Renal replacement therapy in the pediatric cardiac intensive care unit

Introduction: Thrombocytopenia (TCP) is a common finding in patients receiving continuous renal replacement therapy (CRRT). Objective: The purpose of this study was to assess the nature of TCP in patients receiving CRRT. Methods: This is a single-center case-control observational study of 795 patients involving over 166,950 h of delivered CRRT at Johns Hopkins Hospital. Concurrent TCP in patients receiving CRRT was defined as a decrease in platelet count of ≥50% any time within 72 h of initiation of CRRT with strict exclusion criteria. Results: There was a higher incidence of TCP in the cardiac intensive care unit (CICU) (22.5%) compared to medical ICU (MICU) (13.1%). Using logistic regression, the odds of developing concurrent TCP in patients receiving CRRT was 2.46 (95% CI 1.32–3.57, p < 0.05) times higher in the CICU compared with the MICU. There was no difference in the incidence of severe or profound TCP or timing of acute TCP between the CICU and MICU. Conclusion: Safe delivery of dialysis care in the ICU is paramount and creating awareness of potential risks such as concurrent TCP in patients receiving CRRT should be part of this care.

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USE OF CONTINUOUS RENAL REPLACEMENT THERAPY IN THE CARDIAC INTENSIVE CARE UNIT

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)31312-3 ◽

2018 ◽

Vol 71 (11) ◽

pp. A771

Author(s):

Jacob Colin Jentzer ◽

Brandon Wiley ◽

Courtney Bennett ◽

Vasken Keleshian ◽

Abdalla Ismail ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Cardiac Intensive Care Unit ◽

Cardiac Intensive Care

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Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49688 ◽

2020 ◽

Vol 35 (2) ◽

pp. 100-104

Author(s):

Maksudur Rahman ◽

Mohammad Abdullah Al Mamun ◽

MAK Azad Chowdhury ◽

Abu Sayeed Munsi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cardiac Intensive Care Unit ◽

Cross Sectional ◽

Cardiac Intensive Care ◽

Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

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