The Use of Bilevel Positive Airway Pressure in a Tertiary Care Pediatric Intensive Care Unit

2005 ◽  
Vol 18 (2) ◽  
pp. 62-67 ◽  
Author(s):  
Raj Padman ◽  
Scott Penfil ◽  
Jenna Hammond
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Bilevel Positive Airway Pressure

Weaning From Noninvasive Ventilatory Support in Infants With Severe Bronchiolitis: An Observational Study

2021 ◽  
Author(s):  
Julie Cassibba ◽  
Claire Freycon ◽  
Julia Doutau ◽  
Isabelle Pin ◽  
Alexandre Bellier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Pediatric Intensive Care Unit ◽  
Positive Airway Pressure ◽  
Ventilatory Support ◽  
Winter Season ◽  
Pediatric Intensive Care ◽  
High Flow Nasal Cannula ◽  
Tertiary Center

Abstract Background: The aim of the study was to analyze the weaning success, the type of weaning procedures, and weaning duration in consecutive infants hospitalized over a winter season in a Pediatric Intensive Care Unit.Methods: A retrospective observational study in a pediatric intensive care unit in a tertiary center. Infants hospitalized for a severe bronchiolitis were included and the weaning procedure from continuous positive airway pressure (CPAP), noninvasive ventilation (NIV) or high flow nasal cannula (HFNC) was analyzed.Results: Data from 95 infants (median age 47 days) were analyzed. On admission, 26 (27%), 46 (49%) and 23 (24%) infants were supported by CPAP, NIV and HFNC, respectively. One (4%), nine (20%) and one (4%) infants failed weaning while supported by CPAP, NIV or HFNC, respectively (p=0.1). In infants supported by CPAP, CPAP was stopped directly in 5 patients (19%) while HFNC was used as an intermediate ventilatory support in 21 (81%). The duration of weaning was shorter for HFNC (17 hours, [IQR 0-26]) than for CPAP (24 hours, [14-40]) and NIV (28 hours, [19-49]) (p<0.01).Conclusions: The weaning phase represent a large proportion of noninvasive ventilatory support duration in infants with bronchiolitis. The weaning procedure following a “step down” strategy may lead to an increase in duration of weaning.

scholarly journals 1134. Antibiotic Indications and Appropriateness in the Pediatric Intensive Care Unit: A 10 Center Point Prevalence Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S403-S404
Author(s):  
Kathleen Chiotos ◽  
Jennifer Blumenthal ◽  
Juri Boguniewicz ◽  
Debra Palazzi ◽  
Emily Berkman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Antibiotic Use ◽  
Empiric Therapy ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Point Prevalence Study

Abstract Background Antibiotics are prescribed in up to 80% of pediatric intensive care unit (PICU) patients, but multicenter studies systematically evaluating antibiotic indications and appropriateness in this high-utilizing population are lacking. Methods A multicenter point prevalence study was conducted at 10 geographically diverse tertiary care US children’s hospitals. All PICU patients < 21 years of age who were receiving systemic antibiotics at 8:00 AM on each study day were included. Study days occurred in February and March 2019. Data were abstracted by critical care and/or infectious diseases trained clinicians using standardized data collection forms and definitions of antibiotic appropriateness. Results 408 of 732 PICU patients (56%) received 618 antibiotics on the two study days. Empiric therapy for suspected bacterial infections without sepsis was the most common indication for antibiotics (22%), followed by treatment of community-acquired pneumonia and empiric therapy for septic shock (12% each, Figure 1). Overall, 194 antibiotic orders (32%) were classified as inappropriate and 158 patients (39%) received at least one inappropriate antibiotic. Vancomycin, cefepime, and ceftriaxone were the antibiotics most often inappropriately prescribed (Figure 2). Antibiotics prescribed inappropriately for the top 5 indications shown in Figure 1 accounted for 77% of all inappropriate antibiotic use. Prolonged ( >4 days) empiric therapy and prolonged ( >24 hours) post-operative prophylaxis were the most common reasons antibiotics prescribed for these indications were classified as inappropriate. Pneumonia and ventilator-associated infections were the most common infections for which antibiotics were prescribed inappropriately (46%). Reasons for inappropriate antibiotic use included lack of evidence supporting a bacterial infection (no radiographic infiltrate or significant increase in respiratory support) and use of unnecessarily broad antibiotics (Table 1). Conclusion Inappropriate antibiotic use is common in the PICU, particularly for pneumonia. Studies focused on defining optimal treatment strategies, as well as improved diagnostic approaches to curtail prolonged courses of empiric therapy, should be prioritized. Disclosures All authors: No reported disclosures.

scholarly journals Survival among patients admitted in PICU (Pediatric Intensive Care Unit) of tertiary childcare hospital.

