scholarly journals Mean difference of Electrolyte Level measured in Arterial Blood gases and measured in Laboratory in Children presenting in Pediatric Intensive Care Unit

2021 ◽  
pp. 3-6
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
P Value ◽  
Arterial Blood Gases ◽  
K Value ◽  
Electrolyte Level ◽  
Arterial Blood

Background: Electrolytes are measured in arterial and venous blood by arterial blood gas analyzer and the auto-analyzers respectively. Objective: To determine the mean difference in electrolyte level in arterial blood gases (ABGs) level versus laboratory serum electrolyte level in the children admitted in the pediatric intensive care unit. Methodology: This cross-sectional study was conducted at department of Pediatrics, the Children’s Hospital and Institute of Child Health, Lahore from 1st December 2015 to 31st May 2016. Total of 125 children fulfilling inclusion criteria were enrolled in the study from pediatric intensive care unit. The ABGs (whole blood) electrolytes were obtained immediately after collection, using ABGs analyzer. Serum electrolytes were analyzed in the central laboratory of the institution. Reports were assessed and levels of sodium and potassium was noted from reports of ABGs and laboratory. Results: Mean NA+ value on ABGs and from laboratory was 134.66 and 132.26 (p= 0.01). Mean K+ value from on ABGs and from laboratory was 4.51 and 4.28. (p= 0.071). In age group 1-5 and 6-10 years, K+ level was high in ABGs value (p-value=0.065 & p-value=0.073). However, in age group 11-15 years K+ level was significantly higher in ABGs value as that of laboratory value (p-value=0.014). The same trend was observed in male and female children that mean NA+ and K+ value with ABGs was significantly higher as compared to that of laboratory value. Conclusion: NA+ and K+ in arterial blood gases level were different from laboratory serum electrolyte level in children admitted to pediatric intensive care unit. Clinician should be aware of differences so that potential misdiagnosis does not occur and unnecessary treatment or investigation can’t be performed.

scholarly journals Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199153
Author(s):  
Ameer Al-Hadidi ◽  
Morta Lapkus ◽  
Patrick Karabon ◽  
Begum Akay ◽  
Paras Khandhar
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Noninvasive Positive Pressure Ventilation ◽  
Pediatric Intensive Care ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Positive Pressure ◽  
P Value

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.

Comparison of Non-Invasive Oscillometric and Intra-Arterial Blood Pressure Measurements in Children Admitted to the Pediatric Intensive Care Unit

2021 ◽  
Author(s):  
Jaswinder Kaur ◽  
Siddharth Bhargava ◽  
Puneet Aulakh Pooni ◽  
Deepak Bhat ◽  
Gurdeep S. Dhooria ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Arterial Blood Pressure ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Non Invasive ◽  
Arterial Blood ◽  
The Difference

AbstractIntra-arterial blood pressure (IABP) measurement, although considered the gold standard in critically ill children, is associated with certain risks and lacks widespread availability. This study was conducted to determine the differences and agreements between oscillometric non-invasive blood pressure (NIBP) and invasive IABP measurements in children. Inclusion criteria consisted of children (from 1 month to 18 years) admitted to the pediatric intensive care unit (PICU) of a teaching hospital who required arterial catheter insertion for blood pressure (BP) monitoring. The comparison between IABP and NIBP was studied using paired t-test, Bland–Altman analysis, and Pearson's correlation coefficient. In total, 4,447 pairs of simultaneously recorded hourly NIBP and IABP measurements were collected from 65 children. Mean differences between IABP and NIBP were −3.6 ± 12.85, −4.7 ± 9.3, and −3.12 ± 9.30 mm Hg for systolic, diastolic, and mean arterial BP, respectively (p < 0.001), with wide limits of agreement. NIBP significantly overestimated BP (p < 0.001) in all three BP states (hypotensive, normotensive, and hypertensive), except systolic blood pressure (SBP) during hypertension where IABP was significantly higher. The difference in SBP was most pronounced during hypotension. The difference in SBP was significant in children <10 years (p < 0.001), with the maximum difference being in infants. It was insignificant in adolescents (p = 0.28) and underweight children (p = 0.55). NIBP recorded significantly higher BP in all states of BP except SBP in the hypertensive state. SBP measured by NIBP tended to be the most reliable in adolescents and underweight children. NIBP was the most unreliable in infants, obese children, and during hypotension.

scholarly journals Faktor Risiko Kegagalan Ventilasi non Invasif di Pediatric Intensive Care Unit (PICU) RSUD Dr. Moewardi

