Critically Ill Children
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2021 ◽  
Vol 8 (10) ◽  
pp. 1684
Naresh Kumar N. ◽  
Suresh Chelliah D. ◽  
Senguttuvan D.

Background: The objective of the study was to assess prognostic accuracy of SOFA (sequential organ failure assessment score) and Q-SOFA (quick-sequential organ failure assessment) score in detecting morbidity and mortality in critically ill children admitted in our intensive care unit.Methods: All critically ill children admitted were recruited over a time period of 7 months. Q-SOFA score was assessed at presentation, followed by SOFA score on day 1 and day 2 of ICU stay and outcome was observed.Results: Total of 272 sick children were recruited and assessed. All eight (2.94%) mortalities had high Q-SOFA score of three (p<0.001), mean SOFA (day 1) score 11.12±0.99 (p<0.001), mean SOFA (day 2) was 11.62±1.40 (p<0.001).Conclusions: Q-SOFA is a simple, inexpensive and rapid test to assess and predict sick children requiring ICU care in emergency department. High SOFA score predicts high probability of mortality and detects organ failure early.

2021 ◽  
Vol 66 (10) ◽  
pp. 1549-1559
Aline B Maddux ◽  
Peter M Mourani ◽  
Russell Banks ◽  
Ron W Reeder ◽  
Murray M Pollack ◽  

2021 ◽  
Vol 9 ◽  
Vijay Kumar ◽  
Suresh Kumar Angurana ◽  
Arun Kumar Baranwal ◽  
Karthi Nallasamy

Background: The data on long-term nasotracheal intubation among mechanically ventilated critically ill children is limited. The purpose of this study was to compare the rate of post-extubation airway obstruction (PEAO) with nasotracheal and orotracheal intubation.Methods: This open-label randomized controlled trial was conducted in PICU of a tertiary care and teaching hospital in North India from January-December 2020 involving intubated children aged 3 months−12 years. After written informed consent, children were randomized into nasotracheal and orotracheal intubation groups. Post-extubation, modified Westley's croup score (mWCS) was used at 10-timepoints (0-min, 30 min, 1, 2, 3, 6, 12, 24, 36, and 48-h after extubation) to monitor for PEAO. The primary outcome was the rate of PEAO; and secondary outcomes were time taken for intubation, number of intubation attempts, complications during intubation, unplanned extubation, repeated intubations, tube malposition/displacement, endotracheal tube blockade, ventilator associated pneumonia, skin trauma, extubation failure/re-intubation, duration of PICU stay, and mortality.Results: Seventy children were randomized into nasotracheal (n = 30) and orotracheal (n = 40) groups. Both the groups were similar in baseline characteristics. The rate of PEAO was similar between nasotracheal and orotracheal groups (10 vs. 20%, p = 0.14). The maximum mWCS and mWCS at 10-timepoints were similar in two groups. The time taken for intubation was significantly longer (85 vs. 48 s, p &lt; 0.001) in nasotracheal group, whereas other secondary outcomes were similar in two groups.Conclusion: The rate of PEAO was not different between nasotracheal and orotracheal groups.Clinical Trial Registration:, Identifier: CTRI/2020/01/022988.

Devin Murphy ◽  
Etan Orgel ◽  
Wouter Koek ◽  
Melissa Frei-Jones ◽  
Christopher Denton ◽  

AbstractRed cell distribution width (RDW) is an average of the variation in red blood cell (RBC) sizes reported on a complete blood count. An elevated RDW indicates a pathological process that is affecting erythropoiesis. Studies showed that as the severity of disease process increases, the RDW often increases as well. Particularly in resource-limited countries, RDW has been studied as an outcome predictor for conditions in a variety of disciplines and is offered as an adjunct monitoring tool that is cost effective, readily available, and indicative of pathological processes amenable to intervention. Particularly in pediatric critical care settings, RDW has been shown to be a reliable tool for surveillance of disease states such as sepsis. Despite the increased attention of RDW as a marker for disease outcome, collective evaluation on the utility of RDW as a marker for outcome in pediatric critical care settings is lacking. We offer a systematic review and meta-analysis of published studies to assess the ability of RDW to predict illness severity and mortality among pediatric critical care patients. Among eight studies of over 4,800 patients, we found over a two-fold increase in odds for mortality in critically ill children whose RDW was above 15.7%. This is the first systematic review of RDW being used to predict mortality in critically ill children and findings of this study may prompt early intervention in the pediatric critical care setting.

Aline Junqueira Rubio ◽  
Luiza Lobo de Souza ◽  
Roberto J. N. Nogueira ◽  
Marcelo B. Brandão ◽  
Tiago H. de Souza

2021 ◽  
Vol 21 (1) ◽  
Alhassan Sibdow Abukari ◽  
Angela Kwartemaa Acheampong

Abstract Background Critically ill children require optimum feeding in the intensive care units for speedy recovery. Several factors determine their feeding and the feeding method to adopt to address this phenomenon. The aim of this study was to explore and describe the feeding criteria of critically ill children at the neonatal and paediatric intensive care units. Methods A descriptive qualitative design was used to conduct the study. Six focus group discussions were conducted, and each group had five members. In addition, twelve one-on-one interviews were conducted in two public tertiary teaching hospitals in Ghana and analyzed by content analysis using MAXQDA Plus version 2020 qualitative software. Participants were selected purposively (N = 42). Results The decision to feed a critically ill child in the ICU was largely determined by the child’s medical condition as well as the experts’ knowledge and skills to feed. It emerged from the data that cup feeding, enteral, parenteral, and breastfeeding were the feeding processes employed by the clinicians to feed the critically ill children. Conclusions Regular in-service training of clinicians on feeding critically ill children, provision of logistics and specialized personnel in the ICU are recommended to reduce possible infant and child mortality resulting from suboptimal feeding.

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