Outcome analysis of a newly setup pediatric intensive care unit in a teaching hospital of northern India

Chakravarty, Aparna; Mohapatra, Jagannath; Garg, Richa; Kumar, Suman

doi:10.18203/2349-3291.ijcp20193742

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…In this study, the maority of pediatrics admitted were aged between 2-year and 5-years. This is inline with study conducted in India which stated that more than 36% patients were between 1 and 5 year, and about 32% were infants [14]. Similar study conducted in Nigeria showed different from our study.…”

Section: Discussionsupporting

confidence: 52%

Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study

et al. 2022

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Background Assessement of the pattern of admission and treatment outcomes of critically ill pediatrics admitted to pediatric intensive care units (PICU) in developing countries is crucial. In these countries with resource limitations, it may help to identify priorities for resource mobilization that may improve patient service quality. The PICU mortality rate varies globally, depending on the facilities of the intensive care unit, availability of experties, and admission patterns. This study assessed the admission pattern, treatment outcomes, and associated factors for children admitted to the PICU. Methods A retrospective cross-sectional study was implemented on 406 randomly selected pediatrics patients admitted to the PICU of Tikur Anbessa Specialized Hospital from 1-Oct-2018 to 30-Sept-2020. The data were collected with a pretested questionnaire. A normality curve was used to check for data the distribution. Both bivariable and multivariable analyses were used to see association of variables. A variable with a p-value of < 0.2 in the bivariable model was a candidate for multivariate analysis. The strength of association was shown by an adjusted odds ratio (AOR) with a 95% Confidence interval (CI), and a p-value of < 0.05 was considered statistically significant. Frequency, percentage,and tables were used to present the data. Results A total of 361 (89% response rate) patient charts were studied, 197 (54.6%) were male, and 164(45.4%) were female. The most common pattern for admission was a septic shock (27.14%), whereas the least common pattern was Asthma 9(2.50%). The mortality rate at the pediatric intensive care unit was 43.8%. Moreover, mechanical ventilation need (AOR = 11.2, 95%CI (4.3–28.9), P < 0.001), need for inotropic agents (AOR = 10.7, 95%CI (4.1–27.8), P < 0.001), comorbidity (AOR =8.4, 95%CI (3.5–20.5), P < 0.001), length of PICU stay from 2 to 7 days (AOR = 7.3, 95%CI (1.7–30.6), P = 0.007) and severe GCS (< 8) (AOR = 10.5, 95%CI (3.8–29.1), P < 0.001) were independent clinical outcome predictors (mortality). Conclusion The mortality rate at the PICU was 43.8%. Septic shock, and meningitis were the common cause of death and the largest death has happened in less than 7 days of admission.

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Section: Discussionsupporting

confidence: 52%

Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study

et al. 2022

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“…The main factor related to DAMA, in our study, was primarily financial and is consistent with prior studies conducted in developing countries such as India where DAMA ranges from 3 to 25.9%. 15,16 Additional factors such as domestic problems and poor prognosis further contribute to the presence of DAMA. 17,18 In our study, the most common cause of ARDS was pulmonary due to bronchopneumonia.…”

Section: Discussionmentioning

confidence: 99%

Role of Sildenafil in Management of Pediatric Acute Respiratory Distress Syndrome

Janagill

Pooni

Bhargava

et al. 2021

J Pediatr Intensive Care

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Acute respiratory distress syndrome (ARDS) has high mortality and multiple therapeutic strategies have been used to improve the outcome. Inhaled nitric oxide (INO), a pulmonary vasodilator, is used to improve oxygenation. This study was conducted to determine the role of sildenafil, an oral vasodilator, to improve oxygenation and mortality in pediatric ARDS (PARDS). The prevalence of pulmonary hypertension in PARDS was studied as well. Inclusion criteria included children (1–18 years) with ARDS requiring invasive ventilation admitted to the pediatric intensive care unit of a teaching hospital in Northern India over a 1-year period of time. Thirty-five patients met the inclusion criteria. Cardiologist performed a detailed echocardiogram to determine pulmonary arterial pressure (PAP). Patients with persistent hypoxemia were started on oral sildenafil. The majority (77%) patients had a primary pulmonary etiology of PARDS. Elevated PAP (>25 mm Hg) was detected in 54.3% patients at admission. Sildenafil was given to 20 patients who had severe and persistent hypoxemia. Oxygenation improved in most patients after the first dose with statistically significant improvement in PaO2/FiO2 ratios at both 12 and 24 hours following initiation of therapeutic dosing of sildenafil. Improvement in oxygenation occurred irrespective of initial PAP. Outcomes included a total of 57.1% patients discharged, 28.6% discharged against medical advice (DAMA), and a 14.3% mortality rate. Mortality was related to the severity of PARDS and not the use of sildenafil. This is the first study to determine the effect of sildenafil in PARDS. Sildenafil led to improvement in oxygenation in nearly all the cases without affecting mortality. Due to unavailability of INO in most centers of developing countries, sildenafil may be considered as an inexpensive alternative in cases of persistent hypoxemia in PARDS. We recommend additional randomized controlled trials to confirm the effect of sildenafil in PARDS as determined in this study.

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Impact of Nutritional Status of Children Admitted in PICU on Mortality and Morbidity

Samanta,

Das,

Mahato

et al. 2022

D Y Patil Journal of Health Sciences

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Objectives: Anthropometry is a routine and simple procedure to assess the nutritional status of a child. We aimed to study the impact nutritional status has on the mortality and morbidity of children admitted in the pediatric intensive care unit (PICU) in a tertiary care hospital in Eastern India. Materials and Methods: We performed a prospective observational study to assess the relation between anthropometric measurements of children on admission in PICU and their outcomes in terms of mortality and morbidities (total stay in PICU, duration of mechanical ventilation, requirement of inotrope, delay in enteral nutrition, and total duration of enteral feeding). Results: Sixty children were included out of which 45 were under 5 years of age and 15 were more than 5 years of age. Children under 5 years with normal weight for age, weight for height, and mid-upper arm circumference had higher chances of survival. Similarly, in children >5 years of age, those with weight for age and body mass index for age in 25th–50th percentile had higher chances of survival. All these associations were statistically significant. On further analysis, these anthropometric measurements that affected mortality also influenced morbidities significantly. Conclusion: Children with inadequate nutritional status as assessed by anthropometry had statistically significant higher mortality and morbidity in the PICU. Thus nutritional status of a child on admission is an important factor to prognosticate the outcome of a child in PICU.

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Outcome analysis of a newly setup pediatric intensive care unit in a teaching hospital of northern India

Cited by 3 publications

References 14 publications

Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study

Admission pattern, treatment outcomes, and associated factors for children admitted to pediatric intensive care unit of Tikur Anbessa specialized hospital, 2021: a retrospective cross-sectional study

Role of Sildenafil in Management of Pediatric Acute Respiratory Distress Syndrome

Impact of Nutritional Status of Children Admitted in PICU on Mortality and Morbidity

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