scholarly journals Hypophosphatemia in critically ill children

2004 ◽  
Vol 59 (5) ◽  
pp. 306-311 ◽  
Author(s):  
Fernanda Souza de Menezes ◽  
Heitor Pons Leite ◽  
Juliana Fernandez ◽  
Silvana Gomes Benzecry ◽  
Werther Brunow de Carvalho
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Critically Ill ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Pediatric Intensive Care ◽  
Cochrane Library ◽  
Critically Ill Children ◽  
Renal Diseases ◽  
Bibliographic Databases

The purpose of this paper is to review clinical studies on hypophosphatemia in pediatric intensive care unit patients with a view to verifying prevalence and risk factors associated with this disorder. We searched the computerized bibliographic databases Medline, Embase, Cochrane Library, and LILACS to identify eligible studies. Search terms included critically ill, pediatric intensive care, trauma, sepsis, infectious diseases, malnutrition, inflammatory response, surgery, starvation, respiratory failure, diuretic, steroid, antiacid therapy, mechanical ventilation. The search period covered those clinical trials published from January 1990 to January 2004. Studies concerning endocrinological disorders, genetic syndromes, rickets, renal diseases, anorexia nervosa, alcohol abuse, and prematurity were not included in this review. Out of 27 studies retrieved, only 8 involved pediatric patients, and most of these were case reports. One clinical trial and one retrospective study were identified. The prevalence of hypophosphatemia exceeded 50%. The commonly associated factors in most patients with hypophosphatemia were refeeding syndrome, malnutrition, sepsis, trauma, and diuretic and steroid therapy. Given the high prevalence, clinical manifestations, and multiple risk factors, the early identification of this disorder in critically ill children is crucial for adequate replacement therapy and also to avoid complications.

scholarly journals Use of body composition and phase angle analysis for the assessment of nutritional status and clinical outcomes in critically ill children

2021 ◽  
Author(s):  
Zi-Hong Xiong ◽  
Xue-Mei Zheng ◽  
Guo-Ying Zhang ◽  
Meng-Jun Wu ◽  
Yi Qu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Phase Angle ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Duration Time

Abstract BackgroundMalnutrition is highly prevalent in critically ill children in the pediatric intensive care unit .We aimed to investigate the efficiency of bioelectrical impedance analysis (BIA) measurements and phase angle (PhA) analysis for the assessment of nutritional risk and clinical outcomes in critically ill children.MethodsThis single-center observational study included patients admitted to the Pediatric Intensive Care Unit (PICU) of Chengdu Women’s and Children’s Central Hospital. All patients underwent anthropometric measurement in the first 24 h of admission and underwent BIA measurements within 3 days after the admission. The patients were classified into different groups based on body mass index (BMI) for age. Electronic hospital medical records were reviewed to collect clinical data for each patient. All the obtained data were analyzed by the statistics method.ResultsThere were 204 patients enrolled in our study, of which 32.4% were diagnosed with malnutrition. We found that BMI, arm muscle circumference, fat mass, and %body fat were lower in the group with poorer nutritional status (P < 0.05). Evident differences in the score of the Pediatric Risk of Mortality and the duration of mechanical ventilation (MV) among the three groups with different nutritional statuses were observed (P < 0.05). Patients in the severely malnourished group had the longest duration of MV. In the MV groups, there were significant differences (P < 0.05) in albumin level, PhA, and extracellular water/total body water (ECW/TBW ratio). The ECW/TBW ratio and the time for PICU stay had a weak degree of correlation (Pearson correlation coefficient = 0.375). PhA showed a weak degree of correlation with the duration time of medical ventilation (coefficient of correlation = 0.398).ConclusionBIA can be considered an alternative way to assess nutritional status in critically ill children. ECW/TBW ratio and PhA were correlated with PICU stay and duration time of medical ventilation, respectively.

