Predictors of Severity of Scrub Typhus in Children Requiring Pediatric Intensive Care Admission

2021 ◽  
Author(s):  
Arpita Khemka ◽  
Mihir Sarkar ◽  
Ankika Basu ◽  
Partha Pratim Dey ◽  
Satyabrata Roy Chowdhoury ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urine Output ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Case Fatality ◽  
Pediatric Intensive Care ◽  
Age Group ◽  
Intensive Care Admission ◽  
Altered Sensorium ◽  
Number Of Patients

AbstractObjective of our study was to determine the clinical characteristics and laboratory profile of scrub typhus patients requiring pediatric intensive care admission and to find out risk factors for the severity of illness. This was a cross-sectional observational study conducted on 1-month to 12-year-old children admitted with scrub typhus in a tertiary care pediatric intensive care unit (PICU). Relevant demographic, clinical, laboratory, treatment, and outcome-related data were documented. The severity of the disease was measured in the form of multiple organ dysfunction syndrome (MODS). With further correlation, and univariate and multivariate analyses, factors associated with severe disease were identified. During the study period, out of 586 PICU admission, 62 patients (10.6%) were diagnosed with scrub typhus. The mean age was 63.85 ± 52.78 months, where infants constituted 32.3% of the total population. Fever was present in 100% of the cases. Common indications of PICU admission were: respiratory distress 42 (67.7%), altered sensorium 41 (66.1%), convulsion 37 (59.7%), and shock 31 (50%). Total number of patients with MODS was 40 (64.5%). The case fatality rate was 8%. On multivariate analysis, infant age group (p = 0.02), altered sensorium (p = 0.001), reduced urine output (p = 0.02), thrombocytopenia (p = 0.001), raised C-reactive protein (p = 0.004), hyponatremia (p = 0.005), hypoalbuminemia (p = 0.01), deranged international normalized ratio (p = 0.02), and hyperferritinemia (p = 0.02) came out to be independent factors in predictability for development of MODS. Multiorgan dysfunction is a life-threatening manifestation of scrub typus in children, which necessitates PICU admission. Infant age group, presence of altered sensorium, reduced urine output, thrombocytopenia, elevated inflammatory markers, coagulopathy, hypoalbuminemia, and hyponatremia predict risk for MODS.

scholarly journals Clinico-hematological manifestations of malaria in children in Western Uttar Pradesh, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1904
Author(s):  
Najia Hassan ◽  
Sonam Chalotra ◽  
Satinder Aneja
Keyword(s):  
Severe Malaria ◽  
Severe Disease ◽  
Tertiary Care ◽  
Case Fatality ◽  
Pediatric Intensive Care ◽  
Febrile Illness ◽  
Control Programme ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Hematological Manifestations

Background: Globally, malaria is one of the important causes of mortality in pediatric age group.  We describe here the clinico-hematological manifestations of malaria in children in Western Uttar Pradesh.Methods: A Retrospective study was done over 8 months in pediatric ward and pediatric intensive care unit of a tertiary care centre in Greater Noida. Children below 18 years admitted with acute febrile illness with peripheral smear and / or rapid malaria antigen test positive were included in the study.  Detailed clinical, biochemical and hematological characteristics of children hospitalized with severe malaria were recorded and patients were managed according to National Vector Born Disease Control Programme Guidelines for malaria treatment.Results: Out of 115 children admitted with malaria, majority of cases were due to P. vivax (88.7%) compared to P. falciparum (5%) and Mixed infection (6%). Malaria was more common in males and in 1 to 5 years age group. Out of 115 patients, severe malaria was present in 27 (23.4%) patients, all infected with P. vivax. Among them, bleeding was present in 13.04 %, shock in 9.56%, acidosis in 9.56%, jaundice in 5.21%, seizures in 3.47%, severe anemia in 5.21%, renal impairment in 3.47%, impaired sensorium in 1.73% and pulmonary edema was present in 0.86% patients respectively.  Case fatality Rate was 1.73%, all due to severe vivax malaria.Conclusions: The study highlights that P. vivax is a common  cause of malaria in Western UP and can result in a severe disease with potential mortality.

scholarly journals Pattern of Neonatal Admissions and Outcome in an Intensive Care Unit (ICU) of a Tertiary Care Paediatric Hospital in Bangladesh – A One-Year Analysis

