HYPONATREMIA AS A PROGNOSTIC INDICATOR IN LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN ADMITTED IN PAEDIATRIC INTENSIVE CARE UNIT

Objective: To study the serum sodium levels in patients of lower respiratory tract infections admitted in the paediatric intensive care unit with their prognosis. Study Design: Prospective observational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan to Jun 2018. Methodology: Eighty patients suffering from lower respiratory tract infections who were admitted to the paediatric intensive care unit were selected at consecutive sampling. The outcome was recorded in the form of discharge or mortality. Serum sodium was done at the time of admission and then periodically after every 24-48 hours. The Association of patients’ serum sodium with their prognosis was studied using chi-square test and p-value was calculated. Results: A total of 80 patients were enrolled in our study out of which 50 (62.50%) were males and 30 (37.50%) were females. Out of the total, 48 patients suffered from hyponatremia. These 48 patients had a mean serum sodium concentration of 131.24 ± 3.31 mEq/L. The mean age of patients suffering from hyponatremia was 5.78 ± 3.4 years. Mortality occurred in 5 (80.12%) of patients suffering from severe hyponatremia. Conclusion: There was a significant association of hyponatremia with mortality in children admitted in paediatric intensive care settings with lower respiratory tract infections. Therefore, proper management hence correction of serum sodium levels can improve survival in, particularly children admitted in a pediatric intensive care setting.

Download Full-text

Hyperimmune globulins in prevention and treatment of respiratory syncytial virus infections.

Clinical Microbiology Reviews ◽

10.1128/cmr.8.1.22 ◽

1995 ◽

Vol 8 (1) ◽

pp. 22-33 ◽

Cited By ~ 62

Author(s):

V G Hemming ◽

G A Prince ◽

J R Groothuis ◽

G R Siber

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Syncytial Virus ◽

High Risk ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Syncytial Virus ◽

Tract Infections

Respiratory syncytial virus (RSV) is an important community and nosocomial respiratory pathogen for infants and young children. RSV causes especially severe disease in the prematurely born or those with chronic cardiopulmonary diseases. Elderly persons and those with T-cell deficiencies, such as bone marrow transplant recipients, are also at high risk for serious lower respiratory tract infections. To date, prevention of RSV infections by vaccination has proven elusive and no preventive drugs exist. Studies in animals and humans have shown that the lower respiratory tract can be protected from RSV infection by sufficient circulating RSV neutralizing antibody levels. Recently, an RSV hyperimmune immune globulin (RSVIG) was developed and tested for the prevention of RSV infections or reduction of disease severity. Passive immunization of high-risk children with RSVIG during the respiratory disease season effected significant reductions in RSV infections, hospitalizations, days of hospitalization, intensive care unit admissions, days in the intensive care unit, and ribavirin use. Studies in cotton rats and owl monkeys show that RSV infections can also be treated with inhalation of immune globulin at doses substantially smaller than required for parenteral treatment. Therapeutic trials of parenteral RSVIG have been completed and are pending analysis. The use of polyclonal, hyperimmune globulins and perhaps human monoclonal antibodies provides an additional approach to the prevention and perhaps the treatment of certain viral lower respiratory tract infections such as those caused by RSV.

Download Full-text

Lower Respiratory Tract Infections in the Intensive Care Unit: Consequences of Antibiotic Resistance for Choice of Antibiotic

Microbial Drug Resistance ◽

10.1089/mdr.1995.1.163 ◽

1995 ◽

Vol 1 (2) ◽

pp. 163-167 ◽

Cited By ~ 7

Author(s):

HARTMUT LODE ◽

T. SCHABERG ◽

M. RAFFENBERG ◽

H. MAUCH

Keyword(s):

Intensive Care Unit ◽

Antibiotic Resistance ◽

Intensive Care ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Tract Infections

Download Full-text

Budget impact analysis of using procalcitonin to optimize antimicrobial treatment for patients with suspected sepsis in the intensive care unit and hospitalized lower respiratory tract infections in Argentina

PLoS ONE ◽

10.1371/journal.pone.0250711 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250711

Author(s):

Osvaldo Ulises Garay ◽

Gonzalo Guiñazú ◽

Wanda Cornistein ◽

Javier Farina ◽

Ricardo Valentini ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Respiratory Tract ◽

Health System ◽

Lower Respiratory Tract ◽

Respiratory Tract Infections ◽

Budget Impact ◽

Lower Respiratory Tract Infections ◽

Suspected Sepsis ◽

Tract Infections

Background Inappropriate antibiotic use represents a major global threat. Sepsis and bacterial lower respiratory tract infections (LRTIs) have been linked to antimicrobial resistance, carrying important consequences for patients and health systems. Procalcitonin-guided algorithms may represent helpful tools to reduce antibiotic overuse but the financial burden is unclear. The aim of this study was to estimate the healthcare and budget impact in Argentina of using procalcitonin-guided algorithms to guide antibiotic prescription. Methods A decision tree was used to model health and cost outcomes for the Argentinean health system, over a one-year duration. Patients with suspected sepsis in the intensive care unit and hospitalized patients with LRTI were included. Model parameters were obtained from a focused, non-systematic, local and international bibliographic search, and validated by a panel of local experts. Deterministic and probabilistic sensitivity analyses were performed to analyze the uncertainty of parameters. Results The model predicted that using procalcitonin-guided algorithms would result in 734.5 [95% confidence interval (CI): 1,105.2;438.8] thousand fewer antibiotic treatment days, 7.9 [95% CI: 18.5;8.5] thousand antibiotic-resistant cases avoided, and 5.1 [95% CI: 6.7;4.2] thousand fewer Clostridioides difficile cases. In total, this would save $422.4 US dollars (USD) [95% CI: $935;$267] per patient per year, meaning cost savings of $83.0 [95% CI: $183.6;$57.7] million USD for the entire health system and $0.4 [95% CI: $0.9;$0.3] million USD for a healthcare provider with 1,000 cases per year of sepsis and LRTI patients. The sensitivity analysis showed that the probability of cost-saving for the sepsis patient group was lower than for the LRTI patient group (85% vs. 100%). Conclusions Healthcare and financial benefits can be obtained by implementing procalcitonin-guided algorithms in Argentina. Although we found results to be robust on an aggregate level, some caution must be used when focusing only on sepsis patients in the intensive care unit.

Download Full-text