Sari Pediatri ◽  
2019 ◽  
Vol 21 (3) ◽  
pp. 177
Author(s):  
Leksmana Hidayatullah ◽  
Sri Martuti ◽  
Pudjiastuti Pudjiastuti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
Non Invasive ◽  
Non Invasive Ventilation

Latar belakang. Ventilasi non invasif (non invasive ventilation = NIV) dapat menjadi alternatif ventilasi selain intubasi endotrakeal, belum banyak didapatkan penelitian mengenai NIV di negara berkembang. Karakteristik awal pasien mempunyai peranan sebagai faktor risiko kegagalan NIV, tetapi masih didapatkan hasil yang beragam.Tujuan. Menganalisis faktor risiko kegagalan terapi NIV berdasarkan karakteristik awal pasien di Pediatric Intensive Care Unit Rumah Sakit Umum Daerah Dr. Moewardi.Metode. Penelitian analitik dengan desain cross sectional dengan besar sampel 25 anak, dilakukan pengambilan data melalui rekam medik dengan periode november 2016 sampai mei 2018.Hasil. Didapatkan hasil, sebanyak 10 dari 25 pasien (40%) gagal NIV, 22 pasien (88%) sebagai lini pertama sedangkan sebagai penyapihan ventilator sebanyak 3 pasien (12%). Analisis multivariat dengan menggunakan regresi logistik menunjukkan jalur nutrisi enteral (P value 0,028 ;OR 10,64 (1,29-87,56)CI 95%) dapat menjadi prediktor kegagalan penggunaan NIV.Kesimpulan. Pemberian Nutrisi secara enteral pada saat awal penggunaan NIV dapat dijadikan prediktor kegagalan.

scholarly journals Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

2020 ◽  
Vol 37 (3) ◽  
pp. 267-273
Author(s):  
Reza Borabadi ◽  
Mostafa Rad ◽  
Mohammad Rakhshani ◽  
Mojtaba Rad
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Gases ◽  
Metabolic Parameters ◽  
Arterial Blood Gases ◽  
R Software ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference

Analysis of arterial blood gases is necessary for managing the respiratory and metabolic parameters of patients in the intensive care unit. The aim of this study was to compare the effects of heparin 1000 and heparin 5000 units on arterial blood gases in patients admitted to the intensive care unit. This study was a triple-blinded clinical trial. A total of 78 patients with head injury were randomly selected from the emergency department of a hospital in an urban area of Iran in 2017. Data was collected using a questionnaire and a checklist of laboratory parameters. Data was analyzed using descriptive and inferential statistical methods via the R software. Statistically significant differences in Na, SaO2, Ca, BEecf (p < 0.001), and HCO3, BEe and K were observed between the two groups (p < 0.01). No statistically significant difference between the values of PaCO2, PH and PaO2 in the two groups were reported (p > 0.05). The results of this study confirmed that heparin 1000 and heparin 5000 units had no effects on respiratory parameters in analyzing arterial blood gases. However, the concentration of heparin had a significant effect on metabolic parameters for the analysis of arterial blood gases and electrolytes.

scholarly journals Frequency of Electrolyte Disorders and Its Effect On Mortality Among Children Admitted In Pediatric Intensive Care Unit

2021 ◽  
Vol 10 (02) ◽  
pp. 115-119
Author(s):  
Maryam Haider ◽  
Ammara Hameed ◽  
Sara Fatima ◽  
Meher Afroze ◽  
Nadeem Noor ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Serum Sodium ◽  
Laboratory Data ◽  
Pediatric Intensive Care ◽  
P Value ◽  
Electrolyte Disorders ◽  
Mortality Effect ◽  
Sodium And Potassium

Objective: To determine the frequency of electrolyte disorders, i.e., serum sodium and potassium and to evaluate its effect on mortality rate among children admitted at the pediatric intensive care unit. Study Design and Setting: This was a descriptive cross sectional study conducted at Pediatric Intensive care unit of Civil Hospital Karachi from April to December 2017 Methodology: Informed consent was obtained from 150 parents of the children who fulfill the inclusion criteria. Laboratory data (serum sodium and serum potassium) were recorded during the stay in the pediatric intensive care unit. Data was analyzed using SPSS version 20. Mean ± S.D was calculated for quantitative variables. Frequency and percentage were calculated for gender, electrolyte disorders and mortality. Effect modifiers were controlled by stratification of age, gender and electrolyte disorders (Hypernatremia, Hyponatremia, Hyperkalemia, and Hypokalemia). Post-stratification, Chi-squared test was applied. P-value = 0.05 was taken as significant. Results: Out of 150 patients, electrolyte disorders in terms of serum sodium and potassium, were found in 86(57.3%) children. Mortality in children with electrolyte disorders was found to be 46(53.5%) which was significantly higher (P<0.001) than patients without electrolyte disorders 40(46.5%). Hypernatremia was found in 48(32%), hyponatremia 24(16%), hyperkalemia 21(14%) and hypokalemia in 42(28%) patients.In comparison; of electrolyte disorders with mortality; significant association was found in hypernatremia (P<0.001), and hyperkalemia (P<0.001). Conclusion: The most common electrolyte abnormalities were hypernatremia and hypokalemia. Mortality was significantly higher in subjects with electrolyte disorders, especially hypernatremia and hyperkalemia