Skin Integrity in Critically Ill and Injured Children

2007 ◽  
Vol 16 (6) ◽  
pp. 568-574 ◽  
Author(s):  
Christine A. Schindler ◽  
Theresa A. Mikhailov ◽  
Kay Fischer ◽  
Gloria Lukasiewicz ◽  
Evelyn M. Kuhn ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Ventilatory Support ◽  
Pediatric Intensive Care ◽  
Cost Of Care ◽  
Respiratory Illnesses ◽  
Skin Breakdown ◽  
Potential Risk Factors

Background Skin breakdown increases the cost of care, may lead to increased morbidity, and has negative psychosocial implications because of secondary scarring or alopecia. The scope of this problem has not been widely studied in critically ill and injured children. Objectives To determine the incidence of skin breakdown in critically ill and injured children and to compare the characteristics of patients who experience skin breakdown with those of patients who do not. Methods Admission and follow-up data for a 15-week period were collected retrospectively on children admitted to a large pediatric intensive care unit. The incidence of skin breakdown was calculated. The risk for skin breakdown associated with potential risk factors (relative risk) and 95% confidence intervals were determined. Results The sample consisted of 401 distinct stays in the intensive care unit for 373 patients. During the 401 stays, skin breakdown occurred in 34 (8.5%), redness in 25 (6.2%), and breakdown and redness in 13 (3.2%); the overall incidence was 18%. Patients who had skin breakdown or redness were younger, had longer stays, and were more likely to have respiratory illnesses and require mechanical ventilatory support than those who did not. Patients who had skin breakdown or redness had a higher risk of mortality than those who did not. Conclusions Risk factors for skin breakdown were similar to those previously reported. Compared with children of other ages, children 2 years or younger are at higher risk for skin breakdown.

scholarly journals Assessment of delirium in children admitted into the Intensive Care Unit: psCAM-ICU Tool

2020 ◽  
Vol 38 (2) ◽  
pp. 140-148
Author(s):  
Ángela María Henao Castaño ◽  
Edwar Yamith Pinzon Casas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Primary Diagnosis ◽  
Critically Ill Children ◽  
Associated Risk Factors ◽  
Prolonged Hospital

Background: Delirium has been identified as a risk factor for the mortality of critically ill patients, generating great social and economic impacts, since patients require more days of mechanical ventilation and a prolonged hospital stay in the intensive care unit (ICU), thus increasing medical costs. Objective: To describe the prevalence and characteristics of delirium episodes in a sample of 6-month to 5-year-old children who are critically ill. Methods: Cohort study at a Pediatric Intensive Care Unit (PICU) in Bogotá (Colombia). Participants were assessed by the Preschool Confusion Assessment Method for the ICU (psCAM-ICU) within the first twenty-four hours of hospitalization. Results: One quarter of the participants (25.8%) presented some type of delirium. Among them, two sub-types of delirium were observed: 62.5% of the cases were hypoactive and 37.5% hyperactive. Moreover, from them, six were male (75%) and 2 female (25%). Primary diagnosis was respiratory tract infection in 62.55% of the patients, while respiratory failure was diagnosed in the remaining 37.5%. Conclusions: The implementation of delirium monitoring tools in critically ill children provides a better understanding of the clinical manifestation of this phenomenon and associated risk factors in order to contribute to the design of efficient intervention strategies.

Bowel Frequency in Critically III Children

2004 ◽  
Vol 9 (3) ◽  
pp. 187-191
Author(s):  
Karen D. Dominguez ◽  
Matthew E. Borrego
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Prospective Observational Study ◽  
Pediatric Intensive Care ◽  
Male Gender ◽  
Stool Frequency ◽  
Critically Ill Children ◽  
Healthy Children ◽  
Stepwise Linear Regression ◽  
Bowel Movements

BACKGROUND Bowel frequency in healthy children has been determined, but it is not well documented in critically ill children. The objectives of this prospective observational study were to determine if critical illness alters stool frequency in children and to identify risk factors that may increase or decrease stool frequency. METHODS Stool frequency was assessed in children admitted to the pediatric intensive care unit (PICU) over a five month period. The median daily number of bowel movements during admission to the PICU was compared to the patient's estimated number of bowel movements prior to illness. Stepwise linear regression was performed to determine which factors best predicted stool frequency in critically ill children. RESULTS Daily stool frequency was significantly reduced (P &lt; 0.001) during PICU stay (median = 0.5; interquartile: 0, 0.8) compared to preadmission stool frequency estimates (median = 2; interquartile: 1, 2.5). Covariates associated with an increase in stool frequency included male gender and length of stay in the PICU. Conversely, the administration of opioids decreased stool frequency. CONCLUSIONS Bowel frequency was reduced by 75% in children admitted to the PICU. The use of opioids was associated with decreased bowel frequency. Male gender and increased PICU stay was associated with increased bowel frequency.

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