Researcher:
Pehlivanoğlu, Cemile

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Cemile

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Pehlivanoğlu

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Pehlivanoğlu, Cemile

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    Pediatric kidney care experience after the 2023 Türkiye earthquake
    (Oxford Univ Press, 2024) Bakkaloğlu, Sevcan A.; Delibaş, Ali; Döven, Serra Sürmeli; Taner, Sevgin; Yavuz, Sevgi; Erfidan, Gökçen; Vatansever, Esra Danacı; Aynacı, Fatma; Yılmaz, Kenan; Taşdemir, Mehmet; Akacı, Okan; Akıncı, Nurver; Güven, Sercin; Çiçek, Neslihan; Dursun, İsmail; Keleşoğlu, Emre; Sancaktar, Muhammet; Alaygut, Demet; Saygılı, Seha; Yavaşcan, Önder; Yılmaz, Alev; Gülleroğlu, Kaan; Ertan, Pelin; Demir, Belde Kasap; Poyrazoğlu, Hakan; Pınarbışı, Seda; Gençler, Aylin; Baştuğ, Funda; Günay, Neslihan; Çeleğen, Kübra; Noyan, Aytül; Parmaksız, Gönül; Avcı, Begüm; Çaycı, Fatma Şemsa; Bayrakçı, Umut; Özlü, Sare Gülfem; Aksoy, Özlem Yüksel; Yel, Sibel; İnal, Güdane Aylin; Köse, Seçil; Bayazıt, Aysun Karabay; Atmış, Bahriye; Sarıbaş, Emel; Çağlı, Çağla; Tabel, Yılmaz; Elmas, Ahmet Taner; Selçuk, Şenay Zırhlı; Kılıç, Beltinge Demircioğlu; Kara, Mehtap Akbalık; Büyükçelik, Mithat; Balat, Ayşe; Tiryaki, Betül Durucu; Erdoğdu, Bilge; Aksu, Bağdagül; Mahmudova, Günay; Dursun, Hasan; Candan, Cengiz; Göknar, Nilüfer; Mutlubaş, Fatma; Çamlar, Seçil Arslansoyu; Başaran, Cemaliye; Akbulut, Burcu Bulum; Düzova, Ali; Gülhan, Bora; Oruç, Çiğdem; Peru, Harun; Alpay, Harika; Türkkan, Özde Nisa; Gülmez, Rüveyda; Çelakıl, Mehtap; Doğan, Kenan; Büyükkaragöz, Bahar; Leventoğlu, Emre; Alpman, Nuray; Zeybek, Cengiz; Tulpar, Sebahat; Gülşan, Rumeysa Yasemin Çiçek; Kara, Aslıhan; Gürgöze, Metin Kaya; Önder, Esra Nagehan Akyol; Atikel, Yeşim Özdemir; Pul, Serim; Sönmez, Ferah; Yıldız, Gizem; Akman, Sema; Elmacı, Midhat; Küçük, Nuran; Yüksel, Selçuk; Kavaz, Aslı; Nalcıoğlu, Hülya; Alparslan, Caner; Dinçel, Nida; Elhan, Atilla H.; Sever, Lale.; Bilge, İlmay; Pehlivanoğlu, Cemile;  ; School of Medicine; Koç University Hospital
    Background. Two earthquakes on 6 February 2023 destroyed 10 cities in Turkiye. We report our experience with pediatric victims during these catastrophes, with a focus on crush syndrome related-acute kidney injury (Crush-AKI) and death. Method. Web-based software was prepared. Patient demographics, time under rubble (TUR), admission laboratory data, dialysis, and kidney and overall outcomes were recorded. Results. A total of 903 injured children (median age 11.62 years) were evaluated. Mean TUR was 13 h (interquartile range 32.5, max 240 h). Thirty-one of 32 patients with a TUR of >120 h survived. The patient who was rescued after 10 days survived. Two-thirds of the patients were given 50 mEq/L sodium bicarbonate in 0.45% sodium chloride solution on admission day. Fifty-eight percent of patients were given intravenous fluid (IVF) at a volume of 2000-3000 mL/m(2) body surface area (BSA), 40% at 3000-4000 mL/m(2) BSA and only 2% at >4000 mL/m(2) BSA. A total of 425 patients had surgeries, and 48 suffered from major bleeding. Amputations were recorded in 96 patients. Eighty-two and 66 patients required ventilator and inotropic support, respectively. Crush-AKI developed in 314 patients (36% of all patients). In all, 189 patients were dialyzed. Age >15 years, creatine phosphokinase (CK) >= 20 950 U/L, TUR >= 10 h and the first-day IVF volume <3000-4000 mL/m2 BSA were associated with Crush-AKI development. Twenty-two deaths were recorded, 20 of 22 occurring in patients with Crush-AKI and within the first 4 days of admission. All patients admitted after 7 days survived. Conclusions. These are the most extensive pediatric kidney disaster data obtained after an earthquake. Serum CK level was significantly associated with Crush-AKI at the levels of >20 950 U/L, but not with death. Adolescent age and initial IVF of less than 3000-4000 mL/m(2) BSA were also associated with Crush-AKI. Given that mildly injured victims can survive longer periods in the disaster field, we suggest uninterrupted rescue activity for at least 10 days.