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    Early period survival and neurologic prognosis in newborns with perinatal asphyxia: A tertiary center experience and a mortality chart
    (Brieflands, 2025) Yaman, Akan; Kandemir, İbrahim; Alp Ünkar, Zeynep
    Background: Clinicians require more data regarding mortality and brain damage risk factors in perinatal asphyxia. Objectives: To assess early term outcomes and identify mortality risk factors in perinatal asphyxia. Methods: This study was conducted in a referral-center tertiary intensive care unit in Istanbul, Turkey, between 2016 and 2023. We included all patients who underwent therapeutic hypothermia treatment due to perinatal asphyxia. We recorded laboratory follow-up data, magnetic resonance imaging (MRI) findings, amplitude-integrated electroencephalograms (aEEG) results, mortality, and clinical outcomes. Both conventional frequentist statistical methods and Bayesian methods were used for analysis. Results: A total of 164 patients were included in the study, with an overall mortality rate of 9.8%. Risk factors for mortality included LDH, troponin I, INR, lactate, 2nd day creatinine, voltage anomalies, seizures, and male gender, as well as APGAR scores. A basic chart for mortality prediction was developed. The Sarnat score showed strong evidence, and APGAR 1 showed anecdotal evidence for association with brain damage, although brain damage was independent of laboratory results and other clinical findings, based on moderate and anecdotal evidence from Bayesian calculations. Cranial MRI findings revealed profound damage in 14.8% of Sarnat 1, 21.8% of Sarnat 2, and 50% of Sarnat 3 patients. Conclusions: This study presents prognostic factors for survival and brain damage in perinatal asphyxia. We recommend obtaining cranial MRI for all patients diagnosed with asphyxia, as most laboratory tests were independent of brain damage. Given that profound brain damage can occur even in Sarnat stage I patients, we emphasize the importance of therapeutic hypothermia for these patients.
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    Safety monitoring of colistin therapy in critically ıll neonates with late-onset sepsis: A retrospective observational study
    (British Pharmacological Society, 2025) Acargök, Baran Cengiz; Yaman, Akan; Rzayev, Turkay; Jalalzada, Nazlı; Kandemir, İbrahim; Memişoğlu, Aslı; Bilgen, Hülya Selva
    This study aimed to evaluate the safety of colistin therapy by monitoring renal function and electrolyte levels in critically ill neonates with late-onset sepsis (LOS) hospitalized in the neonatal intensive care unit (NICU) between 2015 and 2021. This ret rospective case–control study included 58 critically ill neonates treated with colistin for late-onset sepsis and 22 control neonates with late-onset sepsis who did not receive colistin. Data were analyzed to compare patient outcomes, microbiological profiles, and side effects of treatment. Statistical analyses were performed using repeated-measures ANOVA and Bayesian calculations to evaluate serum creatinine levels and biochemical parameters over time. Serum creatinine levels showed similar alterations within the first 7days of colistin treatment with moderate evidence. However, serum magnesium and sodium levels were lower on the 7th day in the colistin-treated group compared with the control group. Colistin therapy in critically ill neonates with late-onset sepsis appears to be a viable treatment option with an acceptable short-term safety profile. These findings emphasize the importance of routine monitoring of renal function and electrolyte levels during colistin use in neonatal intensive care to minimize potential complications.