Hyperoxemia among Pediatric Intensive Care Unit Patients Receiving Oxygen Therapy

2021 ◽  
Author(s):  
Azadeh R. Fayazi ◽  
Matteo Sesia ◽  
Kanwaljeet J. S. Anand
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Oxygen Therapy ◽  
Oxygen Toxicity ◽  
Pediatric Intensive Care ◽  
Retrospective Chart Review ◽  
Organ Injury ◽  
Arterial Blood Gas ◽  
Arterial Blood

AbstractSupratherapeutic oxygen levels consistently cause oxygen toxicity in the lungs and other organs. The prevalence and severity of hyperoxemia among pediatric intensive care unit (PICU) patients remain unknown. This was the first study to examine the prevalence and duration of hyperoxemia in PICU patients receiving oxygen therapy. This is a retrospective chart review. This was performed in a setting of 36-bed PICU in a quaternary-care children's hospital. All the patients were children aged <18 years, admitted to the PICU for ≥24 hours, receiving oxygen therapy for ≥12 hours who had at least one arterial blood gas during this time.There was no intervention. Of 5,251 patients admitted to the PICU, 614 were included in the study. On average, these patients received oxygen therapy for 91% of their time in the PICU and remained hyperoxemic, as measured by pulse oximetry, for 65% of their time on oxygen therapy. Patients on oxygen therapy remained hyperoxemic for a median of 38 hours per patient and only 1.1% of patients did not experience any hyperoxemia. Most of the time (87.5%) patients received oxygen therapy through a fraction of inspired oxygen (FiO2)-adjustable device. Mean FiO2 on noninvasive support was 0.56 and on invasive support was 0.37. Mean partial pressure of oxygen (PaO2) on oxygen therapy was 108.7 torr and 3,037 (42.1%) of PaO2 measurements were >100 torr. Despite relatively low FiO2, PICU patients receiving oxygen therapy are commonly exposed to prolonged hyperoxemia, which may contribute to ongoing organ injury.

The addition of haloperidol, propofol, or midazolam to sufentanil for intravenous sedation in the intensive care unit using bispectral index

2018 ◽  
Vol 4 (1) ◽  
pp. 34 ◽  
Author(s):  
Baris Tukenmez, MD ◽  
Dilek Memis, MD ◽  
Zafer Pamukcu, MD
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bispectral Index ◽  
Biochemical Parameters ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Infusion Group ◽  
Arterial Blood ◽  
Midazolam Infusion ◽  
Short Period

Aim: Inadequate sedative techniques may adversely affect morbidity and mortality in the intensive care unit (ICU), and the search for the ideal sedative agent continues. Combinations of hypnotics and opiates have are commonly used for sedation. In this study, the authors aimed to assess whether or not the addition of a haloperidol, propofol, or midazolam infusion decreased the sufentanil requirements by using bispectral index (BIS).Material and Methods: The study involved 60 patients in the ICU. All patients received 0.5 μg/kg sufentanil IV bolus. Immediately after, group S received 0.25 μg/kg sufentanil infusion, group SH received sufentanil infusion + haloperidol 3 mg/h infusion, group SP received sufentanil infusion + propofol 25 μg/kg/min infusion, and group SM received sufentanil infusion + midazolam 0.04 mg/kg/h infusion, for 6 hours. Average BIS values 61-80 and Ramsay Sedation Score 2-5 were kept at a range of by decreasing or increasing sufentanil levels in all groups and hourly sufentanil consumption was determined. Hemodynamic and biochemical parameters and arterial blood gases were determined at baseline and were repeated in study hours. Results: There was no significant difference in hemodynamic and biochemical parameters and arterial blood gases among the groups. Propofol, midazolam, haloperidol infusion, when added to sufentanil infusion, decreased the consumption of sufentanil in all the measured times (p < 0.001).Conclusions: The authors aimed to determine the effects of haloperidol, propofol, or midazolam infusion when added to sufentanil infusion in a short period of time. The authors found that propofol, midazolam, and haloperidol infusion decreased the sufentanil requirements in ICU patients.

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