scholarly journals Iatrogenic illness in the paediatric intensive care unit at Gharian teaching hospital, Libya

2012 ◽  
Vol 18 (2) ◽  
pp. 143-150 ◽  
Author(s):  
A.M. Ismail ◽  
S.A. Shedeed
Author(s):  
Sindhu S. ◽  
Syed Mohsin Ahmed

Background: Antibiotic resistance is rising to alarming levels that necessitates the evaluation of prescription patterns for the rational use of antibiotics. Hence this study was conducted to evaluate antibiotic use in a government run general hospital.Methods: A prospective observational study was conducted to evaluate the rationality of antimicrobial prescription in a paediatric intensive care unit (PICU) of a government run tertiary care teaching hospital using the USAID indicators for rational use of antibiotics. Case records of 104 patients were documented and analysed.Results: The most common antimicrobials prescribed were 3rd generation Cephalosporins namely Ceftriaxone, followed by Aminoglycosides (Amikacin), Imipenams (Meropenam), Anti-Influenza Antiviral (Oseltamivir) and Oxazolidinones (Linezolid). A common trend of antibiotic overuse emerged due to paucity of resources to support decision making and choice of antibiotic. This led to patients being exposed to a high number of antibiotics with an associated increase in morbidity.Conclusions: Antibiotic resistance would remain a challenge until systems for rapid, precise and low cost detection of the causative micro-organisms and antibiotic sensitivity are developed, surveillance systems are increased and antibiotic stewardship programs are enforced.


2018 ◽  
Vol 37 (2) ◽  
pp. 168-173
Author(s):  
Vijaydeep Siddharth ◽  
Shakti Kumar Gupta ◽  
Rakesh Lodha ◽  
Sidhartha Satpathy

Introduction: This research aimed to study the outcome of patient care being rendered in Paediatric Intensive Care Unit (PICU) of an apex public sector teaching hospital of North India.Material and methods: A descriptive and observational study was carried out in PICU. Medical records of all admitted patients from January to June 2011 were analysed. Demographic, morbidity and mortality parameters were studied. PIM II score was calculated to assess the severity of illness.Results: In PICU, from January to June 2011, 110 patients were admitted. Almost equal number of patients got admitted in PICU through emergency ward/casualty and other inpatient areas. Of the total patients, 66% (62) were male. Mean age of the patients admitted to PICU was 4.56 years. Three fourth patients admitted in PICU required mechanical ventilation and 652 days of mechanical ventilation was given. Patient’s required mechanical ventilation on an average of 7.01 days. Almost one third, [36.61% (21)] patients were reintubated. Majority (78.7%) of the patients required oxygen support, while 72.3% (68) required vasopressor support. Prevalence of bed sore rate was 2.1%. Only 2.1% patients required readmission within 72 hours. Mean hospital and PICU length of stay was 16.82 and 8.7 days respectively. Mean PIM 2 score of patients was 14.13% (range 0.2% to 86.9%).Conclusion: 43.6% of patients died in PICU, while hospital mortality in PICU admitted patients was 47.2%. Sepsis with septic shock was the major cause of mortality followed by pulmonary haemorrhage, disseminated intravascular coagulation. Standardised mortality was calculated to be 3.09.


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.


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