scholarly journals Critically ill children in paediatric intensive care unit are no less susceptible to infectious diseases amid the COVID-19 pandemic

2021 ◽  
Author(s):  
Karen KY Leung ◽  
KL Hon ◽  
Patrick Ip ◽  
Renee WY Chan
2021 ◽  
pp. 35-37
Author(s):  
Madhan Kumar ◽  
Jolly Chandran ◽  
Pragathesh Pragathesh ◽  
Ebor Jacob Gnananayagam ◽  
Hema Paul ◽  
...  

OBJECTIVE: To determine the effect of chlorhexidine wipes in reducing the incidence of hospital acquired infections (HAIs) among critically ill children admitted in Paediatric Intensive Care Unit (PICU). METHODS: An interventional study, wherein enrolled children were wiped with chlorhexidine after routine bath. The incidence of HAIs were noted and compared with data from historical controls of previous year during the same period (pre-intervention). RESULTS: One hundred and ninety nine children in the intervention period were compared with 271 children from pre-intervention period. The numbers of ventilator-days were 777 and 696 respectively for the intervention period and pre-intervention periods. Incidence of ventilator associated pneumonia (VAP) reduced from 12.9/1000 ventilator-days in the pre-intervention period to 6.4/1000 ventilator-days in the intervention period (p=0.1). VAP prevalence was 3.3% in the pre-intervention period as compared to 2.5% in the intervention period (p=0.6). The incidence of CLABSI was 3.6/1000 catheter-days (catheter days: 1377) with prevalence of 2.5% in the intervention period, whereas among the historic controls of the previous year it was 4.2/1000 days (catheter days 1432) with a prevalence of 2.2% (p= 0.8). No untoward effect was reported. CONCLUSION: The use of chlorhexidine wipes in ICU was feasible but did not signicantly decrease HAIs.


Author(s):  
Jakanattane V. ◽  
Mathivanan M.

Background: Acute Kidney Injury (AKI) refers to a reversible accumulation of urea, creatinine and nitrogenous waste products and disturbances in maintenance of fluid and electrolyte homeostasis. The incidence of AKI continues to increase in the Paediatric age group particularly in critically ill children with the etiology shifting from primary renal disorders to multifactorial cause. The objective of the study to determine the incidence, clinical profile and outcome of AKI in critically ill children using p-RIFLE criteria.Methods: A prospective observational study was done with 342 children aged between 1-12 years, admitted in Paediatric Intensive Care Unit (PICU) of Institute of Child Health and Research Centre, Madurai Medical College, Madurai during July 2015 to June 2016.Results: The overall incidence of AKI among critically ill children was 30.1%. The mortality rate was 43.7% and 20.7% patients with AKI had partial renal recovery at the time of discharge. 27.2% patients required renal replacement therapy (RRT). Infectious causes 57.3% (Sepsis, Meningoencephalitis, Bronchopneumonia) dominated the etiological profile.Conclusions: Incidence of AKI is high in critically-ill children. AKI continues to be associated with adverse outcomes, including high mortality and partial renal recovery.


2019 ◽  
Vol 6 (5) ◽  
pp. 2064
Author(s):  
Vijay L. Bhavari ◽  
Deepali A. Ambike ◽  
Neil D. Pawar

Background: The care of the critically ill children remains one of the most demanding and challenging aspects in the field of paediatrics. The main purpose of Paediatric Intensive care unit is to prevent mortality by intensively monitoring and treating critically ill children who are considered at high risk of mortality. In the developing countries, there is a scarce data on paediatric critical care. Evaluation of the outcome of medical interventions can assess the efficacy of treatment. This helps in better decision making, improving the quality of care and modifying the future of management if required. This study will also help to study the causes of morbidity and mortality among paediatric age group in our hospital. Aims and Objectives of the study is to evaluate the morbidity pattern and outcome of admissions in the PICU of a rural teaching hospital, and to take measures to prevent morbidity and mortality by improving critical care facilities.Methods: This was a retrospective study, the cases admitted in paediatric ICU in our teaching hospital in last two and a half considering the estimated sample size. Data will be collected from PICU and Medical record Department. Details will be studied with the help of medical record and will be analysed and interpreted according to the medical record details.Results: During a period of 30 months of the study, total of 417 patients were admitted in our PICU. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum – maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females. The most common diagnosis was LRTI which was observed in 61(14.7%) of cases. The most common system involved was respiratory system which was observed in 101(21.8%) cases. Of total cases studied, 357(85.6%) were discharged, 36(8.6%) had DAMA (discharge against medical advice) and 24(5.8%) expired.Conclusions: Mortality was low in our PICU. We conclude based on the present study that in our rural set up PICU, with better treatment protocols, skilled expertise/ Paediatric Intensivist we have chances to facilitate the care of critically ill patients giving desirable outcome.


2020 ◽  
Author(s):  
Wanelia Afonso ◽  
Wilza Peres ◽  
Nivaldo Pinho ◽  
Renata Martucci ◽  
Daúbia Saraiva ◽  
...  

