Objectives: Enhanced Recovery After Surgery (ERAS) protocols have been developed to reduce postoperative complications and shorten hospital stays. In this study, we aimed to investigate the effects of prehabilitation and the ERAS protocol in patients who underwent thoracic surgery.
Methods: Between May 15, 2022, and February 15, 2023, 80 individuals scheduled for surgery were included in the study. A prehabilitation program was designed for these patients, which consisted of incentive spirometry, endurance exercises, and breathing exercises within the ERAS protocol. After the prehabilitation program, respiratory function tests were repeated, and pre- and post-program values were compared.
Results: The discharge times of patients in the ERAS group were found to be significantly shorter (p<0.001). A statistically significant difference (p<0.001) was also observed in terms of chest drain removal times. Moreover, when the results of respiratory function tests and the 6-minute walking test before and after prehabilitation were compared, a statistically significant improvement was found in all evaluated parameters following prehabilitation (p<0.001).
Conclusion: Prehabilitation is the first step of the ERAS protocol and the least emphasized component in previous studies. Our study highlighted the effect and importance of prehabilitation in thoracic surgery patients undergoing the ERAS protocol.

Objectives: This study aimed to determine the incidence of acute kidney injury (AKI) and identify risk factors associated with its development in pediatric patients undergoing congenital heart surgery with cardiopulmonary bypass (CPB).
Methods: A prospective study was conducted between May 1, 2022, and May 1, 2023, in a pediatric cardiac intensive care unit. Children under 16 years of age who underwent congenital heart surgery with CPB were included. Postoperative AKI was classified using the pRIFLE criteria. Various clinical and perioperative factors were analyzed for their association with AKI.
Results: A total of 640 patients were included, with a median age of 12 months (IQR 6–24); 52% were male. AKI occurred in 24% of patients: 10% were classified as "Risk," 10% as "Injury," and 4% as "Failure." Patients with AKI had significantly longer durations of mechanical ventilation, ICU and hospital stays, and higher mortality rates. Independent risk factors for AKI included prolonged CPB time (>120 minutes), age<6 months, preoperative pulmonary hypertension, low preoperative serum albumin (<3.5 g/dL), STAT score≥3, red blood cell transfusion>50 mL/kg, and inotrope score≥8.
Conclusion: AKI is a frequent and serious complication after congenital heart surgery. Several modifiable and non-modifiable risk factors contribute to its development, emphasizing the need for early risk stratification and preventive strategies in high-risk pediatric patients.

Objectives: Congenital heart diseases (CHD) are among the most common reasons for intensive care unit (ICU) admission in neonates and infants. Catheter-associated bacteremias (CAB) can lead to increased morbidity and mortality in these patients. This study aimed to investigate the incidence of CAB and the risk factors influencing its development in neonates and infants undergoing congenital heart surgery.
Methods: This retrospective study included patients younger than 12 months who underwent congenital heart surgery and were monitored in a pediatric cardiac intensive care unit between January 1, 2022, and January 1, 2025. The type, location, duration of catheterization, and associated complications were recorded. Demographic data, clinical characteristics, and outcomes were summarized on a per-patient basis. Each case was matched with two control patients based on age and date of surgery. The results were analyzed statistically.
Results: During the study period, congenital heart surgery was performed in 1,200 patients under the age of 12 months. Catheter-associated bacteremia was detected in 32 cases (2.6%). Among the isolated bacterial agents, 84% were gram-negative organisms and 16% were gram-positive organisms. Independent risk factors associated with CAB were: RACHS-1 ≥ 4 (OR 1.2, 95% CI 1–1.5), central venous catheter (CVC) duration > 10 days (OR 1.9, 95% CI 1.2–5), ECMO support (OR 0.8, 95% CI 0.6–2), and delayed sternal closure ≥ 2 days (OR 0.6, 95% CI 0.4–2). The mortality rate due to catheter-associated bacteremia was 18.7%, which was 5.8 times higher compared to the control group.
Conclusion: Catheter-associated bacteremias are a significant cause of morbidity and mortality in neonates and infants undergoing congenital heart surgery, and the majority are caused by gram-negative microorganisms.

Objectives: This study aims to evaluate potential triggers of bloodstream infections in pediatric patients admitted to burn intensive care units.
Methods: In this retrospective, cross-sectional study, we analyzed data from 70 pediatric patients, aged between 3 and 211 months, who were followed in the Burn Intensive Care Unit of our hospital over a five-year period between 2020 and 2024.
Results: The mean age of the 70 pediatric patients was 79±87 months. The causes of burns were flame in 34%, scalding with hot water in 54%, and electrical burns in 9% of cases. The majority of patients (83%, n=58) had partial-thickness burns. The most commonly affected body region was the trunk (12.96%), followed by the head and neck region (6.21%). Total body surface area (TBSA) burned, length of ICU stay, and number of surgical interventions were higher in the transfused group. The mean pre-transfusion hemoglobin (Hb) level was 8.61 g/dL, which increased to 8.97 g/dL post-transfusion. In total, 29 patients received an average of 6.67 units of erythrocyte suspension (ES) and 4.09 units of fresh frozen plasma (FFP). Blood cultures revealed coagulase-negative Staphylococci (CoNS) in five patients and Acinetobacter baumannii in another five.
Conclusion: In pediatric patients (aged 0 to 215 months) followed in the Burn Intensive Care Unit, an increase in total body surface area (TBSA) burned is associated with longer ICU stays, a higher number of surgical interventions, increased transfusion of blood components, and a greater incidence of bloodstream infections.

Central venous catheterization via the subclavian vein is commonly performed due to its advantages, including lower infection rates and greater patient comfort. However, mechanical complications such as malposition may occur. We present a rare case in which a subclavian central venous catheter traversed extravascularly through the thoracic cavity before re-entering the superior vena cava, detected incidentally during video-assisted thoracoscopic surgery. The catheter was successfully removed without complications. This case highlights the importance of verifying catheter placement, as blood aspiration from all lumens does not guarantee correct positioning. In this report, the extravascular course and management of the subclavian catheter in the thoracic cavity during thoracoscopic surgery are discussed.