Abstract
Amaç: Akut bronşiolit, iki yaşından küçük çocuklarda sıklıkla viral etkenlerin neden olduğu, akut solunum hastalığıdır. Akut bronşiolit döneminde inflamasyon ile birlikte ortalama trombosit hacminde (MPV) artış olabilmektedir. Bu çalışmada, hastanemiz acil servisinde akut bronşiolit tanısı alan olguların klinik, laboratuvar ve tedavi özelliklerinin incelenmesi ayrıca bronşiolit dönemi ile sağlıklı dönemdeki MPV değerlerinin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntemler: Çocuk acil servisine 01.01.2015- 12.12.2017 tarihleri arasında akut bronşiolit tanısı alan olgular geriye dönük olarak değerlendirildi,
Bulgular: Çalışmaya alınan 314 olgunun ortanca yaşı (IQR), 14,0 (7,0- 20,0 ay) olup, 199’u (% 63,4) erkek cinsiyette idi. Başvuruda en sık şikayetlerin 298 (% 94,9) öksürük, 196 (% 62,4) burun akıntısı ve 107 (% 34,1) ateş olduğu saptandı. En sık fizik muayene bulguları sırasıyla wheezing (% 58,3), retraksiyon (% 46,2) ve ral (29,3) idi. Olguların 132’si (% 42,0) ilk bronşiolit atağı ile başvurmuştu, 182’sinin (% 58,0) tekrarlayan bronşioliti vardı. Tekrarlayan bronşioliti olan olgularda ortanca atak sayısı 2 idi. Ortalama ilk atak yaşının 6,92± 3,81 ay (1- 19 ay) olduğu saptandı. Olguların 137’si (% 43,6) hafif, 121’i (38,5) orta, 56’sı (17,9) ağır atak olarak değerlendirildi; 182’si (% 58,0) acilden taburcu edildi, 1 tanesi sevk edidi, 131’i (% 41,7) yatırılarak izlendi. Bronşiolit ve sağlıklı dönemdeki platelet (/mm3) ve MPV (fl) (ortanca, minimum-maksimum) değerleri sırasıyla 129,6 (110,0- 1140,0); 349,9 (131,0- 967,0) ve 7,7 (6,1- 12,1); 7,7 (5,6- 11,2) idi. Bronşiolit ve sağlıklı dönemdeki platelet ve MPV değerleri arasında fark saptanmadı (sırasıyla p= 0,655, p= 0,855).
Sonuç: Bronşiolit tanısı öykü ve fizik muayene bulgularıyla konulur, hastalık şiddetinin belirlenmesinde MPV değerinin bir önemi saptanmamıştır.
Keywords
References
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- 25. Christakis DA, Cowan CA, Garrison MM, Molteni R, Marcuse E, Zerr DM. Variation in inpatient diagnostic testing and management of bronchiolitis. Pediatrics. 2005;115(4):878-84.
- 26. Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S, Bhatt M, Joubert G, Black KJ, Turner T, Whitehouse S, Klassen TP. Epinephrine and dexamethasone in children with bronchiolitis. The New England journal of medicine. 2009;360(20):2079-89.
- 27. Güzel EÇ, Fidan Ç, Güzel S, Paketçi C, Çelikkol ÜA. Bronşiyolitli Çocuklarda Hastalık Aktivitesinin Değerlendirilmesinde Nötrofil/Lenfosit Oranı Yeni bir Biyobelirteç Olabilir mi? Namık Kemal Tıp Dergisi 2019;7(1):13-8.
- 28. Turan AH, Arıkoğlu T, Tezol Ö, Aslan G, Kuyucu S. İnfantlarda Sık Hışıltı Gelişimini Öngörmede Erken Yaşam Belirteçleri; Gizemli Bir Yolda Eski Dost, ‘‘Eozinofil’’ ile Devam Etmek. Asthma Allergy Immunol 2017;15:1-5.
Abstract
References
- 1. Cai Z, Lin Y, Liang J. Efficacy of salbutamol in the treatment of infants with bronchiolitis: A meta-analysis of 13 studies. Medicine. 2020;99(4):e18657.
- 2. Smith DK, Seales S, Budzik C. Respiratory Syncytial Virus Bronchiolitis in Children. American family physician. 2017;95(2):94-9.
- 3. Fujiogi M, Goto T, Yasunaga H, Fujishiro J, Mansbach JM, Camargo CA, Jr., Hasegawa K. Trends in Bronchiolitis Hospitalizations in the United States: 2000-2016. Pediatrics. 2019;144(6).
- 4. Meissner HC. Viral Bronchiolitis in Children. The New England journal of medicine. 2016;374(18):1793-4.
- 5. National Collaborating Centre for Ws, Children’s. Bronchiolitis: Diagnosis and Management of Bronchiolitis in Children. London: National Institute for Health and Care Excellence (UK); 2015 Jun.
- 6. Yalçın E, Karadağ B, Uzuner N, Yüksel H, Gürkan F, Altındaş DU ve ark. Türk Toraks Derneği Akut Bronşiolit Tanı ve Uzlaşı Raporu. Türk Toraks Dergisi.2009; 10 (ek sayı 1): S1-7.
- 7. Ergül AB, Torun Y, Uytun S, Aslaner H, Kısaaslan AP, Şerbetçi MC. Akut bronşiolitli çocuklarda ortalama trombosit hacminde azalma. Turk pediatri arsivi. 2016;51:40-5.
