scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units. Methods A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42). Results The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children. Conclusions Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.

scholarly journals Feeding the critically ill child in intensive care units: a descriptive qualitative study in two tertiary hospitals in Ghana

2021 ◽  
Author(s):  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Teaching Hospitals ◽  
Critically Ill Children ◽  
Feeding Method ◽  
Tertiary Teaching ◽  
Critically Ill Child ◽  
Descriptive Qualitative

Abstract Background: Critically ill children require optimum feeding in the intensive care for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units.Methods: A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N=42).Results: The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children.Conclusions: Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU is recommended to reduce possible infant and child mortality resulting from feeding.

scholarly journals Association of Thrombocytopenia and Mortality in Critically ill Children Admitted to PICU in Tertiary Hospital In Biratnagar

2019 ◽  
Vol 4 (1) ◽  
pp. 649-653 ◽  
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Milan KC ◽  
Niraj Niraula
Keyword(s):  
Intensive Care ◽  
Platelet Count ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Hospital ◽  
Critically Ill Children ◽  
Bleeding Tendency ◽  
Time Of Admission

Introduction: Thrombocytopenia is a clinical condition characterized by decrease in number of platelets below the normal range. It is associated with bleeding tendency, hemodynamic instability, impaired inflammatory process and thus affecting host defence mechanism. There has been only few studies published till date in pediatric intensive care units suggesting thrombocytopenia is associated with increased mortality. Objectives: To determine the prevalence of thrombocytopenia in the critically ill children and its relationship with mortality in Pediatric intensive care unit (PICU) admitted children. Methodology: A prospective observational study was performed over a period of 12 months on 102 critically ill children admitted in PICU who fulfilled the criteria. Two patients left the study due to financial problems and as outcome could not be assessed on them, they were excluded from the study. Platelet count was noted at the time of admission and consecutively for the initial four days at PICU. Thrombocytopenia was defined as platelet count less than 150/nL. Mortality in PICU was recorded as primary outcome. Results: The prevalence of thrombocytopenia during consecutive 4 days was 34% (n=34) and at the time of admission in PICU was 16% (n=16) among 100 children analysed in the study. The mortality in the PICU was 27% (n=27). Mortality among thrombocytopenic children was 61.7% (n=21) as compared to 7.6% (n=5) in non-thrombocytopenic children (p=<0.001). Mortality was 18 times more for those who were thrombocytopenic at the time of admission as compared to those who subsequently developed thrombocytopenia during course of stay in PICU. Conclusion: Thrombocytopenia has significant association with increased mortality. Thrombocytopenic children at the time of admission have more likelihood of mortality than nonthrombocytopenic children in intensive care units.

scholarly journals 3 In-Hospital Child Mortality after Consolidation of Two Pediatric Intensive Care Units

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e1-e2
Author(s):  
Sehar Parvez ◽  
Juliet Soper
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Cause Of Death ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Canadian Province ◽  
Pediatric Intensive Care Units ◽  
Hospital Deaths ◽  
Population Rate

Abstract Background While high-volume specialized Pediatric Intensive Care Units (PICUs) increase the survival of critically ill children, the benefits of consolidating PICUs to a single site may be outweighed by the need to transport critically ill children when the area serviced has a low population density and vast geography. Objectives This study seeks to describe the impact of PICU consolidation on mortality of children from the southern part of a Canadian province, after presentation to nearest hospital, following consolidation of PICUs to a single more centrally located PICU. Design/Methods We conducted a retrospective chart review of children with a primary residence in the southern part of the province, who died between January 2008 and December 2017 after presentation to the nearest hospital. Children who died prior to presentation to hospital or did not have return of spontaneous circulation at any time after presentation were excluded from analysis. Child demographics, year of death, cause of death, and Pediatric Risk of Mortality III (PRISM III) score, and duration and type of treatments provided were abstracted from health records. Population census data was obtained from the 2016 Canada Census. Deaths were grouped for analysis according to the child’s place of residence within three specific administrative areas. Nonparametric Mann Whitney U-test was used for descriptive analysis. Results Eighty-six (86) children from the southern part of the province died following presentation to the nearest hospital during the 10-year study period. The observed population rate of in-hospital deaths was 6.8 per 100,000 children per year before consolidation and 8.5 per 100,000 children per year after consolidation of PICU services. Variation in the population rate of in-hospital deaths before and after consolidation of PICUs was observed between administrative areas (p=0.016). The data did not appear to show an association with urban or non-urban areas. Children who died after consolidation were more likely to receive pain relief (p=0.013), and palliative care consultation (p=0.005) than those who died prior to consolidation. No change in acuity at presentation to hospital or cause of death was observed following PICU consolidation (p=0.3). Conclusion This study did not find evidence of a change in the rate of in-hospital child deaths per 100,000 children following consolidation of PICU services in a Canadian province.

