�ocuklarda motorlu ara� �arp��ma travmas� ve di�er travma mekanizmalar�n�n �ocuk yo�un bak�m �ncesi ve �ocuk yo�un bak�m kabulünde uygulanan müdahaleler, klinik �zellikler ve n�rolojik sonu�lar�n kar��la�t�r�lmas�

�zcan, Serhan; Aky�zl�er G�ne�, Merve Setenay; Havan, Merve; Perk, Oktay; Azapa�as�, Ebru; G�n, Emrah; Botan, Edin; Ergun, Ergun; Ate�, Ufuk; Kahilo�ullar�, G�kmen; Kendirli, Tan�l

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�ocuklarda motorlu ara� �arp��ma travmas� ve di�er travma mekanizmalar�n�n �ocuk yo�un bak�m �ncesi ve �ocuk yo�un bak�m kabulünde uygulanan müdahaleler, klinik �zellikler ve n�rolojik sonu�lar�n kar��la�t�r�lmas� [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2022; 28(4): 456-463 | DOI: 10.14744/tjtes.2022.86617

�ocuklarda motorlu ara� �arp��ma travmas� ve di�er travma mekanizmalar�n�n �ocuk yo�un bak�m �ncesi ve �ocuk yo�un bak�m kabulünde uygulanan müdahaleler, klinik �zellikler ve n�rolojik sonu�lar�n kar��la�t�r�lmas�

Serhan �zcan¹, Merve Setenay Aky�zl�er G�ne�², Merve Havan¹, Oktay Perk¹, Ebru Azapa�as�¹, Emrah G�n¹, Edin Botan¹, Ergun Ergun³, Ufuk Ate�³, G�kmen Kahilo�ullar�⁴, Tan�l Kendirli¹
¹Ankara �niversitesi T�p Fakültesi, �ocuk Yo�un Bak�m Bilim Dal�, Ankara
²Ankara �niversitesi T�p Fakültesi, �ocuk Sa�l�� ve Hastal�klar� Anabilim Dal�, Ankara
³Ankara �niversitesi T�p Fakültesi, �ocuk Cerrahisi Anabilim Dal�, Ankara
⁴Ankara �niversitesi T�p Fakültesi, Beyin ve Sinir Cerrahisi Anabilim Dal�, Ankara

AMA�: Motorlu ara� kazalar� (MAK), pediatrik ya� grubunda bir numaral� �l�m nedenidir. Bu �al��man�n amac�, �ocuk yo�un bak�m �nitesinde (�YB�) takip edilen hastalarda MAK ile di�er travma mekanizmalar� (DTM) aras�ndaki farkl�l�klar� belirlemektir.
GERE� VE Y�NTEM: 2014�2018 y�llar� aras�nda ��nc� d�zey �YBܒde yatan pediatrik travma hastalar�n�n veriler geriye d�n�k olarak kay�t edildi. Hastalar MAK ve DTM olarak iki gruba ayr�ld�. Demografik veriler, yo�un bak�m �ncesi yap�lan m�dahaleler (kardiyopulmoner res�sitasyon, ent�-basyon, yaralanma �iddeti skorlar�, yo�un bak�ma ula�ana kadar ge�en s�re), yo�un bak�m m�dahaleleri (invaziv mekanik ventilasyon, non-invaziv mekanik ventilasyon, ameliyat ihtiyac�, ameliyat t�r�, transf�zyon ihtiyac� ve inotrop tedavisi) iki grup aras�nda kar��la�t�r�ld�. Sonu�lar sa�kal�m, hastaneden taburcu olma, taburculukta Pediatrik Serebral Performans Kategorisi (PSPK) ile de�erlendirildi.
BULGULAR: Be� y�ll�k �al��ma s�resi boyunca, 135 hasta travma nedeniyle hastaneye kald�r�ld�. Yaralanan v�cut b�lgeleri ba� ve boyun (%61.5), kar�n ve bel omurgas� (%39.4) ve ekstremiteler ve pelvis (%36.3) idi. �oklu travma en �ok MAK travma grubunda g�r�ld� (p=0.001). Motorlu ara� kaza-lar� grubunda invaziv mekanik ventilasyon ve inotrop tedavi ihtiyac� daha fazlayd� (s�ras�yla, p=0,002, 0,001). Y�z yirmi �� hasta (%91.1) hayatta kald�. Mortalite oran� MAK grubunda daha y�ksekti (p=0.026). Pediatrik Serebral Performans Kategorisi sonu�lar� DTM grubunda daha iyiydi (p=0.017). TARTI�MA: Motorlu ara� kazalar�, DTM�lerden daha fazla �oklu travma olgusuna yol a�ar. �nvaziv mekanik ventilasyon, inotroplar ve di�er yo�un bak�m m�dahaleleri, MAK hastalar�nda DTM hastalar�na g�re �ok daha s�k gerekliydi.

