Acute kidney injury in the pediatric intensive care unit at a tertiary care hospital of the Armed Forces: a cross-sectional observational study

Introduction: Acute kidney injury is a rare complication of pregnancy and is associated with high maternal morbidity and mortality. Obstetric factors associated with it are preeclampsia/eclampsia, sepsis, hemorrhage and dehydration. Here, we aim to find out the prevalence of complete recovery of renal function among obstetric patients with acute kidney injury. Methods: This is a descriptive cross-sectional study conducted in a tertiary care hospital from 1st July 2020 to 30th June 2021 where obstetric patients who had developed acute kidney injury were included and followed till 6 weeks of diagnosis. Ethical approvalwas obtained from Institutional Review Committee of Nobel Medical College and Teaching Hospital (IRC- NMCTH 437/2020). The convenience sampling method was used. Data entry and analysis were done using Statistical Package for Social Sciences version 21. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 66 obstetric patients with acute kidney injury, 45 (68.2%) (57-79.3 at 95% Confidence Interval) had complete recovery of renal function. Rate of renal function recovery in Stage 1, Stage 2 and Stage 3 acute kidney injury were 19 (90%), 19 (86%) and 7 (58%) respectively. The most common causes of acute kidney injury were Preeclampsia/eclampsia 18 (40%), sepsis 23 (28.8%) and hemorrhage 10 (22.2%). Conclusions: The prevalence of complete recovery in obstetric patients with acute kidney injury was similar to findings from other studies done in similar settings.

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Prospective Observational Study of Ventilator Associated Pneumonia in Pediatric Intensive Care Unit in a tertiary care hospital, New Delhi

Annals of International medical and Dental Research ◽

10.21276/aimdr.2017.3.4.mb2 ◽

2017 ◽

Vol 3 (4) ◽

Author(s):

Meenakshi Sharma ◽

Manoj Jais ◽

Rajesh Ranjan ◽

Virendra Kumar ◽

Mitasha Singh ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

New Delhi ◽

Ventilator Associated Pneumonia ◽

Care Hospital

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A Study of Acute Kidney Injury in a Tertiary Care Pediatric Intensive Care Unit

Journal of Pediatric Intensive Care ◽

10.1055/s-0040-1716577 ◽

2020 ◽

Author(s):

Akanksha C. Parikh ◽

Milind S. Tullu

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Hospital Stay ◽

Pediatric Intensive Care Unit ◽

Tertiary Care ◽

Kidney Injury ◽

Pediatric Intensive Care ◽

Critically Ill Children

AbstractThe objective of this study was to calculate the incidence, severity, and risk factors for acute kidney injury (AKI) in a tertiary care pediatric intensive care unit (PICU). Also, to assess the impact of AKI and its varying severity on mortality and length of hospital and PICU stays. A prospective observational study was performed in children between 1 month and 12 years of age admitted to the PICU between July 1, 2013, and July 31, 2014 (13 months). The change in creatinine clearance was considered to diagnose and stage AKI according to pediatric risk, injury, failure, loss, and end-stage renal disease criteria. The risk factors for AKI and its impact on PICU stay, hospital stay, and mortality were evaluated. Of the total 220 patients enrolled in the study, 161 (73.2%) developed AKI, and 59 cases without AKI served as the “no AKI” (control) group. Majority (57.1%) of children with AKI had Failure grade of AKI, whereas 26.1% had Risk grade and 16.8% had Injury grade of AKI. Infancy (p = 0.000), hypovolemia (p = 0.005), shock (p = 0.008), and sepsis (p = 0.022) were found to be significant risk factors for AKI. Mortality, PICU stay, and hospital stay were comparable in children with and without AKI as well as between the various grades of renal injury (i.e., Failure, Risk, and Injury). An exceedingly high incidence of AKI, especially of the severe Failure grade was observed in critically ill children. Infancy and frequent PICU occurrences such as sepsis, hypovolemia, and shock predisposed to AKI.

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Non-Invasive Ventilation in a Paediatric Intensive Care Unit (PICU) with Respiratory Failure: Experience at a Tertiary Care Hospital in Dhaka

Journal of Medical Science & Research ◽

10.47648/jmsr.2019.v3001.04 ◽

2019 ◽

Vol 30 (Number 1) ◽

pp. 20-25

Author(s):

S Hoque ◽

ASM N U Ahmed

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Failure ◽

Tertiary Care ◽

Pediatric Intensive Care ◽

Co2 Concentration ◽

Care Hospital ◽

Invasive Ventilation ◽

Cross Sectional ◽

The Mean

Noninvasive ventilation (NIV) has now become an integral tool within the treatment of both acute and chronic respiratory failure, and at an equivalent time reducing the necessity for invasive ventilation. A cross sectional, retrospective study based on a retrospective review of hospital medical records of patients who underwent NIV in the period between January 2017 and December 2019, to determinate the efficacy of NIV in pediatrics whom admitted to Pediatric intensive care unit (PICU) with respiratory failure (short term evaluation), demographic and clinical data were collected before and after applying the NIV. The data included heart rate (HR), respiratory rate (RR), oxygen concentration (P02) and CO2 concentration (PCO2). NIV was used for a total of 61 pediatric patients admitted to PICU during the period of the study. Pneumonia was the commonest indication for the NIV (n=25, 41.0%), and continuous positive airway pressure (CPAP) was used in 52(85.2%) patients. The mean duration of NIV was 817.2 days, there was a significant clinical improvement after one hour from application of NIV The mean improvement in RR was from 48.412.2 to 35.01I.5 (P=0.000), SPO2 was improved from 88.111.8 to 96.510.7 (P= 0.000), and the PCO2 was improved from 61.4±6.1 to 48.713 7 (P=0.002). Five patients were failing to respond to the NIV and shifted to mechanical ventilation. The NIV is a useful tool for treatment of respiratory failure in pediatrics, especially under the age of one year. Pneumonia was the commonest indication for the use of the NB!. More investigation is needed to fully evaluate the ramifications of increased use of this technology in the PICU.

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Etiology & Outcome of Acute kidney Injury in Intensive Care Unit Settings of a Tertiary Care Hospital

Endocrinology and Disorders ◽

10.31579/2640-1045/058 ◽

2020 ◽

Vol 4 (2) ◽

pp. 01-05

Author(s):

Hassan Mumtaz

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Risk Factor ◽

Intensive Care ◽

Tertiary Care ◽

Hospital Setting ◽

Kidney Injury ◽

Morbidity And Mortality ◽

High Morbidity ◽

Care Hospital

Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and co morbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. The rationale of this study is that, as acute kidney is one of major factors contributing in mortality and morbidity of ICU patients, this study will be helpful in identifying important risk factor for development of acute kidney injury in ICU settings, leading to its early detection and thus decreasing associated morbidity and mortality. Objective: To determine the frequency of etiology and outcome of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI and the outcome associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded. Results: Overall incidence of AKI in ICU settings in this study was 37.8% (n=118). Out of 118 patients who had AKI, 59.3% (n=70) were male, whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2 % (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. In terms of outcome, mortality rate in patients with AKI was significantly higher as compared to patients without AKI(P =<0.001) and 56.8%(n=67) of the patients who had AKI died during their ICU stay as compared to 30.4%(n=59) in patients without AKI. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19% and mortality was 56.8% in patients with acute kidney injury.

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