Background: For children with the multisystem inflammatory syndrome(MIS-C), intravenous immunoglobulins (IVIG) with or without methylprednisolone are the most effective treatment. In this study, IVIG combined with methylprednisolone was compared to IVIG used alone in children with MIS-C.Methods: This retrospective cohort study was carried out between April 1, 2020, and November 1, 2021. This study covered all children with MIS-C. According to whether they received IVIG alone or IVIG with methylprednisolone as an initial treatment for MIS-C, the patients were split into two groups. The IVIG dosage for the patients in group I was 2 gr/kg, whereas the IVIG dosage for the patients in group II was 2 gr/kg + 2 mg/kg/day of methylprednisolone. These two groups were contrasted in terms of the frequency of fever, length of hospital stay, and admission to the pediatric intensive care unit.Results: The study comprised 91 patients who were diagnosed with MIS-C and were under the age of 18. 42 (46.2%) of these patients were in the IVIG alone group (group I), and 49 (53.8%) were in the IVIG + methylprednisolone group (group II). Patients in group II had a severe MIS-C ratio of 36.7%, which was substantially greater than the rate of severe MIS-C patients in group I (9.5%) (p 0.01). When compared to group I (9.5%), the rate of hypotension was considerably higher in group II (30.6%) (p = 0.014). Additionally, patients in group II had considerably higher mean serum levels of C-reactive protein. The incidence of fever recurrence was 26.5% in group II and 33.3% in group I, however the difference was not statistically significant (p > 0.05).Conclusions: The choice of treatment for patients with MIS-C should be based on an individual evaluation. In MIS-C children with hypotension and/or with an indication for a pediatric intensive care unit, a combination of IVIG and methylprednisolone may be administered. For the treatment modalities of children with MIS-C, however, randomized double-blind studies are necessary.

Background: The inability to ensure adequate nutrition for patients, and failure to provide adequate calorie and protein intake, result in malnutrition, leading to increased morbidity and mortality. The present study assesses the two approaches to enteral nutrition—intermittent and continuous enteral feeding—in critically ill pediatric patients in Türkiye to determine the superiority of one method over the other. Methods: Included in this multicenter prospective study were patients receiving enteral nutrition via a tube who were followed up over a 3-month period. Anthropometric data, calorie and protein intake, and signs of feeding intolerance were evaluated in a comparison of the different feeding methods. Results: A total of 510 patients were examined. In the continuous enteral feeding (CEF) group, 20.2% of patients developed metabolic abnormalities, and 49.5% experienced enteral nutrition intolerance, both of which were higher than in the intermittent enteral feeding (IEF) group, and the differences were statistically significant. No significant differences were observed between the two feeding methods in terms of reaching the target calorie intake on days 2 and 7 (p > 0.05). On day 7, there were significant differences between the two feeding methods in terms of calorie and protein intake (p = 0.023 and 0.014, respectively). Conclusions: In the present study, assessing the IEF and CEF approaches to enteral nutrition, critically ill pediatric patients receiving intermittent feeding exhibited lower rates of enteral nutrition intolerance and metabolic abnormalities. Furthermore, the calorie and protein intake on day 7 were noted to be higher in the IEF group than in the CEF group. Further randomized controlled trials are needed to confirm the findings of the present study.

Aim: To reveal the effect of synchronous or asynchronous patients on these values by examining the esophageal pressure (Pes ), transpulmonary pressure (PL), and time-pressure-product (PTP) in active patients who are planned to be weaned from the mechanical ventilator and can trigger their own respiration. Material and Methods: Patients who are monitored on a mechanical ventilator and who can trigger their own respiration, and who are planned to be separated from the mechanical ventilator in the near future, were taken and an esophageal catheter was inserted, then the catheter filling volume was first optimized and then validated, and PL was started to be recorded by removing Pes from the airway pressure. With the recording devices on the ventilator, the mechanical ventilation parameters of the patients were recorded as both monitoring values and waveforms. Then, the mechanical ventilation settings were rearranged by the clinician at the bedside with reference to the esophageal waveform. Then, the waveforms of these patients have examined on the Matlab E2019a (Mathworks, USA) software, and each breath was marked as synchronous-asynchronous and the asynchrony index (AI) was calculated. Accordingly, the asynchronous and synchronous periods of the patient were defined, and the values of ∆Pes, ∆PL, PTP-Pes, PTP-PL, PTP-Pes-minutes, PTP-PL-minutes between the synchronous and asynchronous periods of the same patient were calculated on Matlab software, and synchronous and The changes in these values between asynchronous periods were analyzed with the SPSS statistical program. After examining the distribution of the variables by visual and analytical methods (Shapiro-Wilk), the statistical difference between the groups was examined. Results: When the synchronous and asynchronous periods of all patients were compared, the following differences were found between the synchronous and asynchronous groups in favor of the synchronous group. ∆Peso [5.98 (3.55-9.08)] cmH2O, ∆PL [5 (2.7-7.25]cmH2O, ∆PTP-Peso [3.70 (2.81-4.6)) ]cmH2O*s, ∆PTP-PL [3.36 (1.39-4.18)]cmH2O*s, ∆PTP-Peso/min [1.72 (1.02-2.67)]cmH2O*min , ∆PTP-PL/min [1.25 (0.30-3.01)]cmH2O*min. Conclusion: It has also been shown by statistical analyzes that the synchronization of active patients who are planned to be weaned from mechanical ventilator and who can trigger their own respiration causes a decrease in the values of ∆Peso, ∆Ptranspulmonary, PTP-Peso,PTP-Ptranspulmonary, PTP-Peso-minute, PTP-Ptranspulmonary-minute. When this information about synchronization is correlated with the literature, Pes monitoring in patients and synchronization of patients prevent mechanical ventilation-related lung damage that may occur in these patients, and thus the duration of hospital stay due to asynchrony, failure to wean from the ventilator, and the consequences that may occur. It is a method that can be useful in reducing mortality and morbidity.