2014 ◽  
Vol 31 (3) ◽  
pp. 134-139
Author(s):  
MS Hoque ◽  
S Alam ◽  
ASMNU Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Infections ◽  
Oesophageal Atresia ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Fatality ◽  
Paediatric Hospital ◽  
Number Of Patients ◽  
Surgical Conditions

Objective: To describe the characteristics of neonates admitted to intensive care unit (ICU) and their outcome in a tertiary care paediatric hospital in Bangladesh. Study Design: Retrospective, descriptive study. Setting and Duration of Study: Paediatric intensive care unit in Dhaka Shishu Hospital from January to December 2011. Methods: Data was retrieved from file records of all admitted neonates regarding age, gender, gestational age, birth and admission weight, reason for admission and outcome. Results: During this study period, the total number of patients admitted was 191; most of them were neonates (146, 76.4%). Among the 146 neonates, the highest number comprised of birth asphyxia (55, 37.7%), followed by serious bacterial infections (sepsis, pneumonia, meningitis) (30, 20.5%) preterm low birth weight (LBW) babies (28, 19.2%), surgical conditions (congenital diaphragmatic hernia, oesophageal atresia with trachea-oesophageal fistula, Hirschsprung disease and anorectal malformations) (18, 12.3%), respiratory distress syndrome (RDS) (9, 6.2%), and congenital heart disease (6, 4.1%). Out of 146 patients, 42 expired (28.8%). Most of the expiries were due to sepsis (35.7%); followed by prematurity (21.4%), perinatal asphyxia (19.0%) and surgical conditions (14.3%). Conclusion: Birth asphyxia, septicaemia, and prematurity were the main reasons for neonatal admissions in ICU, while case fatality was highest for septicaemia. Regular antenatal visits, safe delivery practice and timely referral to tertiary care hospitals may result in decreased burden in ICU and also better outcome. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20979 J Bangladesh Coll Phys Surg 2013; 31: 134-139

scholarly journals Correlation of PeradeniyaOrganophosphorus Poisoning Scale (POP) and outcome of Organophosphorus poisoning

2020 ◽  
Vol 5 (1) ◽  
pp. 986-989
Author(s):  
Gunjan Regmi ◽  
Batsalya Arjyal ◽  
Kanak Khanal ◽  
Kumud Pyakurel ◽  
Rejina Shahi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Assessment Tool ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Intensive Care Admission ◽  
Icu Stay ◽  
Number Of Patients ◽  
Organophosphorus Poisoning

Introduction: Organophosphorus poisoning is one of the common causesfor the intensive care admission in the developing countries.This study was conducted to assess the correlation between Peradeniya Organophosphorus Poisoning (POP) scale and the outcomes in poisoningin a tertiary care hospital in Eastern Nepal. Objective: To assess the severity and outcome of OP compound poisoning with the correlation of POP score. Methodology: This was a prospective observational study conducted over 6 months in the intensive care unit at tertiary care hospital in the eastern part of Nepal. The study includedall OP poisoning patients presenting in the emergency department and finally admitted to intensive care unit who fulfilled the inclusion criteria.Correlation was made between POP scores and outcomes in terms of intensive care unit(ICU) stay, need of ventilation and mortality was assessed. Result: Fifty patients with OP poisoning wereincluded in the study. Suicide attempt was the most common reason for poisoning. The incidence of poisoning was more common among males(72%)and significant majority were aged younger than 35 years (84%). On admission, the number of patients in mild, moderate and severepoisoning group were 52%, 30% and 18% respectively. Rates for ICU stay, respiratory failure requiring ventilator and mortality was significantly (p<0.001) higher in severe POP scale. Conclusion: The POP scale is a useful clinical assessment tool to assess and categorize patients with OP poisoning according to severity and in predicting their clinical outcomes.

scholarly journals Sociodemographic Profile, Semiology, and Etiology of Patients with Status Epilepticus: A Study from a Tertiary Care Hospital in North India

2018 ◽  
Vol 09 (04) ◽  
pp. 487-491
Author(s):  
Wasim Qadir ◽  
Khurshid Ahmad Wani ◽  
Bilal Ahmad Bhat
Keyword(s):  
Intensive Care ◽  
Status Epilepticus ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
North India ◽  
Prior History ◽  
Seizure Type ◽  
Care Hospital ◽  
Age Group ◽  
Sociodemographic Profile

