scholarly journals Morbidity and Mortality Pattern of Patients Admitted into Paediatric Intensive Care Unit of Tertiary Level Hospital of Nepal

2020 ◽  
Vol 40 (1) ◽  
pp. 28-33
Author(s):  
Anil Kumar Shrestha ◽  
Susan Bhattarai ◽  
Prajwal Paudel ◽  
Prem Lal Basel
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Paediatric Intensive Care Unit ◽  
Morbidity And Mortality ◽  
Tertiary Level ◽  
Mortality Pattern ◽  
System Involvement ◽  
Level Hospital ◽  
Overall Mortality

Introduction: The paediatric intensive care unit (PICU) takes care of critically ill paediatric patients. Regular evaluation of the outcomes of patients admitted to PICU is important to assess the effectiveness of various interventions. This study aimed to find the morbidity and mortality pattern of patients admitted to PICU of tertiary level Paediatric hospital of Nepal. Methods: We conducted a retrospective, cross sectional observational study using the records of all the patients admitted to PICU of a tertiary level hospital from January 2017 to August 2017. We collected data on age, sex, geographical distribution, duration of PICU stay and the morbidity and mortality outcomes. Outcome is classified as transfer to ward, leave against medical advice (LAMA) and death. Data were analysed descriptively using SPSS version 23. Results: Out of 358 patients admitted to PICU, the mean age was 1.83 years. Majority were infants (54.5%) with male:female ratio of 1.8:1. The major causes of PICU admission were respiratory disease (27.7%) followed by CNS disease (19.6%) and infections (17.3%). The average length of stay was 6.27 days. Overall mortality was 22.7%. Conclusion: Respiratory infections were the primary cause of PICU admission and overall mortality rate was high at 22.7%. However, mortality rate was even worse for patients with multi-system involvement. We need prospective studies to examine the underlying reasons for mortality among patients with multi-system involvement. 

scholarly journals The Effects of Adjuvant Immunoglobulin M-Enriched Immunoglobulin Therapy on Mortality Rate and Renal Function in Sepsis-Induced Multiple Organ Dysfunction Syndrome: Retrospective Analysis of Intensive Care Unit Patients

2012 ◽  
Vol 40 (3) ◽  
pp. 1166-1174 ◽  
Author(s):  
L Yavuz ◽  
G Aynali ◽  
A Aynali ◽  
A Alaca ◽  
S Kutuk ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Renal Function ◽  
Intensive Care ◽  
Mortality Rate ◽  
Organ Dysfunction ◽  
Multiple Organ ◽  
Apache Ii ◽  
Control Group ◽  
Multiple Organ Dysfunction ◽  
Overall Mortality

OBJECTIVE: To determine the effect of immunoglobulin (Ig)M-enriched Ig therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome (MODS), using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. METHODS: Retrospective study of patients with sepsis-induced MODS treated with standard antibiotic plus supportive therapy (control group) or IgM-enriched Ig therapy adjuvant to control group therapy (IVIg group). Total length of stay in the intensive care unit (ICU), overall mortality rate and 28-day case fatality rate (CFR), as well as APACHE II scores and renal function parameters at day 1 and day 4 of therapy, were recorded. RESULTS: A total of 118 patients were included (control group, n = 62; IVIg group, n = 56). In both groups, day 4 APACHE II scores decreased significantly compared with day 1 scores; the effect of treatment on renal function was minimal. Length of ICU stay, overall mortality rate and 28-day CFR were significantly lower in the IVIg group compared with the control group. CONCLUSIONS: Adding IgM-enriched Ig therapy to standard therapy for MODS improved general clinical conditions and significantly reduced APACHE II scores, overall mortality rate and 28-day CFR, although effects on renal function were minimal.

scholarly journals Study of Morbidity and Mortality Pattern of Children Admitted in Paediatric Intensive Care Unit of Tertiary Care Children’s Hospital

2020 ◽  
Vol 40 (3) ◽  
pp. 232-240
Author(s):  
Prakash Joshi ◽  
Sumit Agrawal ◽  
Umesh Prasad Sah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infectious Diseases ◽  
Paediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Paediatric Intensive Care ◽  
Morbidity And Mortality ◽  
Female Ratio ◽  
Children's Hospital ◽  
Children’S Hospital

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.

scholarly journals Containment of varicella outbreak in intensive care unit of a tertiary level hospital

2021 ◽  
Vol 37 (2) ◽  
pp. 279
Author(s):  
Nidhi Bhatia ◽  
Raman Sharma ◽  
Kapil Goyal ◽  
Vikas Rana ◽  
MiniP Singh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Level ◽  
Level Hospital

scholarly journals Stress hyperglycemia: clinical profile and outcome in critically ill children

2017 ◽  
Vol 4 (6) ◽  
pp. 2175
Author(s):  
Diana Grace R. ◽  
Poovazhagi V.
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Critically Ill ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Study Group ◽  
Stress Hyperglycemia ◽  
The Common ◽  
Overall Mortality

Background: Stress hyperglycemia (SH) occurs commonly during critical illness in children with previously normal glucose homeostasis. Objective of present study was to study the clinical presentation, underlying illness and the outcome of stress hyperglycemia among critically ill children.Methods:Children attending the outpatient department and the casualty were admitted to Emergency department based on the triage guidelines. Children with blood glucose above 200 mg/dl on admission to the emergency department were considered to have hyperglycemia and were shifted to the Paediatric intensive care unit or the paediatric wards for further management. Data was collected as per the proforma. The blood sugar values were followed up in these children until restoration of normoglycemia. All the children were followed up till discharge or death in case of mortality. Associated risk factors were analysed between the survivors and nonsurvivors.Results: Among 102 children included in the study group from1 month to 12 yrs, 55 were infants, 37 in the age group of 1-5 yrs and 10 were more than 5 yrs. 60 were males and 42 were females. Family history of diabetes was encountered in 10 children. Out of 102 children, 60 recovered to hospital discharge. Sepsis, seizures, bronchopneumonia and CNS infections were the common illness among children with stress hyperglycemia. Age less than 1year, breathlessness, fever, shock, seizures and altered sensorium were identified to be significantly associated with mortality in children with stress hyperglycemia by univariate analysis in this study. Regression analysis revealed age less than one year, presence of lung infiltrates, longer duration of hyperglycemia, and need for Paediatric Intensive Care Unit (PICU) admission to be significantly associated with mortality. Non survivors had persistent hyperglycemia up to 48 hours in comparison to survivors. Overall mortality in the study group was 41%.Conclusions:Incidence of stress hyperglycemia is high in infants. Infections were the common underlying diagnosis in stress hyperglycemia. Being an infant, prolonged hyperglycemia for 48 hrs and need for PICU care were significantly associated with mortality. Overall mortality in children with stress hyperglycemia is 41%. 

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