scholarly journals Demographic variation of electrolyte imbalance in a tertiary care pediatric intensive care unit

2020 ◽  
Vol 7 (2) ◽  
pp. 224
Author(s):  
Mrutyunjay Routray ◽  
Kishore S. V. ◽  
Jyotiranjan Champatiray ◽  
Saroj Kumar Satpathy
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
The Body ◽  
Electrolyte Imbalance ◽  
Indian Society ◽  
Close Monitoring ◽  
Electrolyte Abnormalities

Background: Electrolyte imbalances are common in critically ill paediatric patients. When present, they can significantly affect the outcome. Critical care provision through Paediatric Intensive Care Units (PICU) is aimed at maintaining ‘homeostasis’ in the body which is vital for the organ’s support and optimal function. This involves fluids and electrolytes balance.Methods: This prospective observational study was conducted in the PICU, SCB MC and Hospital, Cuttack during November 2015 to October 2017. includes Children admitted to PICU (Based on consensus guidelines for PICUs in India, Indian Society of Critical Care Medicine (Pediatric Section) and Indian Academy of Pediatrics (Intensive Care Chapter).Results: Percentage of male children was 65.9%, with male to female ratio 1.9:1, showing male dominance. Most electrolyte imbalances were seen in age group of 1 to 5 years (67.06%). Abnormal serum electrolyte was seen in 37.91% in our study. SIADH was observed in 43.5% of euvolemic hyponatremic patients. SIADH was observed in 27.8% of hyponatremic patients. Respiratory disorder was the most common attributing factor for SIADH followed by CNS disorder.Conclusions: The present study showed high incidence of electrolyte abnormalities in patients admitted to pediatric intensive care unit. Though at times symptoms of electrolyte disorder is indistinguishable from symptoms of primary pathology, so a close monitoring and correction of electrolyte abnormalities is necessary for better outcome. SIADH is recognizable and common cause of electrolyte imbalance in PICU. Thus, this study recommends early routine monitoring of serum electrolytes in all patients admitted to PICU.

scholarly journals STUDY OF MORTALITY IN CHILDREN WITH ELECTROLYTE ABNORMALITIES IN PEDIATRIC INTENSIVE CARE UNIT

2020 ◽  
pp. 37-39
Author(s):  
Mirnalini Rajput ◽  
B.C Yelamali
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Renal Involvement ◽  
Pediatric Intensive Care ◽  
Primary System ◽  
Close Monitoring ◽  
Care Hospital ◽  
Electrolyte Abnormality ◽  
Electrolyte Abnormalities

Background: Electrolyte abnormalities are common in ill children requiring the intensive care. As the electrolytes play an important role to maintain homeostasis and has impact on the final outcome of the patient, the present study was undertaken. The aims of this study was to determine the prevalence of electrolyte abnormalities in children admitted in Pediatric Intensive Care Unit at the time of admission, primary organ involvement seen and the mortality associated with it. Methods: The study enrolled all the patients from 1 month to 12 years admitted in PICU of a tertiary care hospital during January 2019 to June 2020 (18 months). The children were divided according to the presence or absence of electrolyte abnormality. The organ system involved was analyzed in each group. Results: The prevalence of electrolyte abnormality in terms of sodium and potassium in the present study was 55.56% (100 of 180). The most common electrolyte abnormality was hyponatremia (30.6%) followed by hypokalemia (20.6%). The mortality in children with electrolyte abnormality was significantly higher than mortality in those without electrolyte abnormality and was found to be 51.7% in the present study. Maximum children with hyponatremia had infections (23.6%) and those with hypernatremia had gastrointestinal involvement (17.6%). Hypokalemia was most frequently seen in cases of respiratory involvement (27%) and hyperkalemia seen in renal involvement (25%). Conclusion: There is significant association of the electrolyte abnormalities at admission in PICU with mortality and primary system involvement, which was seen in the present study. Close monitoring and correction of electrolyte abnormalities reduces the mortality in ill children.

Parent Advocacy Group for Events of Resuscitation

2016 ◽  
Vol 36 (3) ◽  
pp. 58-64 ◽  
Author(s):  
Tracy Ann Pasek ◽  
Jodi Licata
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Advocacy Group ◽  
Family Presence ◽  
Nurse Caring ◽  
Belief Scale ◽  
Intensive Care Unit Nurses

BACKGROUNDThe presence of patients’ families during resuscitation has been an important practice issue. An American Association of Critical-Care Nurses (AACN) practice alert “Family Presence During Resuscitation and Invasive Procedures” supports family members of patients undergoing resuscitation being given the option of bedside presence. Parent Advocacy Group for Events of Resuscitation (PAGER) is an interdisciplinary collaborative in the pediatric intensive care unit.OBJECTIVESTo ensure that patients’ families are provided the option of being with their child during cardiopulmonary resuscitation.METHODSResuscitation data were collected for 12 months by using the AACN practice alert audit tool. The Family Nurse Caring Belief Scale was administered to 150 pediatric intensive care unit nurses. PAGER nurses received crisis education.RESULTSPediatric intensive care unit nurses were supportive of providing the option of family presence during resuscitation. Family Nurse Caring Belief Scale data revealed areas for improvement in family caring practices. PAGER was implemented with positive outcomes for 2 families.CONCLUSIONSPAGER has improved the care of families whose children experience cardiopulmonary resuscitation and should be implemented in pediatric critical care units. PAGER nurses are prepared to serve as role models in providing family-sensitive care during crisis.