Anahtar Kelimeler: �ocuk, motorlu ara� kazas�; travma; yo�un bak�m.

Comparison of pre-PICU and per-PICU interventions, clinical features and neurologic outcomes of motor vehicle collision trauma and other mechanisms of trauma in children

Serhan �zcan¹, Merve Setenay Aky�zl�er G�ne�², Merve Havan¹, Oktay Perk¹, Ebru Azapa�as�¹, Emrah G�n¹, Edin Botan¹, Ergun Ergun³, Ufuk Ate�³, G�kmen Kahilo�ullar�⁴, Tan�l Kendirli¹
¹Department of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara-Turkey
²Department of Pediatrics, Ankara University Faculty of Medicine, Ankara-Turkey
³Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara-Turkey
⁴Department of Neurosurgery, Ankara University Faculty of Medicine, Ankara-Turkey

BACKGROUND: Motor vehicle collisions (MVCs) are the number one cause of death in the pediatric age group. The aim of this study was to determine the differences between MVCs and other trauma mechanisms (OTMs) in patients who were followed up at a pediatric intensive care unit (PICU).
METHODS: Data were retrospectively collected for pediatric trauma patients hospitalized at a third level PICU between 2014 and 2018. Patients have been divided into two groups as MVC and OTM. Demographic data, pre-PICU interventions (cardiopulmonary resuscitation, intubation, injury severity scores, time period before intensive care), intensive care interventions (invasive mechanical ventilation, non-invasive mechanical ventilation, need for surgery, type of surgery, need for transfusion, and inotrope therapy) were compared between two groups. Outcomes were evaluated by survival, discharge from hospital, Pediatric Cerebral Performance Cate-gory (PCPC) at discharge, tracheotomy presence, and amputation performed.
RESULTS: During the 5-year study period, 135 patients were hospitalized for trauma. The injured body regions were the head and neck (61.5%), abdomen and lumbar spine (39.4%), and extremities and pelvis (36.3%). Multiple trauma was mostly seen in the MVC trauma group (p=0.001). The need for invasive mechanical ventilation and inotrope therapy was greater in the MVC group (p=0.002, 0.001 respectively). One hundred and twenty-three patients (91.1%) survived. The mortality rate was higher in the MVC group (p=0.026). The PCPC results were better in the OTM group (p=0.017).
CONCLUSION: MVCs lead to more multiple trauma cases than OTMs. Invasive mechanical ventilation, inotropes, and other inten-sive care interventions were necessary much more often in MVC victims than in OTM patients.

Keywords: Children, intensive care; motor vehicle; trauma.

Serhan �zcan, Merve Setenay Aky�zl�er G�ne�, Merve Havan, Oktay Perk, Ebru Azapa�as�, Emrah G�n, Edin Botan, Ergun Ergun, Ufuk Ate�, G�kmen Kahilo�ullar�, Tan�l Kendirli. Comparison of pre-PICU and per-PICU interventions, clinical features and neurologic outcomes of motor vehicle collision trauma and other mechanisms of trauma in children. Ulus Travma Acil Cerrahi Derg. 2022; 28(4): 456-463

Sorumlu Yazar: Serhan �zcan, T�rkiye
Makale Dili: �ngilizce

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