Researcher:
Kayas, Kalender

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Doctor

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Kalender

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Kayas

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Kayas, Kalender

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20222

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    Positive direct antiglobulin test: is it a risk factor for significant hyperbilirubinemia in neonates with ABO incompatibility?
    (Thieme Medical Publishers, Inc., 2022) Erçin, Seçil; Coşkun, Yeşim; Kayas, Kalender; Kavas, Nazan; Gürsoy, Tuğba; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 214691
    Objective: ABO blood group (ABO) incompatibility is a common cause of neonatal indirect hyperbilirubinemia. The direct antiglobulin test (DAT) can identify infants developing hemolytic disease. This study aims to evaluate the significance of DAT positivity among neonates with ABO incompatibility. Study Design: This retrospective study included 820 neonates with blood group A or B who were born to blood group O mothers. The study group consisted of neonates (n = 79) who had positive DAT, and the control group consisted of infants (n = 741) who had negative DAT. Demographic and clinical data of the neonates regarding jaundice were collected and compared statistically. Results:The bilirubin level at 24 hours of life (study group: 8 ± 2.6 mg/dL, control group: 6 ± 2.2 mg/dL, p < 0.001) and the highest bilirubin level (study group: 12.7 ± 3.6 mg/dL, control group: 10.4 ± 4.2 mg/dL, p < 0.001) were higher in infants with positive DAT. A total of 37 (46.8%) infants in the study group and 83 (11.2%) infants in the control group received phototherapy (PT) in the nursery (p < 0.001). In neonates with positive DAT, direct bilirubin level, duration of hospitalization, and PT in the nursery were higher (p = 0.002, <0.001, and <0.001, respectively), whereas hemoglobin level was lower (p < 0.001). Conclusion: In neonates with ABO incompatibility, a positive DAT is a risk factor for developing significant hyperbilirubinemia. Close follow-up of newborn infants with ABO incompatibility is crucial for early detection and treatment of neonatal jaundice to avoid early and late complications. Key Points The clinical spectrum of ABO incompatibility varies widely. The ABO incompatibility with positive DAT are at greater risk for high bilirubin levels. Infants with blood group incompatibilities must be monitored closely. © 2022 Georg Thieme Verlag. All rights reserved.
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    Use of silver-impregnated umbilical venous catheters for prevention of catheter associated bloodstream infection in neonates
    (İnönü Üniversitesi Tıp Fakültesi, 2022) Gürsoy, Tuğba; Coşkun, Yeşim; Kayas, Kalender; Erçin, Seçil; Faculty Member; School of Medicine; Koç University Hospital; 214691; N/A; N/A; N/A
    Aim: neonates hospitalized in neonatal intensive care units (NICU)s often require a venous access. Umbilical venous catheter (UVC) is the commonly used one. UVCs are known to cause life-threatening complications such as catheter-associated bloodstream infections (CABSI). To the best of our knowledge, our unit is the first and only NICU in Turkey that used silver-impregnated UVCs. This study aims to evaluate the impact of silver-impregnated UVC insertion on the incidence of CABSI. Materials and methods: a total of 108 patients were included in this retrospective study. After the application of exclusion criteria, the control group was composed of neonates (n=58) who had polyurethane (PU) UVCs inserted and the study group consisted of infants (n=41) who had silver-impregnated UVCs inserted. Demographic and clinical data of the mothers and neonates including duration of UVC insertion and sepsis incidence were collected and compared statistically. Results: there was no statistically significant difference between the groups except for intubation period and mortality. One neonate in each group had CABSI (p=1). Four neonates, two in each group, were diagnosed with clinical sepsis. Total CABSI incidence in our whole population was 2% and 3.3 per 1000 catheter days. Conclusion: strict precautions should be taken to prevent infection in every unit. In NICUs with low incidence of sepsis, silverimpregnated UVCs may have no further effect in the reduction of CABSI.