Etkisi

Yıl 2021, Cilt 54, Sayı 2, 167 - 171, 31.08.2021
https://doi.org/10.20492/aeahtd.935162

Öz

Amaç: Bu çalışmada pandemi döneminde; sosyal izolasyon, alınan önlemler ve hastane protokollerinin üçüncü basamak pediatrik yoğun bakım pratiğine etkisini araştırmak amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza; 15 Mart 2020-1 Haziran 2020 tarihleri arasında çocuk yoğun bakım ünitemize kabul edilen çocuk hastalar dahil edildi. Hastaların demografik özellikleri, yatış tanıları, mekanik ventilatöre bağlanma oranları, mekanik ventilatörde kalış süreleri, ÇYBÜ ve hastane yatış süreleri, PRİSM III skorları ve mortalite durumları medikal dosya verilerinden retrospektif olarak kaydedildi. Elde edilen veriler pandemiden önceki yılın aynı dönemiyle (15 Mart 2019 – 1 Haziran 2019) karşılaştırıldı. Bulgular: Pandemi döneminde ÇYBÜ’ne kabül edilen hasta sayısı 200’dü. Pandemi öncesi (2019) dönemde 379 hasta yatışı olmuştu. ÇYBÜ’ne kabül edilen hasta sayısında pandemi döneminde bir önceki yıla göre %47 oranında bir düşüş saptadık. Pandemi öncesi dönem ile pandemi dönemi; hastaların yoğun bakıma yatış tanıları açısından karşılaştırıldığında, solunum yolu hastalıkları (pnömoni, bronşiolit, astım vb.) ve post-op hasta yatışlarında azalma, diabetik ketoasidoz nedeni ile yatışlarda artış saptandı ve istatistiksel olarak anlamlı farklılık vardı. Ayrıca hastaların pandemi döneminde mekanik ventilatörde kalış süreleri, hastanede kalış süreleri ve yoğun bakımda kalış sürelerinde azalma saptadık ve bu durum istatistiksel olarak da anlamlıydı. Sonuç: Sosyal mesafenin, maske kullanmanın ve hijyen kurallarına uyumun enfeksiyon bulaş riskini azalttığını ve bu durumun yoğun bakım yatış sayısında azalmaya neden olduğu tahmin etmekteyiz. Buradan yola çıkarak; sosyal mesafeye ve el hijyenine uyumu belki de hayatımızın bir parçası olarak kabul edip, bulaş riskinin yüksek olduğu kreş ve okullarda ileriki dönemlerde buna yönelik düzenlemelerin yapılması gerektiğini vurgulamak istiyoruz.

