Objective: This study aims to investigate modes of transmission and clinical features of coronavirus disease 2019 in healthcare workers in pediatric intensive care units. Materials and Methods: This multicenter descriptive study was conducted between March and November 2020. Patient demographics, clinical characteristics, origin of coronavirus disease 2019, treatment modalities, and loss of workdays were recorded. Results: Seven hundred and sixty-eight healthcare workers from 16 pediatric intensive care units were enrolled and 114 (14.8%) healthcare workers with a mean age of 29.7 ± 6.7 years became coronavirus disease 2019 patients. Seventy-six (66.7%) patients were female. Approximately half (54.3%) of the patients were physicians, 34.2% were nurses, and 11.4% were ancillary staff. Transmission was deemed to occur through patient contact in 54.3% of the patients. Comorbid illness was present 10.5% of the patients. Transmission occurred during endotracheal intubation in 21%, cardiopulmonary resuscitation in 9.6%, and non-invasive ventilation in 12.2% of patients, while transmission was a result of multiple possible procedures in 43.8%. Intensive care admission was needed for 13.1% of the patients. Five patients needed oxygen by cannula, 7 needed oxygen with a non-rebreathing mask, 5 needed high-flow nasal cannula support, 5 needed non-invasive ventilation, and 3 needed invasive mechanical ventilation. Fortunately, no infected healthcare workers died. Conclusion: Coronavirus disease 2019 in healthcare workers is a significant problem in pediatric intensive care units. Transmission seems to occur particularly frequently during patient care procedures such as intubation, ventilation and aerosol therapy, which highlights the importance of proper use of full sets of personal protective equipment during all procedures during care of coronavirus disease 2019 patients. Cite this article as: Botan E, Uyar E, Öztürk Z, et al. COVID-19 transmission and clinical features in pediatric intensive care health care workers. Turk Arch Pediatr. 2022;57(1):93-98.

Background. Acute respiratory failure is a prevalent condition in childhood with a high rate of mortality. Invasive mechanical ventilation support may be required for the management of these patients. Extracorporeal membrane oxygenation (ECMO) is a method used when ventilation support is insufficient. However, the less invasive extracorporeal carbon dioxide removal method can be used as an alternative in cases of hypercapnic respiratory failure. Case. A 9-year-old patient with cystic fibrosis presented to the hospital with acute respiratory failure due to pneumonia. Bilateral patchy areas of consolidation were evident in the chest x-ray. Invasive mechanical ventilation support was consequently provided to treat severe hypercapnia. Although peak and plateau pressure levels exceeded 32 cmH₂O (49 cmH₂O) and 28 cmH₂O (35 cmH₂O), respectively, the patient continued to have severe respiratory acidosis. Therefore extracorporeal carbon dioxide removal support was initiated to provide lung-protective ventilation. By Day 10, venovenous ECMO support was initiated due to deteriorating oxygenation. Conclusion. In cases where conventional invasive mechanical ventilation support is insufficient due to acute hypercapnic respiratory failure, extracorporeal carbon dioxide removal support, which is less invasive compared to ECMO, should be considered as an effective and reliable alternative method. However, it should be noted that extracorporeal carbon dioxide removal support does not affect oxygenation; it functions solely as a carbon dioxide removal system.

Objective: This study aimed to compare the efficacy of direct and videolaryngoscopy procedures performed by pediatric residents who had limited experience of direct endotracheal intubation and had not previously used video laryngoscopes in a normal airway child manikin. Material and Methods: The endotracheal intubations performed by pediatric residents with a direct laryngoscope and Storz C-MAC videolaryngoscope on a pediatric manikin with a normal airway were compared. Theoretical and practical training was given before the study. In the first attempt, the success of the intubation procedure, glottis visual duration, and endotracheal tube insertion time were determined. Practitioners grouped the glottis image between 1-4 according to the Cormack-Lehane Staging (Stage 1 ideal image). After the intervention, the participants scored one to ten points on direct and videolaryngoscopy (1 not useful, 10 very useful). Results: The success of direct and videolaryngoscopy of 51 pediatric residents on the same manikin was 48 out of 51 (94%) for each method (p> 0.05). Glottis visual duration was similar in both methods (p>0.05); tube insertion and total intubation time were shorter in the video laryngoscope group (p<0.05); glottis image was better in the video laryngoscope group according to Cormack-Lehane Classification (p<0.05). Participants’ rating was higher on videolaryngoscope (p<0.05). Conclusion: Users with limited endotracheal intubation experience use Video laryncoscope more effectively than direct laryngoscope in children with normal airway model after training. Cite this article as: Anıl AB, Anıl M, Durak F, et al. Comparison of direct and video laryngoscope endotracheal intubations by pediatric residents: A study of a child model with normal airway. Turk Arch Pediatr 2021; 56(3): 224-9.

Management of anomalous aortic origin of coronary arteries in children: A single-center experience - Turkish Journal of Thoracic and Cardiovascular Surgery

Background. Autoimmune limbic encephalitis in children occurs most frequently in those with antibodies against the N-methyl-D-aspartate glutamatergic receptor. We report the case of a 14-year-old girl who was diagnosed with antileucine-rich glioma-inactivated protein 1 limbic encephalitis. Case. A fourteen years old, previously healthy girl applied to the emergency department with suspicion of dystonic seizure, ataxia, gait disturbance and speech disorders. Serum sample of the patient was positive for leucine-rich glioma inactivated protein 1 IgG. Conclusions. Although it is a rare disease in childhood, in the presence of new onset psychotic symptoms or altered mental state, concomittant hyponatremia and unique type of seizures, anti leucine-rich glioma inactivated protein 1encephalitis should be considered in differential diagnosis.