combined with sepsis was 0.841 (P＜0.001, 95%CI 0.750-0.932), and there was no statistical significance in AU-ROC compared with pSOFA(Z =0.406, P=0.6845> 0.05). In 36 non-survival and 58 survival, non-survival group had more significant reduction of Hb and PLT, more serious damage of organ functions, and higher incidence of SF＞4500 ng/ mL. The incidence of sepsis was higher in the non-survival group (52.8%, 19/36) than in the survival group (8.6%, 5/58) (P<0.05). Multivariate analysis showed that sepsis, PLT< 50×10⁹/L and aPTT>48.5s were risk factors for adverse prognosis of HLH, and AU-ROC was 0.891 (95%CI: 0.822-0.961). CONCLUSIONS:The combination of Hb < 60g/L, elevated PCT and SF > 4500 ng/ml is helpful to judge HLH with sepsis. Combined sepsis, platelet level < 50×10⁹/L and aPTT > 48.5s were independent risk factors for predicting poor prognosis of HLH.

BACKGROUND AND AIM:The multisystem inflammatory syndrome in children (MIS-C) is a new entity and needs data to study its evolution. To describe the clinicolaboratory profile, intensive care needs, and outcome of MIS-C during the first and second waves.

BACKGROUND AND AIM:This study aimed at comparing Tetralogy of Fallot (TOF) with Atypical TOF(TOF with subarterial VSD) with respect to their demographics, preoperative, intra-operative details and post-operative course. METHOD:Hospital records of consecutive cases of TOF done was analsyzed based on a questionnaire. All the variables grouped under above category was compared under GroupA(Typical TOF) and Group B (Atypical TOF). Statistical analysis between both the group were compared using chi square test for qualitative. Statistical difference between Group A and Group B was assessed using student independent t-test, Mann whitey u t-test and student independent t-test was used. A p-value of ≤0.05 was considered statistically significant, and two-tailed tests were used for testing significance. RESULTS:A total of 106 cases of TOF were included during the study period (20 month period). Amongst the Perioperative period pre-operative SpO2 and over riding of aorta was considered significant(p<0.001). Amongst the intra-operative period the apart from Infundibular stenosis, its resection and the size of pulmonary arteries(p<0.001), the most important factors included transannular patching and ischemic time (p<0.001). The complications were similar in both the group and the length of stay was smaller in atypical TOF but there was no statistical significance. There was 1 death in the atypical TOF and 3 children had LCOS(low cardiac output syndrome in typical TOF. CONCLUSIONS:The present study did not show any major significant difference between the two groups postoperatively despite significant differences noted intraoperatively.

BACKGROUND AND AIM: Modern cancer treatments often come with life-threatening complications, among which one of the most common is infection. This study aims to evaluate the prevalence and outcomes of common infections in critically ill hemato-oncology patients, and to identify any factors associated with these infections. METHOD:This is a retrospective observational study of all children either with a haemato-oncology diagnosis or undergoing hematopoietic stem cell transplantation, who have been admitted to the Hong Kong Children's Hospital Pediatric Intensive Care Unit(PICU) over a one year period. Infection characteristics and patient outcomes were evaluated and compared across different sub-groups. Univariate and multi-variable analyses were employed to identify risk factors associated with the development of active infection. RESULTS:Out of the 124 critically ill hemato-oncology admissions in this investigation, 45(36.3%) admissions were associated with infections, including 31(25%) admissions involving bacterial infections, 26(20.9%) involving viral infections and 6(4.8%) involving fungal infections. The most common site of infection was bloodstream infection. More than half(61.3%) of the bacterial infections were of an antimicrobial resistant phenotype. After adjusting for confounding variables, post hematopoietic stem cell transplantation status (odds ratio,4.48; 95%CI, 1.75-11.45;p=0.002) and neutropenia (odds ratio,2.69;95%CI,1.12-6.47;p=0.027) were found to be significantly associated with clinically significant active infection. CONCLUSIONS:Critically ill hemato-oncological patients are more likely to develop infections in comparison with general PICU patients (Table ), and infections are significantly associated with post hematopoietic stem cell transplant and neutropenic status. Further studies are warranted to identify the underlying root causes and develop prevention strategies to mitigate the likelihood of infection in this patient population.

BACKGROUND AND AIM: Although therapeutic hypothermia in post cardiac arrest (PCA) patients is internationally debated, strong evidence demonstrates pyrexia is associated with poorer neurological outcomes 1 . Management in any PCA patient focuses upon the prevention of secondary brain injury by tight control of physiological parameters, including targeted temperature management (TTM) to avoid pyrexia 2 . Our aim was to review our adherence to TTM in patients admitted to PICU after out of hospital and in hospital cardiac arrest.METHOD: PCA patients from January 2017 to December 2020 were identified through previous data submission to PICANet© UK. Analysis through our electronic medical record was performed. Standards included targets of 100% for the application of a cooling mattress, maintenance of normothermia (core temperature 36.5-37.5ºC) and avoidance of pyrexia (defined as core temperature >38.0°C) in the first 72 hours PCA.RESULTS: 66 patients were included in the data analysis. 31 patients (47%) developed pyrexia within the first 72 hours PCA (31 patients). Pyrexia occurred across the 72 hours PCA and not only in the first 24 hours. Cooling mattresses, essential for TTM, were only used in 39 patients (59%) most commonly in response to a rising core temperature. CONCLUSIONS:Our findings are consistent with evidence that a significant proportion of PCA patients experience pyrexia episodes outside of clinical trials 3 . Most surface cooling devices have a lag between a rising temperature and cooling⁴. We therefore suggest the use of cooling devices should become a standard of care aiming for mild hypothermia 35.5-36.5ºC in order to avoid pyrexia.