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  • Küçük Resim
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    Incidence, risk factors and severity of retinopathy of prematurity in Turkey (TR-ROP study): A prospective, multicentre study in 69 neonatal intensive care units
    (BMJ Publishing Group, 2018) Baş, Ahmet Yağmur; Demirel, Nihal; Koç, Esin; Ulubaş Işık, Dilek; Hirfanoğlu, İbrahim Murat; Tunç, Turan; Sarı, Fatma Nur; Karatekin, Güner; Köklü, Esad; Altunhan, Hüseyin; Turgut, Hatice; Narter, Fatma; Tarakçı, Nuriye; Tekgündüz, Kadir Şerafettin; Özkiraz, Servet; Aydemir, Cumhur; Özdemir, Ahmet; Çetinkaya, Bilin; Kazancı, Ebru; Taştekin, Ayhan; Calkavur, Şebnem; Özyurt, Banu Mutlu; Demirelli, Yaşar; Asker, Hüseyin Selim; Mutlu, Birgül; Uygur, Özgün; Özkan, Hilal; Armangil, Didem; Özlü, Ferda; Mert, Mustafa Kurthan; Ergin, Hacer; Özcan, Beyza; Baş, Evrim Kiray; Okulu, Emel; Acunaş, Betül; Çelik, Ülker; Uslu, Sait İlker; Mutlu, Mehmet; Demir, Nihat; Eroğlu, Funda; Gökmen, Zeynel; Beken, Serdar; Bayraktar, Bilge Tanyeri; Hakan, Nilay; Küçüktaşçı, Kazım; Orman, Ayşen; Cömert, Serdar; Ertuğrul, Sabahattin; Üstün, Nuran; Şahin, Özlem; Terek, Demet; Kale, Yusuf; Konak, Murat; Yurttutan, Sadık; Aydemir, Özge; Zenciroğlu, Ayşegül; Sarıcı, Dilek; Güzoğlu, Nilüfer; Hamilcikan, Şahin; Gürsoy, Tuğba; Tüzün, Funda; Ors, Rahmi; Arslan, Selda; Akdağ, Arzu; Memişoğlu, Aslı; Yaşa, Beril; Hekimoğlu, Berna; Turan, Özden; Aylanç, Hakan; Takçı, Şahin; Çelik, Tolga; Şahin, Suzan; Kılıç, İlknur; Kara, Caner; Tunay, Zuhal Özen; Çelik, Gökhan; Gözen, İbrahim; Satırtav, Günhal; Polat, Nihat; Oral, Ayşe Yeşim; Tokgöz, Mine; Keleş, Sadullah; Bilgin, Burak; Ugurbaş, Şilay Cantürk; Karaca, Çağatay; Keşkek, Nedime Şahinoğlu; Ekinci, Dilbade Yıldız; Balcı, Özlem; Altan, Emir Volkan; Bakbak, Sevda; Ceylan, Nihan Aksu; Kimyon, Sabit; Alyamaç, Günay; Türe, Gamze; Yıldız, Meral; Çalış, Feyza; Sızmaz, Selçuk; Sükgen, Emine; Çetin, Ebru Nevin; Özçimen, Muammer; Tiryaki Demir, Semra; Atila, Huban; Özal, Altan; Tufaner, Gökhan; Eski Yücel, Özlem; Kola, Mehmet; Seven, Erbil; Özdek, Şengül; Durukan, Ali Hakan; Kal, Ali; Çelebi, Ali Rıza Cenk; Koytak, İbrahim Arif; Alacamlı, Göksu; Esme, Arif; Çatak, Onur; Perente, İrfan; Şahin, Alparslan; Ardagil Akçakaya, Aylin; Kiray, Gülünay; Nalcacı, Serhat; Aksoy, Ümit; Bakbak, Berker; Çömez, Ayşegül; Gürsoy, Hüseyin; Kabataş, Emrah Utku; Petriçli, İkbal Seza; Yumuşak, Mehmet Erhan; Kırgız, Ahmet; Uludağ, Günay; Yaman, Aylin; Dadacı, Zeynep; Karataş, Ali; Çeliker, Hande; Cebeci, Zafer; Esenülkü, Mahmut Cenap; Akkoyun, İmren; Ersan, İsmail; Demir, Selim; Kadayıfçılar, Sibel; Ünsal, Ayşe İpek Akyüz; Hocaoğlu, Mümin
    Background To evaluate the prevalence, risk factors and treatment of retinopathy of prematurity (ROP) in Turkey and to establish screening criteria for this condition. Methods A prospective cohort study (TR-ROP) was performed between 1 April 2016 and 30 April 2017 in 69 neonatal intensive care units (NICUs). Infants with a birth weight (BW)=1500 g or gestational age (GA)<= 32 weeks and those with a BW> 1500 g or GA> 32 weeks with an unstable clinical course were included in