ABSTRACT Background and Objectives: Despite advance in treatment of status epilepticus (SE), a major neurological emergency, it is still associated with mortality and morbidity. The objective of our study was to estimate sociodemographic profile, semiology, and etiology in the children with SE admitted in pediatric intensive care. Materials and Methods: Children between 1 month and 18 years with continuous seizure activity of >5 min or two or more sequential seizures without full recovery of consciousness between seizures, admitted in the Pediatric Intensive Care Unit of the Department of Pediatrics, Government Medical College, Srinagar, were included in the study. A semi-structured tool was designed to record the sociodemographic details. Detailed history, clinical examination, and investigations (including neuroimaging as and when needed) were used to determine the type of seizure and etiology. Results: A total of 51 patients were included in our study. Most of the patients were <5 years with 47.10% in 1–5 years’ age group and 43.10% in >1-year age group. Males (60.80%) outnumbered females. Thirty-nine patients (76.47%) belonged to “known” or “symptomatic” group with 35 (68.60%) of them presenting with SE as their fresh seizure. Thirty-nine (76.47%) of our patients had generalized tonic–clonic seizure (GTCS) type of SE. Conclusion: Most of the children (90%) were below the age of 5 years with male predominance. Most of the patients had SE as their first seizure without prior history of seizures with GTCSs was the most frequent seizure type.

scholarly journals A study on clinical profile and outcome of patients in PICU (paediatric intensive care unit) at tertiary care unit

2019 ◽  
Vol 6 (2) ◽  
pp. 757
Author(s):  
Aruna Jyothi K. ◽  
Korisipati Ankireddy
Keyword(s):  
Intensive Care Unit ◽  
Central Nervous System ◽  
Intensive Care ◽  
Paediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Medical Advice ◽  
Clinical Profile ◽  
Age Group ◽  
Medical College

Background: This study was carried out with the objectives to study the clinical profile and to find the outcome of children admitted to pediatric intensive care unit (PICU) of Kurnool medical college and hospital, Andhra Pradesh.Methods: A retrospective study was carried in children aged more than 28 days to 12 years admitted in PICU from 1st January 2016 to 31st December 2016 when a total of 600 patients were admitted.Results: Out of these, 400 (66.66%) cases were males and 200 (33.33%) cases were females. Maximum numbers of patients were in the age group of more than 28 days to 1 year which constituted 325 (54.16%) cases. This was followed by 1 year to less than 5 years age group which constituted 150 (i.e. 25%) cases. Under 5 years aged children constituted 500 (83.33%) cases. Next most common age group admitted was 5 years to 10 years with 85 (i.e. 14.16%) cases and 10 to 12 years age group constituted 40 (6.66%) cases. In this study, central nervous system was the commonest system involved (n=195, 32.5%). Other systems involved were: respiratory system (n=122, 20.33%), cardiovascular system (n=65, 10.83%), gastro-intestinal system (n=32, 5.33%), hematological (n=35, 5.83%) and renal system (n=23, 3.83%).   Other causes include infections (n=97, 16.16%), metabolic (n=17, 2.83%), down syndrome (n=7, 1.16%) and poisoning (n=7, 1.16%) etc.Conclusions: Out of the 600 patients admitted to PICU, 168 (28%) patients died. 315 (52.5%) cases improved.  117 (19.5%) cases constituted those who were shifted to higher centre or another department or were taken against medical advice.

Risk Factors for Pediatric Intensive Care Admission among Asthmatic Children in Aseer, South-West Saudi Arabia

2020 ◽  
Vol 11 (2) ◽  
pp. 1684
Author(s):  
Mohammed Abdullah Alshehri ◽  
Mohannad Mohammed Al gossadi Alsheri ◽  
Reema Mohammed Al gossadi Alsheri ◽  
Renad Mohammed Al gossadi Alsheri
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Pediatric Intensive Care ◽  
Intensive Care Admission ◽  
Asthmatic Children ◽  
South West

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

scholarly journals Vitamin D deficiency at pediatric intensive care admission

2014 ◽  
Vol 90 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Corsino Rey ◽  
David Sánchez-Arango ◽  
Jesús López-Herce ◽  
Pablo Martínez-Camblor ◽  
Irene García-Hernández ◽  
...  
Keyword(s):  
Vitamin D ◽  
Intensive Care ◽  
Vitamin D Deficiency ◽  
Pediatric Intensive Care ◽  
Intensive Care Admission
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