scholarly journals Association between off-hour admission of critically ill children to intensive care units and mortality in a Japanese registry

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takahiro Kido ◽  
Masao Iwagami ◽  
Toshikazu Abe ◽  
Yuki Enomoto ◽  
Hidetoshi Takada ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Regression Models ◽  
Critically Ill Children ◽  
Functional Score ◽  
Limited Information ◽  
Logistic Regression Models ◽  
Independent Association ◽  
Multicenter Registry

AbstractLimited information exists regarding the effect of off-hour admission among critically ill children. To evaluate whether children admitted to intensive care units (ICUs) in off-hour have worse outcomes, we conducted a cohort study in 2013–2018 in a multicenter registry in Japan. Pediatric (age < 16 years) unplanned ICU admissions were divided into regular-hour (daytime on business days) or off-hour (others). Mortality and changes in the functional score at discharge from the unit were compared between the two groups. We established multivariate logistic regression models to examine the independent association between off-hour admission and outcomes. Due to the small number of outcomes, two different models were used. There were 2512 admissions, including 757 for regular-hour and 1745 for off-hour. Mortality rates were 2.4% (18/757) and 1.9% (34/1745) in regular-hour and off-hour admissions, respectively. There was no significant association between off-hour admission and mortality both in model 1 adjusting for age, sex, and Pediatric Index of Mortality 2 (adjusted odds ratio [aOR] 0.89, 95% confidence interval [CI] 0.46–1.72) and in model 2 adjusting for propensity score predicting off-hour admission (aOR 1.05, 95% CI 0.57–1.91). In addition, off-hour admission did not show an independent association with deterioration of functional score.

scholarly journals Early physiotherapeutic interventions in Intensive Care Units

2017 ◽  
Vol 64 (1) ◽  
pp. 15-20
Author(s):  
Sanja Tomic ◽  
Jovan Matijasevic ◽  
Ilija Andrijevic ◽  
Dragana Milutinovic
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Medical Condition ◽  
Early Rehabilitation ◽  
Social Functions ◽  
Limited Mobility ◽  
Personalized Approach ◽  
Therapy Interventions ◽  
General Physical

Physical morbidity represents the deterioration of the general physical condition and it occurs as a result of illness and/or injury. When this condition is combined with acute diseases and limited mobility it is followed by a large number of complications that usually occur in patients treated in Intensive Care Units (ICU). Its treatment demands a comprehensive approach and early rehabilitation of the critically ill patients aimed at achieving the highest possible level of functionality within the boundaries of what is permitted by the illness/injury and its treatment. However, the prolonged period of immobilization of the critically ill is followed by shorter and/or longer periods of sequelae during and after treatment. The most common sequelae include physical deficits or psycho-emotional problems associated with PICS (post intensive care syndrome). General recommendations for early rehabilitation in the ICU undoubtedly point to the need of introducing physical therapy interventions as soon as possible, that is, as soon as the patient?s medical condition permits it. The primary goal of early rehabilitation of the critically ill during their stay in the ICU is to maximize the restoration of physical, psycho-emotional and social functions by implementing a personalized approach that reflects the needs of the patient.

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