Kaynakça

  • Referans1 Anedda L, Bianchini L, Cuzzolin L, et al. What if COVID-19 affects the child: which weapons and how to use them. Eur Rev Med Pharmacol Sci. 2021; 25: 3325-37. doi: 10.26355/eurrev_202104_25744.
  • Referans2 Kaplan LJ, Kleinpell R, Maves RC, et al. Critical Care Clinician Reports on Coronavirus Disease 2019: Results From a National Survey of 4,875 ICU Providers. Crit Care Explor. 2020; 2: e0125. doi: 10.1097/CCE.0000000000000125.
  • Referans3 Ghinai I, McPherson TD, Hunter JC, et al. First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. Lancet. 2020; 395: 1137-44. doi: 10.1016/S0140-6736(20)30607-3.
  • Referans4 Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020; 109: 1088‐ 95. doi: 10.1111/apa.15270
  • Referans5 Dayal D. We urgently need guidelines for managing COVID‐19 in children with comorbidities. Acta Paediatr. 2020; 109: 1497‐ 98. doi: 10.1111/apa.15304.
  • Referans6 Lazzerini M, Barbi E, Apicella A, et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet child Adolesc Heal. 2020; 4: e10–e11. doi: 10.1016/S2352-4642(20)30108-5.
  • Referans7 Wilder JL, Parsons CR, Growdon AS, et al. Pediatric Hospitalizations During the COVID-19 Pandemic. Pediatrics. 2020; 146: e2020005983. doi: 10.1542/peds.2020-005983.
  • Referans8 Graciano AL, Bhutta AT, Custer JW. Reduction in paediatric intensive care admissions during COVID-19 lockdown in Maryland, USA. BMJ Paediatrics Open. 2020; 4: e000876. doi: 10.1136/bmjpo-2020-000876.
  • Referans9 Chu DK, Akl EA, Duda S, et al. COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395: 1973-87. doi: 10.1016/S0140-6736(20)31142-9.
  • Referans10 Vásquez-Hoyos P, Diaz-Rubio F, Monteverde-Fernandez N, et al. Reduced PICU respiratory admissions during COVID-19. Arch Dis Child 2020; archdischild-2020-320469. doi: 10.1136/archdischild-2020-320469.
  • Referans11 Lönnrot M, Lynch KF, Elding Larsson H, et al. Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study. Diabetologia. 2017; 60: 1931– 40. doi: 10.1007/s00125-017-4365-5.
  • Referans12 Liu F, Long X, Zhang B, et al. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020; 18: 2128-30. doi: 10.1016/j.cgh.2020.04.040.
  • Referans13 Hawkes CP, Willi SM. A trend towards an early increase in ketoacidosis at presentation of paediatric type 1 diabetes during the coronavirus-2019 pandemic. Diabet Med. 2021; 38: e14461. doi: 10.1111/dme.14461.
  • Referans14 Dayal D, Gupta S, Raithatha D, et al. Missing during COVID-19 lockdown: Children with onset of type 1 diabetes. Acta Paediatr. 2020; 109: 2144-46. doi: 10.1111/apa.15443.
  • Referans15 Rubino F, Amiel SA, Zimmet P, et al. New-Onset Diabetes in Covid-19. N Engl J Med. 2020; 383:789-90. doi: 10.1056/NEJMc2018688.
  • Referans16 Gupta R, Gupta J, Ammar H, Impact of COVID‑19 on the outcomes of gastrointestinal surgery. Clin J Gastroenterol. 2021; 29: 1-15. doi: 10.1007/s12328-021-01424-4.
  • Referans17 Lin JA, Braun HJ, Schwab ME, et al. Pandemic Recovery: Persistent Disparities in Access to Elective Surgical Procedures. Ann Surg. 2021 Mar 3. doi: 10.1097/SLA.0000000000004848.

The Effect of Covid-19 Pandemic on Pediatric Intensive Care Admissions

Yıl 2021, Cilt 54, Sayı 2, 167 - 171, 31.08.2021
https://doi.org/10.20492/aeahtd.935162

Öz

Aim: This study aimed to investigate the effects of social isolation, precautions, and hospital protocols on tertiary pediatric intensive care (PICU) during the pandemic period. Material and Method: Patients who were admitted to our PICU between March 15 and 1 June 01 2020, were included in this retrospective study. The demographic characteristics of the patients like hospitalization diagnoses, mechanical ventilation rates, duration of stay in mechanical ventilation, length of stay (LOS) in the PICU and hospitalization, PRISM III scores, and mortality status were recorded retrospectively. The data obtained were compared with the same period of the year before the pandemic (15 March and 1 June 2019). Result: During the pandemic period, the number of patients admitted to the PICU was 200 while the pre-pandemic (2019) period was 379 patients. We found a 47% decrease in the number of admitted patients during the pandemic period compared to the previous year. When the patients were compared in terms of the diagnoses of PICU admission, a decrease in respiratory tract diseases (pneumonia, bronchiolitis, asthma, etc.) and post-op patient admissions, an increase in hospitalizations due to diabetic ketoacidosis were found, and there was a statistically significant difference pre-pandemic period and pandemic period. In addition, we found a statistically significant decrease in the duration of stay in the mechanical ventilation during the pandemic period, LOS in PICU, and hospitalization. Conclusion: We think that social distance, wearing masks, and compliance with hygiene rules reduce the risk of infection and this situation causes a decrease in the number of intensive care hospitalizations. In the light of this data, we would like to accept compliance with social distance and hand hygiene as a part of our lives and emphasize that arrangements should be made in the future in kindergartens and schools where the risk of contamination is high.