- 8. Shemirani AH, Nagy B, Jr., Takats AT, Zsori KS, Andras C, Kappelmayer J, Csiki Z. Increased mean platelet volume in primary Raynaud's phenomenon. Platelets. 2012;23(4):312-6.
- 9. Lee IR, Shin JI, Park SJ, Oh JY, Kim JH. Mean platelet volume in young children with urinary tract infection. Scientific reports. 2015;5:18072.
- 10. Karadag-Oncel E, Ozsurekci Y, Kara A, Karahan S, Cengiz AB, Ceyhan M. The value of mean platelet volume in the determination of community acquired pneumonia in children. Italian journal of pediatrics. 2013;39:16.
- 11. Renshaw AA, Drago B, Toraya N, Gould EW. Respiratory syncytial virus infection is strongly correlated with decreased mean platelet volume. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2013;17(9):e678-80.
- 12. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118(4):1774-93.
- 13. Çiftel M, Biçer S, Şiraneci R. Çocuklarda Akut Bronşiolit. JOPP Derg 2009;1(3):115-23.
- 14. Schuh S, Babl FE, Dalziel SR, Freedman SB, Macias CG, Stephens D, Steele DW, Fernandes RM, Zemek R, Plint AC, Florin TA, Lyttle MD, Johnson DW, Gouin S, Schnadower D, Klassen TP, Bajaj L, Benito J, Kharbanda A, Kuppermann N. Practice Variation in Acute Bronchiolitis: A Pediatric Emergency Research Networks Study. Pediatrics. 2017;140(6).
- 15. Gokce S, Kurugol Z, Suner A. The role of mean platelet volume in the early detection of acute bronchiolitis: A prospective study. The clinical respiratory journal. 2018;12(10):2513-8.
- 16. Kanık A, Eliaçık K, Koyun B, İnce OT, Derici YK, Yılmaz NÖ ve ark. . Viral Etiology of Acute Bronchiolitis in Hospitalized Infants and the Effect on Clinical Course. J Pediatr Inf 2016;10:93-8.
- 17. Johnson LW, Robles J, Hudgins A, Osburn S, Martin D, Thompson A. Management of bronchiolitis in the emergency department: impact of evidence-based guidelines? Pediatrics. 2013;131 Suppl 1:S103-9.
- 18. Florin TA, Byczkowski T, Ruddy RM, Zorc JJ, Test M, Shah SS. Variation in the management of infants hospitalized for bronchiolitis persists after the 2006 American Academy of Pediatrics bronchiolitis guidelines. The Journal of pediatrics. 2014;165(4):786-92.e1.
- 19. Ergin H, Dağdeviren E, Polat A, Kılıç İ, Semiz S, Cinbiş M. Akut Bronşiyolitli Olguların Retrospektif Değerlendirilmesi. ADÜ Tıp Fakültesi Dergisi 2005;6(3):29-32.
- 20. Ralston SL, Lieberthal AS, Meissner HC. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2014;134(5):e1474-e1502. Pediatrics. 2015;136(4):782.
- 21. Friedman JN, Rieder MJ, Walton JM. Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatrics & child health. 2014;19(9):485-98.
- 22. National Institute for Health and Care Excellence. Bronchiolitis in children: diagnosis and management. 2015 [cited 2016 June 24]. Available from: https:// www. nice. org. uk/guidance/ ng9.
- 23. Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L. Glucocorticoids for acute viral bronchiolitis in infants and young children. The Cochrane database of systematic reviews. 2013(6):Cd004878.
- 24. Macias CG, Mansbach JM, Fisher ES, Riederer M, Piedra PA, Sullivan AF, Espinola JA, Camargo CA, Jr. Variability in inpatient management of children hospitalized with bronchiolitis. Academic pediatrics. 2015;15(1):69-76.
- 25. Christakis DA, Cowan CA, Garrison MM, Molteni R, Marcuse E, Zerr DM. Variation in inpatient diagnostic testing and management of bronchiolitis. Pediatrics. 2005;115(4):878-84.
- 26. Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S, Bhatt M, Joubert G, Black KJ, Turner T, Whitehouse S, Klassen TP. Epinephrine and dexamethasone in children with bronchiolitis. The New England journal of medicine. 2009;360(20):2079-89.
- 27. Güzel EÇ, Fidan Ç, Güzel S, Paketçi C, Çelikkol ÜA. Bronşiyolitli Çocuklarda Hastalık Aktivitesinin Değerlendirilmesinde Nötrofil/Lenfosit Oranı Yeni bir Biyobelirteç Olabilir mi? Namık Kemal Tıp Dergisi 2019;7(1):13-8.
- 28. Turan AH, Arıkoğlu T, Tezol Ö, Aslan G, Kuyucu S. İnfantlarda Sık Hışıltı Gelişimini Öngörmede Erken Yaşam Belirteçleri; Gizemli Bir Yolda Eski Dost, ‘‘Eozinofil’’ ile Devam Etmek. Asthma Allergy Immunol 2017;15:1-5.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | June 26, 2020 |
| Submission Date | April 25, 2020 |
| Published in Issue | Year 2020 Volume: 14 Issue: 4 |
The publication language of Turkish Journal of Pediatric Disease is English.
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