Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Hanta, Denizsearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccess

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    Primary Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula in a Low-Birth-Weight Neonate
    (2015) Hanta, Deniz; Metin, Seval; Cekinmez, Eren Kale; Torer, Birgin; Kilicdag, Hasan; Cevirgenoglu, Bahar
    Esophageal atresia is complex congenital anomaly of respiratory tract occuring often associated with anomalies of other systems and chromosomal abnormalities. This congenital anomaly is a surgical emergency. The management mode of Esophageal atresia/Tracheoesophageal Fistula in the premature, low birth weight neonate remains controversial. Traditionally, treatment has been based on a staged approach. The primary repair of Esophageal atresia and fistula closure is achievable in Low Birth Weight infants and offer a good treatment in the absence of additional severe malformations. Treatment of these neonates should not be limited to tertiary pediatric surgical centers, contrarily it is also achievable in secondary heath care centers. Near cooperation with neonatal intensivist and the pediatric surgeon is essential for good survival.
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    Determination of tissue hypoxia by physicochemical approach in premature anemia
    (2017) Torer, Birgin; Ozdemir, Zeliha; Hanta, Deniz; Cetinkaya, Min; Gulcan, Hande; Tarcan, Aylin; 28395879
    Background: Anemia is a common problem in premature infants and its most rapid and effective therapy is erythrocyte transfusion. However, owing to inherent risks of transfusion in this population, transfusions should be administered only when adequate oxygen delivery to tissues is impaired. The aim of this study was to determine tissue acid levels using Stewart method in an attempt to evaluate the tissue oxygenation level and thereby the accuracy of transfusion timing. Methods: This study included 47 infants delivered at gestational age below 34 weeks who required erythrocyte transfusion for premature anemia. Strong ion gap (SIG), unmeasurable anions (UMA), tissue acid levels (TA), and Cl/Na ratios were calculated before and after transfusion. Results: The mean birth weight and gestational age of the study population were 121 +/- 365 g and 29.2 +/- 2.7 weeks, respectively. Tissue acid levels were increased (TA > 4) and tissue hypoxia developed in 10 (16.6%) of 60 erythrocyte transfusions administered according to the restrictive transfusion approach. The patients were divided into two. groups according to tissue acid levels as low (<4) and high (>4) tissue acid groups. The group with tissue hypoxia (TA > 4) had significantly higher UMA levels but a significantly lower Cl/Na ratio; and UMA levels decreased and Cl/ Na ratio increased after transfusion in this group. Tissue hypoxia secondary to anemia was shown to be improved by erythrocyte transfusion. Conclusion: The results of the present study suggest that the determination of the level of tissue hypoxia by the Stewart approach may be an alternative to restrictive transfusion guidelines for timing of transfusion in premature anemia. It also showed that a low Cl/Na ratio can be used as a simple marker of tissue hypoxia. Copyright (C) 2017, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license