scholarly journals Incidence and predictors of mortality among children admitted to the pediatric intensive care unit at the University of Gondar comprehensive specialized hospital, northwest Ethiopia: A prospective observational cohort study

2020 ◽  
Author(s):  
Nahom Worku Teshager ◽  
Ashenafi Tazebew Amare ◽  
koku Tamirat
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Pediatric Critical Care ◽  
Predictors Of Mortality

Abstract Background Pediatric intensive care unit (PICU) tremendously improves the success of saving patients having potentially life-threatening illness. An accurate estimate of lives saved through pediatric critical care intervention is important to evaluate the quality of the health care system. Data on pediatric critical care in developing countries remain scarce yet is much needed to improve clinical practices and outcomes. This study aimed to determine the incidence and predictors of mortality in the pediatric intensive care unit in the study setting.Method An institution based prospective cohort study was conducted from February 2018 to July 2019. We collected data by interview, chart and registration book review. Life table was used to estimate the cumulative survival of patients and Log rank test was used to compare survival curves between different categories of the explanatory variables. Survival trend over the follow up time was described using the Kaplan Meier graph. Bivariate and multivariate Cox proportional hazard model were used to identify predictors.Result Based on the 10 th version of international classifications of disease (ICD) of WHO, neurologic disorders (22.7%) infectious disease (18.8%) and environmental hazards (11.8%) account for the top three diagnoses. The median observation time was 3 days with IQR of 1 to 6 days. Of the total of 313 participants, 102 (32.6%) died during the follow-up time. This gives the incidence of mortality of 6.9 deaths per 100 person day observation. Caregivers’ occupation of government-employed (AHR=0.35, 95%CI: 0.14, 0.89), weekend admission (AHR=1.63, 95%CI: 1.02, 2.62), critical illness (AHR=1.79, 95%CI: 1.13, 2.85) Mechanical ventilation AHR=2.36,95%CI: 1.39, 4.01)and PIM2 score (AHR=1.53, 95%CI: 1.36, 1.72) were predictors of mortality in the pediatric ICU.Conclusion Neurologic disorder was the leading causes of admission followed by infectious diseases, and environmental hazards. Rate of mortality was high and admission over weekends, caregivers' occupation, mechanical ventilation, critical illness diagnosis, and higher PIM2 scores were found to be significant and independent predictors of mortality at the PICU. This suggests that ICU medical equipment, diagnostics, and interventions should be available up to the standard. Intensivist and full staffing around the clock has to be available in the PICU.

Guidelines and Levels of Care for Pediatric Intensive Care Units

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 166-175 ◽  
Author(s):  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
American Academy ◽  
Pediatric Intensive Care Unit ◽  
Hospital Care ◽  
Pediatric Intensive Care ◽  
Critical Care Medicine ◽  
Pediatric Critical Care ◽  
American Academy Of Pediatrics

Pediatric critical care medicine has matured dramatically during the past two decades. Knowledge of the pathophysiology of life-threatening processes and the technologic capacity to monitor and treat pediatric patients suffering from them have advanced rapidly during this period. Along with the scientific and technical advances has been the evolution of the pediatric intensive care unt (PICU), where the special needs of critically ill or injured children can be met by pediatric specialists. In 1985, the American Board of Pediatrics recognized the new subspecialty of Pediatric Critical Care Medicine and established criteria for subspecialty certification. The American Boards of Medicine, Surgery, and Anesthesiology gave similar recognition to the subspecialty. In 1990, the Residency Review Committee of the Accreditation Council for Graduate Medical Education completed its first accreditation of Pediatric Critical Care Medicine Training Programs. In view of these developments, the Pediatric Section of the Society of Critical Care Medicine and the American Academy of Pediatrics Section on Critical Care Medicine and Committee on Hospital Care believe that existing published1 guidelines should now be revised for the pediatric intensive care unit. This policy represents the consensus of the three above-mentioned groups who believe the recommendations that follow are current, necessary, and attainable in 1993. The guidelines are not intended as a statement of the ideal or ultimate requirements for PICUs. We expect standards for PICUs to rise as critical care medicine continues to develop and appropriately trained providers become more readily available. In view of these developments, the Pediatric Section of the Society of Critical Care Medicine and the American Academy of Pediatrics Section on Critical Care Medicine and Committee on Hospital Care believe that existing published1 guidelines should now be revised for the pediatric intensive care unit.

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