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PURPOSE: The aim of the study is to examine the follow-up and treatment results of late renal functions in children with high-grade (Grades 4, 5) renal trauma resulting from blunt abdominal injury. METHODS: The follow-up and treatment reports of 41 patients with renal trauma admitted to our clinic between the years 2005 and 2015 were reviewed retrospectively. RESULTS: Eight of the 41 cases had Grade 1, five had Grade 2, and 12 had Grade 3 renal trauma. The remaining 16 cases (12 of which were Grade 4, four were Grade 5) had high grade renal trauma. Four (25%) patients with high-grade renal trauma were operated (JJ stent placement was performed on one, renorraphy was performed on two, pyeloplasty and urinoma drainage were performed on one), and 12 patients were followed conservatively. In the long-term follow-up (>1 year), Tc-99m mercaptoacetyltriglycine (MAG3) kidney scintigraphy examination of three (30%) patients out of the 10 patients who were followed up conservatively, the affected kidneys were found to be nonfunctional (renal differential function 0%). The mean differential renal function in four patients who underwent surgery was 31% (between 25% and 40%). CONCLUSION: It should be kept in mind that kidneys may become atrophic or non-functional in the late period of follow-up in cases that are followed conservatively due to high-grade renal trauma. There is no standard algorithm or treatment method in the management of high-grade renal trauma. In order to achieve a good outcome, the treatment should be individualized as much as possible.
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Objectives: In our study, we aimed to determine the effect of vitamin C on short-term mortality and length of intensive care unit (ICU) stay in patients with coronavirus disease (COVID-19) followed up in the ICU. Methods: The patients who received and those who did not receive the high-dose intravenous vitamin C protocol were assigned to the treatment and control groups, respectively. The primary study findings in both groups were length of ICU stay and short-term mortality, while the secondary findings were vasopressor and invasive mechanical ventilation requirements and change in sequential organ failure assessment score from the 0 to the 96th hour. Results: Thirty-eight patients were included in the treatment group and 40 were included in the control group. The mortality rates were 44% and 60% in the treatment and control groups, respectively; however, the difference between the groups was not statistically significant (p>0.05). The median length of ICU stay in both groups was 10 days (p>0.05). No significant differences in the invasive mechanical ventilation and vasopressor requirements were found between the groups (p>0.05). Conclusion: Consequently, the high-dose vitamin C therapy in the patients with acute respiratory failure due to COVID-19 pneumonia did not reduce the length of ICU stay, mortality, and invasive mechanical ventilation and vasopressor reqirements.
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Objectives: In this study, we aimed to see the effects of smoking prevalence, the length of stay regarding the usage of cigarettes, and the effects on the mortality of COVID-19 in our Intensive Care Unit (ICU). Methods: This is a retrospective single-centered study that was done in the ICU on patients with COVID-19 between 16th of March and 16th of May in 2020. The demographic data, comorbidity status, the units they were accepted from, clinical symptoms, respiratory support, prevalence of smoking, length of stay in the ICU, and mortalities of the patients were recorded. There were two groups: Smoker and non-smoker. There were 1100 COVID-19 patients and 150 of these were treated in ICU unit. 95 patient's data were accessed. Statistical analyses were performed with the Scientific Package for the Social Science (version 21.0; SPSS Inc.). Results: There were 69.4% non-smoker and 35.8% smoker, and 5.3% of the smoker did smoke before (Table 1). The average age of the patients in smoker group was less than nonsmoker. The incidence of chronic obstructive pulmonary disease was higher in smokers (Table 2). The most common symptom was cough and it was 82% in nonsmoker group and 76.5% in smoker group (Table 3). In both groups, respiratory support was provided by IMV (Table 4). There was no relationship between two groups according to age (p=0.044) and gender of patients (p:0.062) (Table 2). The length of ICU stay was 7.6 days for smoking patients in the ICU and 9.3 days for non-users. While the mortality was 52.9% for smokers, it was 39.3% for non-smokers. No statistical correlation was found between smoking status, length of stay in ICU, and survival (Fig. 1). Smoking is blamed among the factors that cause this aggressive process, which can progress to respiratory failure and result in mortality in COVID-19 disease. Conclusion: Some studies also claim that smoking can be protective. There is still no clarity on this issue. It was concluded that smoking has no effect on the duration of ICU stay and mortality in patients treated in the ICU with respiratory failure due to COVID-19 pneumonia.
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BACKGROUND: In Covid-19 pneumonia, high mortality rates reported in intubated patients have raised non-invasive methods of respiratory support. OBJECTIVE: We aimed to evaluate the impact of HFNC application on intubation requirement, intensive care length of stay, and short-term mortality in patients with COVID-19 pneumonia. MATERIAL-METHOD: Patients receiving oxygen by reservoir mask or HFNC therapy in our intensive care units due to COVID-19 pneumonia were included in the study. Group H consisted of patients who received HFNC, and Group K consisted of patients who received conventional oxygen therapy (COT). The number of patients intubated, duration of intensive care stay and short-term mortality were recorded. RESULTS: 43 patients were included. The short-term mortality and the number of patients with intubation need was lower in Group H. There was no significant difference between the Groups in the length of intensive care stay. CONCLUSION: Administration of HFNC in respiratory failure secondary to COVID-19 pneumonia decreases the need for intubation and mortality.