Background: It is difficult to predict the complications and prognosis of ECMO, which is gaining widespread use in patients with pediatric surgery. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are emerging inflammatory markers that can be calculated from complete blood count, which is a cheap and easily accessible laboratory analysis. The ratios between cellular elements in peripheral blood have been demonstrated to provide information on inflammation, infection, and immune response. Methods: Sixty-seven patients who needed ECMO application after undergoing pediatric cardiovascular surgery in our clinic, between May 2005 and April 2020, were included in this study. The age of patients varied between 4 days and 17 years with a mean of 30.59 ± 147.26 months. Results: The relationships between PLR or NLR values and various blood parameters and blood gas results were found to be statistically nonsignificant in our group of pediatric ECMO recipients. Even if the effect of PLR and NLR values on mortality and prognosis is statistically nonsignificant in patients who need ECMO after congenital heart surgery, PLR and NLR are typically elevated in the postoperative period. An increase in these values above a certain threshold may be a statistically significant indicator for the prediction of mortality. Conclusions: There are few studies in the literature concerning PLR and NLR values in patients with pediatric heart surgery. We consider this study will make way for new studies in the future.

Objectives: Infants and children with congenital heart disease may develop respiratory failure in association with cardiac surgery or as a result of heart disease. In fact, the postextubation period in this group of patients can be complex and the use of continuous positive airway pressure or non-invasive ventilation may be necessary if conventional oxygen therapy is not sufficient. The aim of our study was to compare efficiency and outcomes of high-flow nasal cannula or conventional oxygen therapy post-extubation after pediatric cardiac surgery . Patients and Methods: A single centre retrospective study was conducted between January and december 2020 in our 12 beds pediatric cardiac intensive care unit. Patients were divided into two groups. In one group 45 patients (Group I), those who received high-flow nasal cannula after extubation, and in the other group 45 patients (Group II), those who received oxygen therapy with a mask after extubation. The aim of the study was to evaluate the relative efficacy of high flow nasal cannula and conventional oxygen therapy on PaCO2 ,PaO2 and PaO2/FiO2. Results: PaO2 values at 1, 6, 12, 24 and 48 h post-extubation were significantly higher in high-flow nasal cannula group (p<0,05). PaCO2 values were significantly lower in the high-flow nasal cannula group at 1, 6, 12, 24 and 48 h post-extubation (p=0,01). PaO2/FiO2 values in high-flow nasal cannula group at all-time points post-extubation were significantly higher than in conventional oxygen therapy group (p=0,01). Conclusion: High-flow nasal cannula is useful in decreasing PaCO2 and improving PaO2 in children following extubation after cardiac surgery. In addition, the simplicity of and tolerability to high-flow nasal cannula is also important. Although more expensive, the use of high-flow nasal cannula can be considered as a safe and effective alternative to conventional oxygen therapy following pediatric cardiac surgery.

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Objectives: This study aims to investigate the relationship between anxiety levels and perceived caregiver burden in mothers of children who had undergone Congenital Heart Disease Surgery (CHDS) and who were followed up in the intensive care unit with the surgical type and clinical variables applied. Patients and Methods: The study was conducted with the mothers of both patient groups who underwent Palliative Surgery (PS) (n:32) or Corrective (Biventricular) Repair (CR) (n:35) in the Pediatric Cardiovascular Surgery clinic of Istanbul Koşuyolu High Specialty Educational and Research Hospital. Sociodemographic-Clinical Data Form, Beck Depression Inventory (BDI), Standardized Mini-Mental Test, State-Trait Anxiety Inventory (STAI TX I-II), and Zarit Burden Interview (ZBI) were applied to the parents. Results: The rate of interventional birth was higher in the PS group whereas there was no difference between the PS and CR groups in terms of age, gender, birth weights, and presence of additional diseases (p: 0.001). There was no difference between maternal education levels and pregnancy duration. This difference was not significant even though the mean age of the mothers in the CR group was higher compared to the PS group. The mean STAI-S scores of the PS group (State Anxiety) were lower than the CR group, and the STAI-T scores of the PS group (Trait Anxiety) were higher. The ZBI scores were significantly higher in the PS group (p: 0.03) Conclusion: Congenital heart diseases and surgical interventions, as a result, are a major source of distress for affected families. Mothers are mainly affected by this situation. Changes in the mental status of the caregiver may have serious adverse effects on the operated child at every stage of the disease. Caregiving in parents is perceived as a burden and increased anxiety leads to different psychiatric clinical manifestations. Therefore, it is recommended that parents of children who have undergone congenital cardiac surgery receive routine psychiatric support from the early stages of the disease.

ÖZ Amaç