the study. Predictors for the development of ROP were determined by logistic regression analyses. Results The TR-ROP study included 6115 infants: 4964 (81%) with a GA <= 32 weeks and 1151 (19%) with a GA>32 weeks. Overall, 27% had any stage of ROP and 6.7% had severe ROP. A lower BW, smaller GA, total days on oxygen, late-onset sepsis, frequency of red blood cell transfusions and relative weight gain were identified as independent risk factors for severe ROP in infants with a BW=1500 g. Of all infants, 414 needed treatment and 395 (95.4%) of the treated infants had a BW <= 1500 g. Sixty-six (16%) of the treated infants did not fulfil the Early Treatment for Retinopathy of Prematurity requirements for treatment. Conclusions Screening of infants with a GA <= 34 weeks or a BW<1700 g appears to be appropriate in Turkey. Monitoring standards of neonatal care and conducting quality improvement projects across the country are recommended to improve neonatal outcomes in Turkish NICUs.
  • Küçük Resim
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    The efficacy and safety of isotonic and hypotonic fluids in intravenous maintenance fluid therapy in term newborns: national multicenter observational "neofluid" study
    (2024) Özkan, Hasan; Duman, Nuray; Tüzün, Funda; Narter, Fatma; Akyıldız, Can; Büyüktiryaki, Mehmet; Keskinoğlu, Pembe
    Objective: The objective of this study was to evaluate the efficacy and safety of isotonic and hypotonic intravenous fluids in maintenance fluid therapy for term infants. Methods: This was a multi-centre, prospective, observational study conducted in 21 participating centres from December 30, 2020, to June 30, 2023. The study included term newborns requiring parenteral fluid therapy for maintenance (NCT04781361). The fluid treatment was divided into two groups based on the concentration of sodium in the parenteral fluid, designated as hypotonic (NaCl <130 mmol/L) and isotonic (NaCl = 130–154 mmol/L). The primary outcomes were the change in mean plasma sodium (pNa) levels per hour (∆pNa mmol/L/h), the incidence of hyponatremia (pNa <135 mmol/L) and hypernatremia (pNa >145 mmol/L), and the occurrence of clinically significant changes in sodium levels (∆pNa >0.5 mmol/L/h). Results: A total of 420 patients from 21 centers were included. The ∆pNa was negative in the hypotonic fluid group and positive in the isotonic fluid group, with a significant difference between the groups [respectively −0.07 ± 0.03 (95% CI: −0.13 to −0.02); 0.04 ± 0.03 (95%CI: −0.02 to 0.09), p = 0.04]. There was no difference between the groups in terms of the development of hypernatremia or a clinically meaningful pNa increase. The hypotonic fluid group had a higher incidence of hyponatremia and a clinically meaningful sodium decrease compared to the isotonic fluid group [7.9% vs. 1.2% (OR:6.5, p:0.03)] and [12.2% vs.4.2% (OR:2.9, p = 0.03)]. Conclusion: Contrary to current understanding, this large-scale study is the first to demonstrate that the use of hypotonic fluids in maintenance fluid therapy for newborns poses a risk of hyponatremia development, whereas isotonic fluid therapy appears safe.