scholarly journals Post-extubation stridor after prolonged intubation in the pediatric intensive care unit (PICU): a prospective observational cohort study

2020 ◽  
Vol 277 (6) ◽  
pp. 1725-1731 ◽  
Author(s):  
L. L. Veder ◽  
K. F. M. Joosten ◽  
K. Schlink ◽  
M. K. Timmerman ◽  
L. J. Hoeve ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Prolonged Intubation ◽  
Observational Cohort

scholarly journals Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialised hospital, northwest Ethiopia: a prospective observational cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036746
Author(s):  
Nahom Worku Teshager ◽  
Ashenafi Tazebew Amare ◽  
Koku Sisay Tamirat
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Critical Illness ◽  
Northwest Ethiopia ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Predictors Of Mortality ◽  
Observational Cohort ◽  
The University

ObjectiveTo determine the incidence and predictors of mortality among children admitted to the paediatric intensive care unit (PICU) at the University of Gondar comprehensive specialised hospital, northwest Ethiopia.DesignA single-centre prospective observational cohort study.ParticipantsA total of 313 children admitted to the ICU of the University of Gondar comprehensive specialised hospital during a one-and-a-half-year period.MeasurementsData were collected using standard case record form, physical examination and patient document review. Clinical characteristics such as systolic blood pressure, pupillary light reflex, oxygen saturation and need for mechanical ventilation (MV) were assessed and documented within the first hour of admission and entered into an electronic application to calculate the modified Pediatric Index of Mortality 2 (PIM 2) Score. We fitted the Cox proportional hazards model to identify predictors of mortality.ResultThe median age at admission was 48 months with IQR: 12–122, 28.1% were infants and adolescents accounted for 21.4%. Of the total patients studied, 59.7% were males. The median observation time was 3 days with (IQR: 1–6). One hundred and two (32.6%) children died during the follow-up time, and the incidence of mortality was 6.9 deaths per 100 person-day observation. Weekend admission (adjusted HR (AHR)=1.63, 95% CI: 1.02 to 2.62), critical illness diagnoses (AHR=1.79, 95% CI: 1.13 to 2.85), need for MV (AHR=2.36, 95% CI: 1.39 to 4.01) and modified PIM 2 Score (AHR=1.53, 95% CI: 1.36 to 1.72) were the predictors of mortality.ConclusionThe rate of mortality in the PICU was high, admission over weekends, need for MV, critical illness diagnoses and higher PIM 2 scores were significant and independent predictors of mortality.

Ultrasound assessment of peripheral intravenous catheters by nurses in the pediatric intensive care unit

2021 ◽  
pp. 112972982110248
Author(s):  
Ryan J Good ◽  
Elizabeth Diaz ◽  
Robin Thomas ◽  
Beth Wathen ◽  
Todd C Carpenter
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Observational Cohort Study ◽  
Traditional Assessment ◽  
Observational Cohort ◽  
Ultrasound Assessment ◽  
The Impact ◽  
Intravenous Catheters

Objective: Establish the feasibility of pediatric intensive care unit (PICU) nurse-directed ultrasound assessment (UA) of peripheral intravenous (PIV) catheters, compare the results of UA to traditional assessment (TA), and determine PIV survival after UA. Design: Prospective observational cohort study. Setting: PICU within a children’s hospital. Patients: PICU patients with a PIV. Interventions: None. Measurements and main results: Eight nurses performed UA on 131 PIVs in 85 patients. Median age was 3.0 years (IQR 1.0–13.8) and median weight was 15.0 kg (IQR 9.6–59.3). The most common PIV location was the arm (43%) and extravasation occurred in 15% of PIVs. Agreement between TA and UA was moderate with a Kappa of 0.47 (95% CI 0.28–0.66). Nursing confidence in the UA was significantly higher than TA (92% vs 21% very confident, p < 0.0001). In 106 PIVs with a UA that indicated the PIV was intravascular (i.e. negative UA), the median survival was 50.0 h (IQR 21.8–100.3). Conclusions: Nurses can perform UA of PIV status in PICU patients and express greater confidence in the findings of UA than TA. Further study is necessary to determine the impact of UA on the rate of PIV complications.

Sign in / Sign up

Export Citation Format

Share Document