Clinico-virological Profile, Intensive Care Needs and Outcome of Infants with Acute Viral Bronchiolitis: A Prospective Observational Study

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

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Abstract 14868: Incidence and Outcomes of Cardiopulmonary Resuscitation in Pediatric Intensive Care Units

Circulation ◽

10.1161/circ.132.suppl_3.14868 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Robert Berg ◽

Amy Clark ◽

Vinay M Nadkarni ◽

Frank Moler ◽

Robert M Sutton ◽

...

Keyword(s):

Intensive Care ◽

Observational Study ◽

Hospital Discharge ◽

Administrative Data ◽

Neurological Outcome ◽

Prospective Observational Study ◽

Pediatric Intensive Care ◽

Cardiac Patients ◽

Neurologic Outcomes ◽

Favorable Neurological Outcome

Introduction: Although registry and administrative data suggest that >6000 children have in-hospital cardiac arrests each year, most occur in pediatric intensive care units (PICUs), and 39% survive to hospital discharge, prospective research quality data on the incidence and outcomes of PICU CPR are not currently available. Objectives: To determine the incidence and outcomes CPR provided in PICUs. Methods: Multi-center prospective observational study of children <18 years old randomly selected and intensively followed from PICU admission to hospital discharge in the NICHD-funded Collaborative Pediatric Critical Care Research Network from December 2011 to April 2013. Results: Among 10,078 children enrolled, 139 (1.4%) received CPR for ≥1 minute and/or defibrillation. Of these children, 78% attained return of circulation, 45% survived to hospital discharge, and 89% of survivors had favorable neurological outcomes. The relative incidence of CPR events was higher for cardiac patients compared with non-cardiac patients (3.4% versus 0.8%, p<0.001), but survival rate to hospital discharge with favorable neurological outcome was not statistically different (41% versus 39%, respectively). Shorter duration of CPR was associated with higher survival rates: 66% [29/44] survived to hospital discharge after 1-3 minutes of CPR versus 28% [9/32] after >30 minutes, p<0.001. Among survivors, 26/29 (90%) had a favorable neurological outcome after 1-3 minutes versus 8/9 (89%) after >30 minutes of CPR. Conclusions: These data establish that contemporary PICU CPR, including long durations of CPR, results in high rates of survival to hospital discharge (45%) and favorable neurologic outcomes among survivors (89%). Rates of survival with favorable neurologic outcomes were similar among cardiac and non-cardiac patients. The rigorous prospective, observational study design avoided the limitations of missing data and potential selection biases inherent in registry and administrative data.

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Outcomes of an indian intensive care unit in a tertiary hospital - a prospective observational study

Intensive Care Medicine Experimental ◽

10.1186/2197-425x-3-s1-a760 ◽

2015 ◽

Vol 3 (S1) ◽

Author(s):

S Jakkinaboina ◽

P Peddapyata ◽

S Paul ◽

R Celerappa ◽

M Aleem

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Observational Study ◽

Prospective Observational Study ◽

Tertiary Hospital

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A Prospective Observational Study of the Change in Systemic Ionised Calcium following 4% Citrate Locking of Venous Haemodialysis Catheters in Intensive Care Patients

Anaesthesia and Intensive Care ◽

10.1177/0310057x1804600406 ◽

2018 ◽

Vol 46 (4) ◽

pp. 381-385

Author(s):

S. Shewdin ◽

Y. C. Bong ◽

S. Okano ◽

M. D. Chatfield ◽

J. Walsham

Keyword(s):

Intensive Care ◽

Observational Study ◽

Prospective Observational Study ◽

Clinical Signs ◽

Dialysis Catheter ◽

Citrate Solution ◽

Arterial Blood Gas ◽

Intensive Care Patients ◽

Arterial Blood ◽

Ionised Calcium

Traditionally heparin has been the anticoagulant of choice for venous dialysis catheter locking. There is systemic leakage of heparin catheter locking solutions at the time of injection. Alternative agents, such as citrate, are increasingly being used. We are not aware of any data in the critical care literature on the effect of citrate locking of venous dialysis catheters on systemic ionised calcium (iCa2+). To assess the effect of 4% citrate locking of venous dialysis catheters on systemic iCa2+ in intensive care patients we performed a prospective observational study of 50 paired samples in 26 intensive care patients receiving 4% citrate dialysis catheter locking in an adult tertiary intensive care unit between May 2016 and December 2016. Arterial blood gas (ABG) analysis was performed prior to venous dialysis catheter locking and a baseline iCa2+ result obtained. The catheter was locked with 4% citrate solution. A further ABG was sampled between 30 and 120 seconds later and the iCa2+ results were compared. Patients were observed for clinical signs of hypocalcaemia. On average, there was little difference between the pre- and post-catheter locking iCa2+ (median pre-locking iCa2+ 1.19 mmol/l, mean change of +0.004 mmol/l, 95% confidence interval [CI] −0.004 to 0.013, P=0.34). There was no evidence this difference differed by length of catheter (P=0.26) or site of catheter (P=0.85) insertion, but there was some evidence that this differed by receipt of citrate dialysis circuit anticoagulation (P=0.013). Patients who received citrate dialysis circuit anticoagulation had an increase in catheter locking iCa2+ by 0.017 mmol/l (95% CI 0.005 to 0.028). Locking of venous dialysis catheters with 4% citrate solution has no clinically significant effect on systemic iCa2+ in intensive care patients with indwelling venous dialysis catheters.

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