scholarly journals Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ashenafi Seifu ◽  
Oliyad Eshetu ◽  
Dawit Tafesse ◽  
Seyoum Hailu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Treatment Outcomes ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Common Pattern ◽  
Cross Sectional ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital

Abstract Background Assessement of the pattern of admission and treatment outcomes of critically ill pediatrics admitted to pediatric intensive care units (PICU) in developing countries is crucial. In these countries with resource limitations, it may help to identify priorities for resource mobilization that may improve patient service quality. The PICU mortality rate varies globally, depending on the facilities of the intensive care unit, availability of experties, and admission patterns. This study assessed the admission pattern, treatment outcomes, and associated factors for children admitted to the PICU. Methods A retrospective cross-sectional study was implemented on 406 randomly selected pediatrics patients admitted to the PICU of Tikur Anbessa Specialized Hospital from 1-Oct-2018 to 30-Sept-2020. The data were collected with a pretested questionnaire. A normality curve was used to check for data the distribution. Both bivariable and multivariable analyses were used to see association of variables. A variable with a p-value of < 0.2 in the bivariable model was a candidate for multivariate analysis. The strength of association was shown by an adjusted odds ratio (AOR) with a 95% Confidence interval (CI), and a p-value of < 0.05 was considered statistically significant. Frequency, percentage,and tables were used to present the data. Results A total of 361 (89% response rate) patient charts were studied, 197 (54.6%) were male, and 164(45.4%) were female. The most common pattern for admission was a septic shock (27.14%), whereas the least common pattern was Asthma 9(2.50%). The mortality rate at the pediatric intensive care unit was 43.8%. Moreover, mechanical ventilation need (AOR = 11.2, 95%CI (4.3–28.9), P < 0.001), need for inotropic agents (AOR = 10.7, 95%CI (4.1–27.8), P < 0.001), comorbidity (AOR =8.4, 95%CI (3.5–20.5), P < 0.001), length of PICU stay from 2 to 7 days (AOR = 7.3, 95%CI (1.7–30.6), P = 0.007) and severe GCS (< 8) (AOR = 10.5, 95%CI (3.8–29.1), P < 0.001) were independent clinical outcome predictors (mortality). Conclusion The mortality rate at the PICU was 43.8%. Septic shock, and meningitis were the common cause of death and the largest death has happened in less than 7 days of admission.

scholarly journals Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Severity Score ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multi Organ Dysfunction Syndrome

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Home Environment ◽  
Clinical Characteristics ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Mitigation Measures ◽  
Sectional Study ◽  
Cross Sectional

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.

Septic Shock Outcome and Factors Associated with Mortality in the Intensive Care Unit in Vietnam

2021 ◽  
Vol 104 (8) ◽  
pp. 1249-1254
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Mortality Rate ◽  
Mortality Risk ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Old Patients ◽  
Shock Outcome

Objective: To evaluate the mortality rate of septic shock patients and to learn about the associated risk factors for death. Materials and Methods: Septic shock is a life-threatening subset of sepsis with profound circulatory, cellular, and metabolic abnormalities. The authors conducted an analytical cross-sectional study on adult patients diagnosed with septic shock using Sepsis-3 criteria between May 2016 and May 2018 at an intensive care unit at a hospital in Vietnam. Data on patients’ outcomes and associated factors were collected through questionnaires and the patient medical records. To measure the association between independent variables and outcomes, odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression. Results: One hundred fifty patients with septic shock were enrolled in the present study. Septic shock occurred in 71.3% of the 60-years-old patients and 54% were men. The mean age was 68.5±15.52 years. The mortality rate was 62% and 17.3% of patients died within 24 hours after being diagnosed with septic shock. The median length of ICU stay was four days. The initial mean SOFA and APACHE II scores were significantly higher in the death group. Septic shock patients with comorbidities had a higher mortality risk compared to those without comorbidity (OR 2.9, 95% CI 1.116 to 7.700). Patients who developed septic shock in the hospital were at greater death risk (OR 7.8, 95% CI 3.3 to 18.2). Septic shock due to pneumonia had a higher mortality risk in comparison with those due to the other causes (OR 5.2, 95% CI 2.4 to 11.0). Conclusion: The mortality rate of patients with septic shock in Vietnam was considerably high. Many factors were identified as risks, such as nosocomial infection and respiratory tract diseases. Keywords: Septic shock; Outcome; Risk factors; Vietnam

scholarly journals Two Serial Hematocrit Level Just After Admission to Predict Dengue Hemorrhagic Fever Severity

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Fauziyyah Ramadhani ◽  
Mohammad Ghozali ◽  
Leni Lismayanti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Hemorrhagic Fever ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Plasma Leakage ◽  
The Difference

Dengue hemorrhagic fever (DHF) is still the leading cause of hospitalization and death among children in Indonesia because of plasma leakage leading to shock syndromes. This study aimed to associate the hematocrit difference (first and second) from serial hematocrit (Hct) examination just after admission with DHF severity. A analytical cross-sectional study was involving medical records of pediatric patients with DHF admitted at the pediatric ward and the Pediatric Intensive Care Unit (PICU) of Dr. Hasan Sadikin General Hospital, Bandung in January–December 2015. The subjects excluded if other conditions also cause plasma leakage. The difference in first and second Hct (∆Hct) from serial Hct examination just after admission and DHF grade of severity (DHF I–IV) confirmed by a positive result in serologic tests (anti-dengue IgM/IgG), or detection of dengue virus antigen (NS1Ag test) obtained. Spearman association analysis test used for analysis. A total of 16 subjects with DHF I, 21 subjects with DHF II, 31 subjects with DHF III and two subjects with DHF IV included in this study. There was no significant correlation between positive ∆Hct value (hemoconcentration) and DHF severity (r=0.247, p=0.394, CI=95%). In conclusion, the difference in first and second Hct from serial Hct examination just after admission has no significant association with the disease severity. DUA NILAI HEMATOKRIT SERIAL SESAAT SETELAH ADMISI SEBAGAI PREDIKTOR KEPARAHAN DEMAM BERDARAH DENGUEDemam berdarah dengue (DBD) merupakan penyebab utama hospitalisasi dan kematian anak di Indonesia disebabkan oleh kebocoran plasma yang berujung pada syok. Tujuan penelitian ini mengetahui hubungan perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial sesaat setelah admisi dengan keparahan DBD. Penelitian merupakan analytical cross-sectional study menggunakan data sekunder berupa rekam medis pasien anak yang dirawat di ruang perawatan anak dan Pediatric Intensive Care Unit (PICU) RSUP Dr. Hasan Sadikin Bandung pada Januari–Desember 2015. Subjek penelitian dieksklusi apabila pada rekam medis terdapat diagnosis lain yang menyebabkan kebocoran plasma. Variabel penelitian ini adalah perbedaan hematokrit pertama dan kedua (∆Hct) pada pemeriksaan hematokrit serial serta diagnosis DBD (DBD I–IV) yang dikonfirmasi oleh hasil positif pada pemeriksaan serologis (IgM/IgG antidengue) atau deteksi antigen virus (NS1Ag). Terdapat 16 subjek DBD I, 21 subjek DBD II, 31 subjek DBD III, dan 2 subjek DBD IV. Dengan menggunakan Uji Analisis Spearman, tidak terdapat korelasi yang signifikan antara nilai positif ∆Hct (hemokonsentrasi) dan tingkat keparahan DBD (r=0,247; p=0,394; CI=95%). Simpulan, perbedaan hematokrit pertama dan kedua pada pemeriksaan hematokrit serial tidak berhubungan dengan keparahan DBD.

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

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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