Objectives: In this study, we aimed to investigate the contribution of the early systemic immune-inflammatory index (SII) and acute-phase reactants in predicting nosocomial infections in term newborns who underwent congenital heart surgery.
Methods: This retrospective study was conducted in neonates who underwent cardiopulmonary bypass (CPB) surgery for congenital heart disease (CHD) between November 1, 2021, and December 1, 2022, and were followed in the pediatric cardiac intensive care unit. Demographic and clinical characteristics, as well as changes in the systemic inflammatory index (platelet count×neutrophil/lymphocyte count) and acute-phase reactants during the preoperative period and the first 72 postoperative hours, were evaluated in patients with and without nosocomial infection. The results were statistically analyzed.
Results: This study included 160 neonatal patients. The median age was 10 days (IQR, 6–15 days), and the median weight was 3 kg (IQR, 2.8–3.2 kg). Eighty patients were male (50%). Fifty-five different nosocomial infections were identified in 44 patients (27.5%). Bloodstream infections were the most common (62%), followed by lower respiratory tract infections (23%) and wound infections (15%). Mortality due to nosocomial infections was 34%. SII and NLR values measured on postoperative days 2 and 3 were significantly higher in patients with nosocomial infections (p<0.05). An SII value >510 (72% specificity, 85% sensitivity) on postoperative day 2 and >730 (72% specificity, 80% sensitivity) on postoperative day 3 were highly predictive of nosocomial infection.
Conclusions: Nosocomial infections are an important cause of mortality and morbidity in neonates undergoing congenital heart surgery. An easy-to-use systemic inflammatory index measurement may help predict nosocomial infections.

Objectives: Prolongation of the QT/QTc interval is associated with an increased risk of torsade de pointes. Although obtaining a standard 12-lead ECG is common for this evaluation in pediatric cardiac intensive care unit (CICU) patients, it may interrupt patient care or increase staff workload. Continuous QT/QTc measurements can be performed using bedside monitors with dedicated software in the pediatric CICU. This study aimed to evaluate the agreement between computerized QT/QTc measurements obtained from bedside monitors (three leads) and time-matched standard 12-lead ECGs.
Methods: This study was designed as a retrospective observational study. QT/QTc measurements were obtained using convenience sampling, with both ECG types recorded within ≤30 minutes of each other. Agreement between the two methods was assessed using Bland–Altman analysis.
Results: During the study period, 100 patients had both bedside monitor and 12-lead ECG measurements compared. For QT measurements, the mean bias difference was not statistically significant (β=−1.9, 95% CI=4, −11.05; p=0.6; limits of agreement [LOA]=−60, 54). For QTc measurements, the mean bias difference was also not statistically significant (β=−3.20, 95% CI=4, −11.05; p=0.6; LOA=−65, 57).
Conclusion: There was good agreement between the two methods for both QT and QTc measurements. Bedside monitor QT/QTc assessments may help identify patients at risk.

Objectives: The aim of this study was to evaluate the effects of combined bilateral pecto-intercostal fascial plane block (PIFB) and recto-intercostal fascial plane block (RIFPB) on the quality of postoperative analgesia and recovery in cardiac surgery patients undergoing median sternotomy.
Methods: This prospective, randomized controlled study was conducted in 40 patients who underwent cardiac surgery via median sternotomy. Patients were randomized into two groups: the block group (PIFB+RIFPB, n=20) and the control group (no regional block, n=20). The primary outcome measure was postoperative pain scores (NRS) during the first 24 hours. Secondary outcomes were the Quality of Recovery-15 (QoR-15) score at 24 hours postoperatively, opioid consumption, and opioid-related side effects. Blocks were performed bilaterally using PIFB (20 mL of 0.25% bupivacaine on each side) and RIFPB (10 mL of 0.25% bupivacaine on each side) under ultrasound guidance.
Results: Pain scores (NRS) were significantly lower in the block group during the first 24 postoperative hours, both at rest and during movement. Consequently, QoR-15 scores at 24 hours were significantly higher in the block group than in the control group. Tramadol consumption was significantly lower in the block group. Additionally, opioid-related side effects, such as nausea and vomiting, were significantly less common in the block group. No complications related to the blocks were observed.
Conclusion: The combination of bilateral PIFB and RIFPB after median sternotomy significantly improved postoperative analgesia, reduced opioid use, and increased the quality of recovery by minimizing side effects. These results, evaluated for the first time in a prospective random-ized controlled trial, indicate that the combination of PIFB and RIFPB can be included in multimodal analgesia protocols in cardiac surgery.

