A PROSPECTIVE DESCRIPTIVE STUDY OF REFERRED NEONATES ADMITTED TO A TERTIARY CARE CENTER OF NORTH INDIA

2021 ◽  
pp. 219-221
Author(s):  
Divya Mishra ◽  
Arun Kumar Thakur ◽  
Rashmi Kispotta ◽  
Neeraj Neeraj
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Observational Study ◽  
Care Center ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
North India ◽  
Tertiary Care Centre ◽  
Neonatal Transport ◽  
One Year

Objectives: The Study was conducted with an objective to analyze the important contributors of neonatal mortality and outcome of referred neonates admitted to intensive care unit of a tertiary care centre. Methods: In this prospective observational study conducted over one year period included extramural neonates only. Respiratory and hemodynamic status of all neonates at admission was assessed and outcome was evaluated. Results: At admission 80 % of neonates were hypothermic, hypoxic – 37 %, prolonged capillary lling time (CFT)- 85% and hypoglycemic – 28 %. Sepsis was the most common nal diagnosis followed by birth asphyxia and neonatal jaundice. 39% of neonates had poor outcome whereas 61% had good outcome. Culture positivity was 40 % for at risk neonates for sepsis. Among these, most common organism was klebsiella pneumoniae followed by Staph aureus. Conclusion: This prospective study reveals the need of better neonatal transport facility from labor room to intensive care unit and from periphery to tertiary centers.

scholarly journals Clinical Profile of Acute Kidney Injury in Intensive care unit: a prospective observational study from a rural tertiary care centre in North India

2020 ◽  
Vol 19 (4) ◽  
pp. 685-691
Author(s):  
Shashwat Jindal ◽  
Sandeep Joshi ◽  
Ruby Sharma ◽  
Chander Mohan Adya ◽  
Nitin Gupta
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre

Introduction: Acute Kidney Injury is characterized by an acute and potentially reversible deterioration of renal function, which results in failure of the kidney to excrete nitrogenous waste products and to maintain fluid and electrolyte balance. There is marked variation in epidemiological data of Acute Kidney Injury depending upon the definitions used, population being studied and the clinical settings. Aims and Objectives: This study was designed to determine the clinical profile of adult patients with Acute Kidney Injury (AKI) admitted in the medical ICU at a rural tertiary care centre in North India. Materials and Methods: This prospective observational study was conducted on 70 patients of Acute Kidney Injury admitted in the Medical Intensive Care Unit in Department of Medicine at M. M. Institute of Medical Sciences and Research, Mullana, Ambala. AKI was diagnosed and staged for severity according to the KDIGO criteria. Results and Observations: Amongst the 70 cases of AKI, 32 cases (45.7%) were females while 38 cases (54.3%) were males. The mean age at presentation was 55.22 ± 14.91 years. Sepsis was found to be the major cause of AKI. Out of 70 patients in our study, 45 (64.2%) cases were attributed to sepsis. Mortality rate seen in this study was 40% (n=28). Conclusion: Acute Kidney Injury is a common clinical problem encountered in critically ill patients, especially in the medical ICU. Early detection and adequate management is important to reduce AKI related as well as all- cause mortality in critically ill patients. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.685-691

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit (NICU) at a Tertiary Care Centre in Eastern Nepal

2013 ◽  
Vol 33 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gauri Shankar Shah ◽  
Satish Yadav ◽  
Anil Thapa ◽  
Lokraj Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Development Goals

Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447   J. Nepal Paediatr. Soc. 2013;33(3):177-181

scholarly journals Transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India: a prospective observational study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044625
Author(s):  
Jasbir Singh ◽  
Poonam Dalal ◽  
Geeta Gathwala ◽  
Ravi Rohilla
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Predictors Of Mortality ◽  
Transport Services ◽  
Interhospital Transport

ObjectiveThe paucity of specialised care in the peripheral areas of developing countries necessitates the referral of sick neonates to higher centres. Organised interhospital transport services provided by a skilled and well-equipped team can significantly improve the outcome. The present study evaluated the transport characteristics and predictors of mortality among neonates referred to a tertiary care centre in North India.DesignProspective observational study.SettingsTertiary care teaching hospital in North India.Patients1013 neonates referred from peripheral health units.Main outcome measuresMortality among referred neonates on admission to our centre.ResultsOf the 1013 enrolled neonates, 83% were transferred through national ambulance services, 13.7% through private hospital ambulances and 3.3% through personal vehicles. Major transfer indications were prematurity (35%), requirement for ventilation (32%), birth asphyxia (28%) and hyperbilirubinaemia (19%). Hypothermia (32.5%, 330 of 1013), shock (19%, 192 of 1013) and requirement for immediate cardiorespiratory support (ICRS) (10.4%, 106 of 1013) on arrival were the major complications observed during transfer. A total of 305 (30.1%, N=1013) deaths occurred. Of these, 52% (n=160) died within 24 hours of arrival. On multivariate logistic analysis, unsupervised pregnancy (<4 antenatal visits; p=0.037), antenatal complications (p<0.001), prematurity ≤30 weeks (p=0.005), shock (p=0.001), hypothermia (p<0.001), requirement for ICRS on arrival (p<0.001), birth asphyxia (p=0.004), travel time >2 hours (p=0.005) and absence of trained staff during transfer (p<0.001) were found to be significant predictors of mortality.ConclusionThe present study depicts high mortality among infants referred to our centre. Adequate training of peripheral health personnel and availability of pre-referral stabilisation and dedicated interhospital transport teams for sick neonate transfers may prove valuable interventions for improved outcomes.

scholarly journals Pattern of morbidity and mortality among neonates admitted to neonatal intensive care unit in tertiary care centre, western Nepal

2021 ◽  
Vol 14 (1) ◽  
pp. 24-28
Author(s):  
Namrata K.C. ◽  
Bandana Shrestha ◽  
Arjun Bhattarai ◽  
Shankar Paudel ◽  
Nabraj Subedi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Study Data ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity

Background: The objective of this study was to determine the disease pattern and outcome of diseases in neonatal intensive care unit (NICU) as the common causes of mortality and morbidity in our region are preventable. Methods: The retrospective study was carried out in 1041 newborns admitted from 1st August 2019 to 30th July 2020 in Gandaki Medical College Teaching Hospital in Western Nepal. Age, sex, gestational age, diagnosis at admission, outcome of admitted newborns were the main variables under study. Data was entered and analyzed using SPSS 20 version. Result: Among 1041 newborns, 599 (57.54%) were male and 442(42.46%) were female. 1028(98.75%) were born in hospital while 8(0.77%) were born at home and 5(0.48%) in ambulance. The majority 610 newborns were admitted during the first 24 hours of life. Infection and hyperbilirubinemia were the main reasons for admission (44.96% and 23.15 % respectively), followed by prematurity (9.51%) and Birth Asphyxia (9.13%). A total of 831patients (79.83%) were improved and discharged, 79(7.59%) were discharged on request, 61(7.59%) left against medical advice, 34 (3.26) were referred and 36 (3.46%) expired. The major causes for neonatal mortality were prematurity (44.45%), Sepsis (27.78%), and Birth Asphyxia (13.89%) respectively. Among the expired neonates, 24(66.67%) were outborns and 12(33.33%) were inborns and majority 27(75%) expired at the age between 24-48 hours of life. Conclusions: Infection was the leading cause of morbidity and prematurity the leading cause of mortality in the neonatal care unit. This is preventable with antenatal care, training of manpower and procurement of necessary equipments.

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