Kaynakça

  • Referans1 Anedda L, Bianchini L, Cuzzolin L, et al. What if COVID-19 affects the child: which weapons and how to use them. Eur Rev Med Pharmacol Sci. 2021; 25: 3325-37. doi: 10.26355/eurrev_202104_25744.
  • Referans2 Kaplan LJ, Kleinpell R, Maves RC, et al. Critical Care Clinician Reports on Coronavirus Disease 2019: Results From a National Survey of 4,875 ICU Providers. Crit Care Explor. 2020; 2: e0125. doi: 10.1097/CCE.0000000000000125.
  • Referans3 Ghinai I, McPherson TD, Hunter JC, et al. First known person-to-person transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the USA. Lancet. 2020; 395: 1137-44. doi: 10.1016/S0140-6736(20)30607-3.
  • Referans4 Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020; 109: 1088‐ 95. doi: 10.1111/apa.15270
  • Referans5 Dayal D. We urgently need guidelines for managing COVID‐19 in children with comorbidities. Acta Paediatr. 2020; 109: 1497‐ 98. doi: 10.1111/apa.15304.
  • Referans6 Lazzerini M, Barbi E, Apicella A, et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet child Adolesc Heal. 2020; 4: e10–e11. doi: 10.1016/S2352-4642(20)30108-5.
  • Referans7 Wilder JL, Parsons CR, Growdon AS, et al. Pediatric Hospitalizations During the COVID-19 Pandemic. Pediatrics. 2020; 146: e2020005983. doi: 10.1542/peds.2020-005983.
  • Referans8 Graciano AL, Bhutta AT, Custer JW. Reduction in paediatric intensive care admissions during COVID-19 lockdown in Maryland, USA. BMJ Paediatrics Open. 2020; 4: e000876. doi: 10.1136/bmjpo-2020-000876.
  • Referans9 Chu DK, Akl EA, Duda S, et al. COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet 2020; 395: 1973-87. doi: 10.1016/S0140-6736(20)31142-9.
  • Referans10 Vásquez-Hoyos P, Diaz-Rubio F, Monteverde-Fernandez N, et al. Reduced PICU respiratory admissions during COVID-19. Arch Dis Child 2020; archdischild-2020-320469. doi: 10.1136/archdischild-2020-320469.
  • Referans11 Lönnrot M, Lynch KF, Elding Larsson H, et al. Respiratory infections are temporally associated with initiation of type 1 diabetes autoimmunity: the TEDDY study. Diabetologia. 2017; 60: 1931– 40. doi: 10.1007/s00125-017-4365-5.
  • Referans12 Liu F, Long X, Zhang B, et al. ACE2 expression in pancreas may cause pancreatic damage after SARS-CoV-2 infection. Clin Gastroenterol Hepatol. 2020; 18: 2128-30. doi: 10.1016/j.cgh.2020.04.040.
  • Referans13 Hawkes CP, Willi SM. A trend towards an early increase in ketoacidosis at presentation of paediatric type 1 diabetes during the coronavirus-2019 pandemic. Diabet Med. 2021; 38: e14461. doi: 10.1111/dme.14461.
  • Referans14 Dayal D, Gupta S, Raithatha D, et al. Missing during COVID-19 lockdown: Children with onset of type 1 diabetes. Acta Paediatr. 2020; 109: 2144-46. doi: 10.1111/apa.15443.
  • Referans15 Rubino F, Amiel SA, Zimmet P, et al. New-Onset Diabetes in Covid-19. N Engl J Med. 2020; 383:789-90. doi: 10.1056/NEJMc2018688.
  • Referans16 Gupta R, Gupta J, Ammar H, Impact of COVID‑19 on the outcomes of gastrointestinal surgery. Clin J Gastroenterol. 2021; 29: 1-15. doi: 10.1007/s12328-021-01424-4.
  • Referans17 Lin JA, Braun HJ, Schwab ME, et al. Pandemic Recovery: Persistent Disparities in Access to Elective Surgical Procedures. Ann Surg. 2021 Mar 3. doi: 10.1097/SLA.0000000000004848.

Ayrıntılar

Birincil Dil Türkçe
Konular Tıp
Bölüm Araştırma Makalesi
Yazarlar

Serhat EMEKSİZ (Sorumlu Yazar)
ANKARA YILDIRIM BEYAZIT ÜNİVERSİTESİ
0000-0002-8951-4774
Türkiye


Emel UYAR
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0002-8265-0618
Türkiye


Oktay PERK
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0002-2586-5954
Türkiye


Serhan ÖZCAN
SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ANKARA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, ÇOCUK SAĞLIĞI VE HASTALIKLARI ANABİLİM DALI
0000-0003-4465-6063
Türkiye

Yayımlanma Tarihi 31 Ağustos 2021
Başvuru Tarihi 12 Mayıs 2021
Kabul Tarihi 27 Haziran 2021
Yayınlandığı Sayı Yıl 2021, Cilt 54, Sayı 2

Kaynak Göster

AMA Emeksiz S. , Uyar E. , Perk O. , Özcan S. Covid-19 Pandemisinin Çocuk Yoğun Bakım Ünitesi Yatışlarına Etkisi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. 2021; 54(2): 167-171.