Overweight or obese women who underwent reduction mammaplasty showed significant improvements in certain PFT and all of the ABG measurements at 3 months after surgery. The more resected breast tissue predicts greater improvements in FEF 25-75 % and Sat O2, and greater reductions in BMI predicted increased improvements in FEF 25-75 % and FVC.

A baby case of haematogenous rib osteomyelitis that was caused by Leuconostoc lactis was presented. The patient had high fever and an abscess formation on the right scapula. Diagnosis was made with the results of blood, bone and abscess cultures, pathological findings of the involved rib and direct bone graphies. The patient was treated succesfully with cefotaxime for 6 weeks.

Bu çalışmada, sağ lateral mini-torakotomi ile atriyal septal defekt kapatılması yapılan pediatrik hastalarda interkostal sinir blokunun ameliyat sonrası ağrı yönetimindeki etkinliği değerlendirildi. Ça lış mapla nı:Ocak 2016-Ocak 2019 tarihleri arasında sağ lateral minitorakotomi ile atriyal septal defekt kapatılması için düzeltici doğuştan kalp cerrahisi yapılan toplam 63 pediatrik hasta (37 erkek, 26 kız; ort. yaş 34.8±26.8 ay; dağılım, 2-96 ay) retrospektif olarak incelendi. Hastalar interkostal sinir bloku ve genel anestezi verilenler (Grup 1, n=33) ve yalnızca genel anestezi verilenler (Grup 2, n=30) olmak üzere iki gruba ayrıldı. Ramsay Sedasyon Ölçeği skoru >4 ve Doğu Ontario Çocuk Hastanesi Ağrı Ölçeği skoru >7 olan hastalara kurtarma analjezisi olarak 0.03 mg/kg dozunda intravenöz morfin uygulandı. Toplam analjezik gereksinimi, yan etkiler, mekanik ventilasyon süresi ve yoğun bakım ünitesinde kalış süresi kaydedildi. Bul gu lar: Ortalama mekanik ventilasyon ve yoğun bakım ünitesinde kalış süresi Grup 1'de Grup 2'ye kıyasla daha kısa idi (sırasıyla, 3.6±1.3'e kıyasla 9.4±2.1 saat; 23±2.6'ya kıyasla 30±7.2 saat) (p<0.0001). Ameliyat sonrası kurtarma analjezi ihtiyacı Grup 1'de Grup 2'ye kıyasla istatistiksel olarak anlamlı düzeyde daha düşüktü (sırasıyla, 0.3±0.5 mg'ye kıyasla 1.1±0.9 mg) (p= 0.003). Ortalama toplam morfin tüketimi de Grup 1'de Grup 2'ye kıyasla daha düşüktü (sırasıyla, 4.0±2.2 mg'ye kıyasla 9.0±3.4 mg) (p<0.0001). So nuç: Mini-torakotomi ile atriyal septal defekt onarımı yapılan pediatrik hastalarda torakotomi kapatılmadan önce interkostal sinir bloku, erken ekstübasyon, daha kısa mekanik ventilasyon ve yoğun bakım ünitesinde kalış süresi ve daha az analjezik gereksinimi sağlar. Anah tar söz cük ler: Atriyal septal defekt, interkostal sinir bloku, mini-torakotomi, pediatrik kalp cerrahisi, ameliyat sonrası analjezi.

Background and aim: In patients undergoing congenital cardiac surgery, it is crucial to maintain oxygen demand-consumption balance. Central venous oxygen saturation (ScvO 2) is a useful indicator of oxygen demand and consumption balance which is an invasive method. Near-infrared spectroscopy (NIRS) is a noninvasive, continuous monitoring technique that measures regional tissue oxygenation. NIRS that is placed over the internal jugular vein cutaneous area (NIRSijv) has the potential to show ScvO 2 indirectly. In this study, we aimed to determine the correlation between ScvO 2 with NIRSijv in pediatric patients undergoing congenital cardiac surgery. Materials and methods: Fifty children participated in the study. Four patients were excluded for the inability of internal jugular vein (IJV) catheterization due to technical difficulties. After anesthesia induction, NIRS probes were placed on the IJV site with ultrasound guidance for the measurement of continuous transcutaneous oxygen saturation. The catheter insertion was also done through the IJV from the other side using ultrasound guidance. Cerebral oxygenation monitoring was done using NIRS with a single pediatric probe placed on the right forehead. Values of NIRSijv, cerebral NIRS (NIRSc) and ScvO 2 , were recorded at certain times until postoperative 24th hour. Results: Data were collected at 8 different time points. There was a significant correlation between ScvO 2 and NIRSijv in all measurement time points (r = 0.91), (P = 0.001). The mean bias between ScvO 2 and NIRSijv was 2.92% and the limits of agreement were from 11% to-5.2%. There was a moderate correlation between ScvO 2 and NIRSc (r = 0.45), (P = 0.001). The mean bias between ScvO 2 and NIRSc was 2.7% and the limits of agreement were from +26% to-20%. Conclusion: In this study, we found a strong correlation between ScvO 2 and NIRS measurements taken from the internal jugular vein site. Accordingly, continuous noninvasive monitoring with transcutaneous NIRSijv can be an alternative method as a trend monitor for the central venous oxygen saturation in pediatric cardiac patients undergoing congenital cardiac surgery.

Background and Aim of the Study Transfusion‐associated hyperpotassemia is a serious complication of packed red blood cell (PRBC) transfusion after congenital cardiac surgery. Our study aimed to identify risk factors and potential preventive measures of transfusion‐associated hyperpotassemia in neonates and infants after congenital cardiac surgery. Methods Pediatric patients who underwent congenital cardiac surgery and need transfusion were enrolled in this prospective study. The potassium concentration of PRBC was checked from the sample taken from the segment. The volume of transfusion, age of PRBC, potassium concentration of unit were recorded. The estimated increment of potassium level in patients after PRBC transfusion was calculated. Results Seventy‐four individual patients, 95 distinct transfusions, 112 blood products were evaluated. The mean age of the blood unit was 3.8 ± 1.4 days. The mean potassium concentration in the PRBCs was 9.9 ± 2.4 mmol/L. A weak correlation was observed between the potassium value of the PRBC and the age of PRBC (p = 0.049, r = 0.2, y = 0.24 × x + −0.68). There was a weak correlation between the potassium value of PRBCs and the age of the unit (p < 0.001, r = 0.37, y = 2.8 × x + −3.6). Conclusions Before transfusion, even PRBC is fresh, measuring the potassium level of PRBC and the potassium that will be given to the pediatric patient with transfusion can prevent transfusion‐related hyperpotassemia and related complications. Otherwise, high potassium levels, which may be overlooked despite being fresh, may cause serious complications, even cardiac arrest, especially in neonates and infants.