Background: The aim of this study is to determine the indication, timing, and administration of extracorporeal therapies such as total plasma exchange and continuous renal replacement therapy in children with acute liver failure or acute-on-chronic liver failure. Methods: This study is conducted as a retrospective, single-center study. Between January 2016 and December 2021, pediatric acute liver failure or acute-on-chronic liver failure patients for whom total plasma exchange and/or continuous renal replacement therapy was performed were included in this study. Results: Thirty-four children with acute liver failure or acute-on-chronic liver failure were included during the study period. The children comprised 14 (41.1%) males, and the median age of the patients was 54 months (5-21). Twenty-four patients (70.6%) had pediatric acute liver failure, and 10 patients (29.4%) had acute-on-chronic liver failure. Patients’ median model for end-stage liver disease and pediatric end-stage liver disease scores were 24.7/23.5, respectively. Total plasma exchange therapy was performed on all patients whereas continuous renal replacement therapy was performed on 13 patients (38.2%). The median duration of continuous renal replacement therapy was 2.5 days (2-24). The median number of the total plasma exchange sessions was 3 (1-20). The median length of stay in pediatric intensive care unit was 4.5 (2-74) days. Eleven (32.5%) patients had 1 or more improvements in hepatic encephalopathy scores after extracorporeal therapy. Eleven (32.5%) patients died. There was a significant difference between the survivors and non-survivors with respect to levels of albumin, ammonia, pediatric risk of mortality scores, and pre-hepatic encephalopathy scores. Liver transplantation was performed in 4 of 24 pediatric acute liver failure patients, and all of them survived. Conclusion: Total plasma exchange and continuous renal replacement therapy are life-saving, and both methods may reduce morbidity and mortality, also bridging to liver transplantation. Cite this article as: Gün E, Durak A, Botan E, et al. Extracorporeal therapies in children with acute liver failure: A single-center experience. Turk J Gastroenterol. 2023; 34(1): 73-79.

Amaç: Yenidoğan bebekler silik yakınmaları nedeniyle hastalıkları gözden kaçabilen bazense hasta olmadıkları halde çeşitli yakınmaları nedeniyle hasta sanılabilen hassas bir popülasyondur. Uygun koşullarda ve uzman hekim tarafından muayenesi gereken bu grubun çocuk acil servisine başvurmaları tercih edilmemekle beraber bu durumla sık karşılaşılmaktadır. Bu çalışmadayenidoğanların çocuk acil servise başvuru şekillerinin incelenmesi amaçlanmıştır. Başvuru yakınmaları, alınan tetkikler ve taburculuk bilgileri değerlendirilmiştir. Gereç ve Yöntem: Ocak 2020 ile Eylül 2023 arasında Çocuk Acil Servisi’ne herhangi bir yakınma ile getirilen 0-28 günlük bebekler hastane veritabanından retrospektif olarak incelenmiştir. Bulgular: Çalışma süresince çocuk acil servise başvuran toplam 228 yenidoğan bebek incelenmiştir. Bunların içinde en sık başvuruyu 4-7 günlük bebekler oluşturmaktadır. En sık başvuru yakınması sarılık olarak saptanmış, bunu huzursuzluk ve göbek ilişkili yakınmalar takip etmiştir. Bebeklerin çoğunluğundan kan tetkiki istenmiş ve en sık kan istenme endikasyonu sarılık olarak belirlenmiştir. Acile başvuran bebeklerin 198’i (%86,8) taburcu edilirken 30’una (%13,2) yatış gerekmiştir. Bebeklerin yaklaşık onda birinde acil servise tekrarlayan başvuru saptanmıştır. Sonuç: Yenidoğanların acil servise en sık başvuru şikayetlerini sarılık, huzursuzluk, göbek ilişkili yakınmalar, uyanmama, ateş, kusma, öksürük ve burun tıkanıklığı oluşturmaktadır. 17 hastaya 1.basamak yenidoğan yoğun bakım ünitesine yatış verilmiş, 13 hastaise ileri tetkik ve tedavi amacıyla tam teşekküllü hastaneye yönlendirilmiştir.

Background: Despite many well-documented benefits of breastfeeding, only 44% of babies worldwide are exclusively breastfed for the first 6 months. The aggressive marketing of formula food companies may be contributing to why mothers are choosing artificial feeding over breastfeeding. Objective: To identify when and how mothers become aware of infant formula food and the impact it has on breastfeeding. Methods: Four commonly used formula food logos were modified to unbranded versions using photoshop and shown to 444 participants at a tertiary level hospital. The participants included first-time pregnant women and mothers of infants aged 0–6 months. They were asked if they recognized the logos and how they knew them. Breastfeeding practices and media usage were also examined with a questionnaire. Results: The overall rate of logo recognition was 60.8%, increasing with the baby’s age. Of the mothers who had never used formula, 51.6% still recognized them. Of the participants, 70.5% admitted to getting baby care ideas from the media, with the logo recognition rate being higher among them. Exclusive breastfeeding was lower among the mothers who were aware of the logos. Conclusion: The awareness of formula food was quite high among the group that needed to breastfeed exclusively. More than half of those who recognized the logos stated that they saw them through the media, highlighting its role in formula awareness.