{"id":25496,"date":"2018-02-27T00:00:00","date_gmt":"2018-02-26T21:00:00","guid":{"rendered":"https:\/\/tatd.org.tr\/blog\/2018\/02\/27\/cocuk-yogun-bakim-hastalarinda-septik-sok-yonetiminde-erken-kortikosteroid-tedavisinin-degerlendirilmesi-randomize-klinik-calisma\/"},"modified":"2021-11-20T03:04:41","modified_gmt":"2021-11-20T00:04:41","slug":"cocuk-yogun-bakim-hastalarinda-septik-sok-yonetiminde-erken-kortikosteroid-tedavisinin-degerlendirilmesi-randomize-klinik-calisma","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/en\/haber-ve-duyuru\/cocuk-yogun-bakim-hastalarinda-septik-sok-yonetiminde-erken-kortikosteroid-tedavisinin-degerlendirilmesi-randomize-klinik-calisma\/","title":{"rendered":"\u00c7ocuk Yo\u011fun Bak\u0131m Hastalar\u0131nda Septik \u015eok Y\u00f6netiminde Erken Kortikosteroid Tedavisinin De\u011ferlendirilmesi: Randomize Klinik \u00c7al\u0131\u015fma"},"content":{"rendered":"<p>El-Nawawy A, Khater D, Omar H, Wali Y. <strong>Evaluation of Early CorticosteroidTherapy in Management of Pediatric Septic Shock in Pediatric IntensiveCare Patients: A Randomized Clinical Study. <\/strong><em>Pediatr InfectDis J 2017;36:155-159<\/em><\/p>\n<p><strong>Haz\u0131rlayan: Dr. \u00d6zge Duman Atilla<\/strong><\/p>\n<p><strong>Giri\u015f:<\/strong> Septik \u015fok major sa\u011fl\u0131k sorunudur. Septik \u015foklu \u00e7ocuklarda adrenal yetmezlik (AI), hen\u00fcz y\u00f6netimi ve mortalite \u00fczerine etkileri hakk\u0131nda tart\u0131\u015fmalar\u0131n devam etti\u011fi tan\u0131mlanm\u0131\u015f bir komplikasyondur. G\u00fcncel k\u0131lavuza g\u00f6re, AI risk fakt\u00f6rleri olan \u00e7ocuklar tedavinin 3. basama\u011f\u0131nda stres doz steroid almal\u0131d\u0131r. Bu \u00e7al\u0131\u015fma pediatrik septik \u015fok hastalar\u0131nda steroidlerin geleneksel kullan\u0131m\u0131 ile erken kortikosteroid tedavisini de\u011ferlendirmeyi ve kar\u015f\u0131la\u015ft\u0131rmay\u0131 ama\u00e7lamaktad\u0131r.<\/p>\n<p><strong>Metot:<\/strong> Bu ileriye d\u00f6n\u00fck randomize giri\u015fimsel klinik \u00e7al\u0131\u015fma 3 grup hasta i\u00e7ermektedir (her biri 32 hasta) ve Alexandria \u00dcniversitesi pediatrik yo\u011fun bak\u0131mda yap\u0131lm\u0131\u015ft\u0131r. Protokol olarak, birinci grup g\u00fcncel uluslararas\u0131 k\u0131lavuza g\u00f6re tedavinin 3. basama\u011f\u0131nda steroidleri ald\u0131 (grup A) ve ikinci grup Grup A gibi y\u00f6netildi ve intramuskuler ACTH (cosyntropin) ile adrenal stimulasyon testi yap\u0131larak AI yetmezlik i\u00e7in test edildi (grup B). \u00dc\u00e7\u00fcnc\u00fc grup s\u0131v\u0131 tedavisinin ba\u015flang\u0131c\u0131nda steroidleri ald\u0131 (grup C). D\u00f6rd\u00fcnc\u00fc grup (grup D) uluslararas\u0131 protokol grup 1\u2019e g\u00f6re tedavinin \u00fc\u00e7\u00fcnc\u00fc basama\u011f\u0131nda kortikosteroid gereken grup A ve B\u2019den hastalar\u0131n eklenmesi ile olu\u015fturuldu. T\u00fcm hastalar bazal serum kortizol ve plazma ACTH konsantrasyonlar\u0131 ile de\u011ferlendirildi.<\/p>\n<p><strong>Sonu\u00e7lar:<\/strong> Veriler tedavi ba\u015flang\u0131c\u0131nda kortikosteroid alan hastalarda tedavinin \u00fc\u00e7\u00fcnc\u00fc basama\u011f\u0131nda alan hastalara g\u00f6re \u015fokun geri d\u00f6n\u00fc\u015f s\u00fcresinin anlaml\u0131 oranda daha k\u0131sa oldu\u011funu g\u00f6sterdi (p=0.046); ancak mortalite aras\u0131nda fark yoktu. Ek olarak, erken steroid tedavisi alan vakalarda superenfeksiyona rastlanmad\u0131.<\/p>\n<p><strong>Tart\u0131\u015fma:<\/strong> Septik \u015foklu hastalarda kortikosteroidlerin erken kullan\u0131lmas\u0131 mortalite art\u0131\u015f\u0131 ve superenfeksiyon olmaks\u0131z\u0131n \u015fokun geri d\u00f6n\u00fc\u015f s\u00fcresini k\u0131saltabilir.<\/p>\n<p><strong>Anahtar kelimeler: <\/strong>septic shock, corticosteroids, shock reversal, superinfection<\/p>\n","protected":false},"excerpt":{"rendered":"<p>El-Nawawy A, Khater D, Omar H, Wali Y. Evaluation of Early CorticosteroidTherapy in Management of Pediatric Septic Shock in Pediatric IntensiveCare Patients: A Randomized Clinical Study. Pediatr InfectDis J 2017;36:155-159&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10011],"tags":[],"class_list":["post-25496","post","type-post","status-publish","format-standard","hentry","category-haber-ve-duyuru"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/posts\/25496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/comments?post=25496"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/posts\/25496\/revisions"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/media?parent=25496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/categories?post=25496"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/en\/wp-json\/wp\/v2\/tags?post=25496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}