Objectives: This study aimed to evaluate the clinical, demographic, and process-related factors affecting in-hospital mortality among patients undergoing extracorporeal membrane oxygenation (ECMO).
Methods: This single-center retrospective study included data from a total of 279 patients (233 adults and 46 pediatric patients) who underwent ECMO between 01 January 2014 and 31 December 2023. Patient demographics, ECMO indications, ECMO configurations, sites and timing of ECMO initiation, duration of ECMO support, and clinical outcomes were analyzed. A p value <0.05 was considered statistically significant.
Results: The most common indication for ECMO was post-cardiotomy failure (36.5%), followed by COVID-19–related acute respiratory failure (26%). Veno-arterial ECMO was the most frequently used configuration in both adult and pediatric patients, whereas veno-venous ECMO was associated with the longest duration of support. Pediatric patients demonstrated significantly higher ECMO weaning and hospital discharge rates than adults.
Conclusion: Pediatric patients receiving ECMO showed higher rates of successful weaning and hospital discharge compared with adults. While patient age and ECMO indication were significant determinants of mortality, ECMO configuration, timing, and site of initiation were not independently associated with mortality or weaning success.

Objectives: Pain is a pathological condition that affects the individual both in terms of health and socioeconomic aspects. Non-cardiac chest pain is a frequent symptom in patients admitted to the hospital. The aim of this study was to evaluate the surgical treatments and pathological results of chronic chest pain of unknown cause.
Methods: In this study, patients admitted to the Gaziantep City Hospital Department of Thoracic Surgery with complaints of chest pain between October 2023 and December 2024 were retrospectively examined. Patients older than 18 years of age, with normal radiological examinations, rib pain lasting at least 1 year, unresponsive to drug therapy and intercostal neurolytic treatments, and treated surgically were included. The visual analog scale (VAS) was used to quantify pain.
Results: A total of 69 patients were analyzed retrospectively. Of the patients, 50.7% were male and 49.3% were female. The mean age was 30.6 (19–55) years. According to the VAS score, the mean pain severity was 6.28. No pathological findings were detected radiologically or scintigraphically in 89%–90% of the patients. Pathology results included benign lesions, chronic inflammation, enchondroma, chondroma, chondrosarcoma, osteoma, osteomyelitis, and malignant mesenchymal tumor. In the first postoperative month, 81.1% of the patients had no complaints of pain, while 15.9% reported mild pain.
Conclusion: Even if radiological and scintigraphic examinations are normal, pain may be caused by an underlying disease. In chronic rib pain, pain control can be achieved with surgical treatment despite unsuccessful analgesic therapies.

Objectives: It has been shown that patients who have undergone noncardiac surgery experience decreased postoperative pain when given magnesium sulfate (MgSO₄). In this study, we aimed to investigate the effects of MgSO₄ infusion on postoperative pain in coronary artery bypass graft (CABG) surgery.
Methods: After approval from the Ethics Committee and obtaining informed consent, 100 patients undergoing elective CABG, classified as ASA-III and having a preoperative EF above 40%, were selected. The patients were prospectively randomized to group I (n=50), which received MgSO₄ (15 mg–1kg–1h–1), and group II (control) (n=50). Both groups received morphine infusion (0.07 mg–1kg–1h–1) postoperatively via PCA. To evaluate analgesia, pain scores were assessed using VAS immediately after extubation and at 2, 6, and 12 hours. Simultaneously, the number of requests made to the PCA device, the number of requests met, and the total morphine dose were determined and recorded. In the statistical analysis (SPSS), differences between groups were evaluated using Student’s t test and two-way analysis of variance (p<0.05). The results were expressed as mean value±standard deviation.
Results: VAS scores at the 6th and 12th hours after extubation were lower in the magnesium group compared with the control group (p<0.05). The total morphine amount and frequency of PCA use were lower in the magnesium group than in the control group. However, these dif-ferences were not statistically significant.
Conclusion: We suggest that magnesium therapy for postoperative analgesia could be a useful option in CABG surgery.

Objectives: To evaluate the analgesic efficacy of the serratus posterior superior intercostal plane block (SPSIPB) as a component of multimodal analgesia in patients undergoing open-heart surgery via median sternotomy.
Methods: This retrospective observational study included 10 ASA III patients undergoing open-heart surgery. All patients received bilateral ultrasound-guided SPSIPB with 30 mL of 0.25% bupivacaine per side. Postoperative pain was assessed using the Numeric Rating Scale (NRS) at sternotomy and drain sites during the first 24 hours after extubation. Opioid consumption, rescue analgesia requirements, mechanical ventilation time, ICU and hospital length of stay, and postoperative complications were recorded.
Results: Mean resting and dynamic NRS scores remained low at both sternotomy and drain sites throughout the first 24 hours. Six patients required rescue analgesia, whereas four required none. No block-related complications were observed. Opioid consumption was limited, and patient satisfaction was high.
Conclusion: SPSIPB provided effective postoperative analgesia following open-heart surgery and appears to be a promising component of multimodal pain management strategies.

Venous cannulation is one of the most important steps in establishing cardiopulmonary bypass. Misplacement of the cannula is a rare occurrence. Transoesophageal echocardiography can help identify misplacement during conventional cardiac surgery.

Robotic-assisted cardiac surgery offers benefits such as reduced blood loss, shorter hospital stays, and improved recovery. Enhanced Recovery After Surgery (ERAS) protocols further optimize outcomes by promoting early mobilization, minimizing opioid use, and improving patient satisfaction. This case report highlights the successful implementation of a thoracic paravertebral block (PVB) as part of an ERAS strategy in robotic atrial septal defect (ASD) closure surgery.