2021 ◽  
Vol 28 (12) ◽  
pp. 1773-1777
Author(s):  
Fatima Jabeen ◽  
Asim Khurshid ◽  
Maria Saleem
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Care Hospital ◽  
Group Iii ◽  
Group I ◽  
Male Patients ◽  
Study Participants

Objective: To determine the frequency of survival among patients admitted in Paediatric Intensive Care Unit (PICU) of tertiary care hospital according to disease severity score PRISM III. Study Design: Descriptive study. Setting: PICU of The Children’s Hospital and Institute of Child Health, Multan. Period: October 2019 to April 2020. Material & Methods: A total of 205 admitted children in PICU were recruited. PRISM III forms were filled and PRISM III score was calculated for all study participants. Results: Of these 205 study cases, 124 (60.5 %) were male patients while 81 (39.5 %) were female patients. Mean age of our study cases was 3.64 ± 1.96 years. Mean duration of PICU stay was 4.52 ± 3.59 days and 139 (67.8%) patients had PICU stay for upto 5 days. Mean PRISM III score was 11.25 ± 4.69 and 69 (33.7%) had group I score, 118 (57.6%) had group II score, 14 (6.8%) had group III score and 4 (2%) had group IV score. Of these 205 study cases, mortality was noted in 31 (15.1%). Conclusion: High Frequency of mortality among children admitted to pediatric intensive care unit (PICU) was observed and mortality was found to be increasing with increasing PRISM III score.

Mortality Review of Children Admitted in Pediatric Intensive Care Unit Over One Year in a Tertiary Care Hospital

2021 ◽  
Vol 6 (1) ◽  
pp. 1369-1372
Author(s):  
Pun Narayan Shrestha ◽  
Sumit Agrawal ◽  
Kosh Raj R C ◽  
Prakash Joshi ◽  
Ajit Rayamajhi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Congenital Heart ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Care Hospital ◽  
Female Ratio

Introduction: Childhood mortality is still high in developing countries. This can be reduced with good preventive and curative services especially with critical care. The treatment of critically ill children must be focused for better outcome. The pediatrics deaths audit and review provide feedback to health workers and to the institution. The outcome measures of critical care medicine include mortality, morbidity and disability rate. Objectives: The aim of this study is to review the causes and mode of death in children and length of PICU (pediatric intensive care unit) stay. Methodology: A retrospective study was conducted of the patients who were admitted and died within the period of 16 July 2019 to 15 July, 2020 at PICU of Kanti Children Hospital (KCH). Variables recorded were patient's demography, diagnosis, co- morbidities, complications, length of PICU stay (LOS), mode and time of death. Data were tabulated into MS Excel and analyzed using SPSS version 23. Result: Out of 718 admitted children, 99 (13.78%) died with male to female ratio of 1.8:1. The maximum death (75%) was observed in less than five year of age and most of them were from outside the Kathmandu valley. The leading causes of death were pneumonia (28%), sepsis (20%) and congenital heart diseases (21%). The common complications seen were disseminated intravascular coagulation (DIC), multi- organ dysfunction syndrome (MODS), acute kidney injury (AKI) (5.1 %) and acute respiratory distress syndrome (ARDS) (6.1%) and co- morbidities were congenital heart disease (CHD) (18.2%) and global developmental delay (GDD) (9.1%). Mechanical ventilation was needed in 80.8%. Most of the cases (86%) died despite active treatment and (75%) during off hours (4pm-9am). Conclusion: Pneumonia, sepsis and CHD were the main reason of death and most of them were from outside the valley. 

Sign in / Sign up

Export Citation Format

Share Document