Abstract Background and Aim: Delays in both the prescription of, as well as interruptions in the administration of ENT, have been widely investigated. The most common reasons for damage in the nutritional impairment in children in a PICU are the presence of gastrointestinal disorders, together with medical and nursing procedures. This study aims to describe enteral nutrition practices in children with cancer and to evaluate the factors related to clinical outcomes, hospitalisation time (HT) and mechanical ventilation time (MVT), in a Paediatric Intensive Care Unit (PICU) of an Oncological Treatment Centre in Rio de Janeiro, Brazil.Method: It is a retrospective longitudinal study, with children that were admitted into the PICU during 2013. Those children who had been diagnosed with a malignancy, aged 1 to 18 years, HT > 72 h, as well as with the use of enteral nutrition therapy (ENT) during their hospitalisation in the PICU, were included in the study. The controlled variables were severity, age, caloric deficiencies, cumulative proteins, gastrointestinal symptoms and the early initiation of ENT. The odds ratios between the exposure factors were estimated with a confidence interval (CI) of 95% and a significance level of p < 0.05. Results: The study selected 54 patients; the median age was 8.02 (2.35–12.79) years. The cumulative deficiencies of calories and proteins were 21.5 (14.0–29.6) kcal / kg / day and 0.60 (0.33–0.97) g / kg / day, respectively. Diarrhoea and younger age and the cumulative caloric deficiencies were HT predictors. Abdominal distention and younger age were associated with a higher MVT. Conclusions: Changes in the gastrointestinal tract, with evaluation of the cumulative caloric deficiencies in critically ill children with cancer, should be monitored more continuously, as well as with the impact of these variables on the HT and MVT outcomes.


2020 ◽  
Vol 40 (3) ◽  
pp. 232-240
Author(s):  
Prakash Joshi ◽  
Sumit Agrawal ◽  
Umesh Prasad Sah

Introduction: Intensive care is predominantly concerned with the management of patients with acute life threatening conditions in a specialised unit. The objective of this study was to describe the morbidity and mortality patterns as well as outcome of patients admitted in the Paediatric Intensive Care Unit (PICU) of a tertiary care government paediatric hospital in Nepal. Methods: A cross-sectional study of 652 children admitted to the PICU of Kanti Children’s Hospital was undertaken from 1st January 2018 to 31st December 2018. The data were retrieved retrospectively from the record files of PICU regarding patient’s age, sex, inhabitant, admitting and final diagnosis, length of stay in the ICU and final outcome. Data were entered into MS Excel and analysed using Pearson’s Chi Square Test. Results: Among 652 admitted children between 1 month to 14 years of age, 397 (61%) were males and 255 (39%) females with male to female ratio 1.55:1. Majority 352 (54%) of them were in the age group of one month to 12 months of age. Pneumonia (216, 33.1%) was the major disease seen followed by septicemia (123, 18.9%), bronchiolitis (44, 6.7%), Other infectious diseases (38, 5.8%) and so on. Out of total admission, 484 (74.23%) cases improved, 46 (7.05%) left against medical advice (LAMA) and 120 cases died with mortality rate of 18.46%. More than half of the deaths (n = 87/120, 72.5%) were due to infections (Septicemia, acute gastroenteritis, pneumonia and meningitis and other infectious diseases). Conclusions: Pneumonia with respiratory distress was the major cause of PICU admission while fatality was highest for acute leukemia. Therefore it seems justifiable to improve primary and secondary health care facilities for timely and reliable delivery of current standardised therapeutic practice as well as to increase ICU facilities in those areas.


2021 ◽  
Vol 8 (32) ◽  
pp. 2928-2932
Author(s):  
Surender Kagithapu ◽  
Padmini Soujanya Balla ◽  
Aparna Varma Bhongir ◽  
Pratap Gudi ◽  
Sri Harsha K ◽  
...  

BACKGROUND Face is the index of mind. All human beings tend to express various emotions through different facial expressions. Parents of children who are critically ill, experience both positive and negative emotions simultaneously as they may feel love, affection and sometimes sad, angry, and helpless. METHODS We observed facial expressions of mothers of children and recorded vital data of these children in our Paediatric Intensive Care Unit (PICU). 107 children were observed, and vitals recorded simultaneously by two different observers from time of admission to 72 hours at fixed time intervals, using Hamilton’s scoring system. RESULTS 107 critically ill children were observed. Glasgow Coma Scale (GCS), AVPU scale, peripheral temperature, capillary filling time (CFT), seizures at admission, were corelated with facial expressions of the mother at the time of admission, at 12 hours, at 24 hours, at 48 hours and at 72 hours. We found that facial expressions of the mothers changed from fearful/sad to happy as the vital data of the child improved with time interval. CONCLUSIONS At ‘0’ hour of admission, irrespective of the categorization of the GCS score, AVPU scores, peripheral temperature, and capillary filling time, 78 mothers were fearful, and 29 mothers were sad, amounting to a total of 107. None were happy, irrespective of the child’s clinical condition, as, the child being admitted, is in itself a stressful condition. There was a good increase in number of happy mothers in co-relation with child’s improvement. Hence by observing the mother’s face, we can definitely predict the clinical condition of the child and expressions on the mother’s face is a reflection of the clinical condition of the child. KEYWORDS Cues, Mother’s Face, Critically Ill Children


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