Background: Recently, short-term outcome among survival of children from pediatric intensive care unit (PICU) is assessed using the Functional Status Scale (FSS). New morbidity was defined as an increase in FSS score of ≥3 points from baseline to discharge from PICU. The objective of the study was to assess the incidence of newly acquired morbidity based on FSS in children on discharge from PICU. Subjects and Methods: A cross-sectional retrospective study was conducted on children (1 month–15 years) who were discharged alive from PICU from November 2021 to January 2022. The functional status was evaluated using FSS on the 1st day of admission and discharge from PICU to measure newly acquired morbidity. Results: Of a total of 200 patients, 155 patients were included in the study. The mean age was 3.79 ± 3.76 years, and 63.2% (98) were male. The mean PRISM score was 12.99 ± 5.22. The most common diagnostic categories were acute respiratory illnesses (41.3%) and infectious diseases (23.2%). The median FSS was 6.00 on admission, and the mean FSS on discharge was 7.02 ± 2.22. The incidence of morbidity was 12.2% (19/155). Young children and children with neurological diseases were highly associated with new morbidity in critically ill children on discharge from PICU. However, there was no statistical significance. The mortality rate was 11.5% during the same period. Conclusions: The incidence of new morbidity in critically ill pediatric patients at PICU discharge was 12.2%. Young age and children with neurological diseases were at high risk for new morbidity. Most of the patients (>94%) were discharged with good functional status.
{"title":"Incidence of new morbidity based on Functional Status Scale in children on discharge from pediatric intensive care unit of a developing country: A single-center observational study","authors":"A. Haque, Shoaib Bhatti, Saira Ahmed, I. Muhammad","doi":"10.4103/jpcc.jpcc_46_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_46_22","url":null,"abstract":"Background: Recently, short-term outcome among survival of children from pediatric intensive care unit (PICU) is assessed using the Functional Status Scale (FSS). New morbidity was defined as an increase in FSS score of ≥3 points from baseline to discharge from PICU. The objective of the study was to assess the incidence of newly acquired morbidity based on FSS in children on discharge from PICU. Subjects and Methods: A cross-sectional retrospective study was conducted on children (1 month–15 years) who were discharged alive from PICU from November 2021 to January 2022. The functional status was evaluated using FSS on the 1st day of admission and discharge from PICU to measure newly acquired morbidity. Results: Of a total of 200 patients, 155 patients were included in the study. The mean age was 3.79 ± 3.76 years, and 63.2% (98) were male. The mean PRISM score was 12.99 ± 5.22. The most common diagnostic categories were acute respiratory illnesses (41.3%) and infectious diseases (23.2%). The median FSS was 6.00 on admission, and the mean FSS on discharge was 7.02 ± 2.22. The incidence of morbidity was 12.2% (19/155). Young children and children with neurological diseases were highly associated with new morbidity in critically ill children on discharge from PICU. However, there was no statistical significance. The mortality rate was 11.5% during the same period. Conclusions: The incidence of new morbidity in critically ill pediatric patients at PICU discharge was 12.2%. Young age and children with neurological diseases were at high risk for new morbidity. Most of the patients (>94%) were discharged with good functional status.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44702210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diphtheria: Still a problem in pediatric intensive care units, well beyond the prediction radar of PRISM III","authors":"L. Tiwari","doi":"10.4103/jpcc.jpcc_71_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_71_22","url":null,"abstract":"","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43410841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Intravenous (IV) access exposes patients to risk of catheter-related infections. The source of infection is either microbial colonization of the cannula or contamination of the hub or drugs. The study objectives were to estimate the prevalence of the peripheral venous cannula (PVC)-related infection and the factors associated with colonization and the antibiotic sensitivity pattern of the organisms causing infection. Subjects and Methods: It was a cross-sectional study which included infants and children who required an indwelling PVC. Visual infusion phlebitis (VIP) score was recorded for insertion site changes. Cannula tip and blood were sent for culture and antibiotic sensitivity. Catheter-related bloodstream infection was diagnosed based on bacterial growth in both the cannula tip and blood culture. Results: Out of the 256 children recruited in the study, 57% were males and 13% were undernourished. The most common primary illness was respiratory disease. Cannula tip growth was noted in 8.5%. The PVC colonization rate was 37.9/1000 catheter days. Multivariate analysis showed significant association between the primary illness, multiple attempts for insertion, longer duration of IV fluid use, retention of cannula beyond 96 h, and higher VIP scores >2 and cannula colonization. Conclusions: Apart from strict adherence to infection prevention techniques, disposal of cannula after one failed attempt, changing IV cannula after 96 h, inspection of cannula site to identify phlebitis early, and removal of the cannula when the VIP score is >2 may help to minimize cannula-related colonization and infection.
{"title":"Prevalence of peripheral venous cannula-related colonization and infections in pediatric intensive care unit: A single-center observational study","authors":"Parasuraman Nithya, K. Meenakshi, S. Naaraayan","doi":"10.4103/jpcc.jpcc_25_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_25_22","url":null,"abstract":"Background: Intravenous (IV) access exposes patients to risk of catheter-related infections. The source of infection is either microbial colonization of the cannula or contamination of the hub or drugs. The study objectives were to estimate the prevalence of the peripheral venous cannula (PVC)-related infection and the factors associated with colonization and the antibiotic sensitivity pattern of the organisms causing infection. Subjects and Methods: It was a cross-sectional study which included infants and children who required an indwelling PVC. Visual infusion phlebitis (VIP) score was recorded for insertion site changes. Cannula tip and blood were sent for culture and antibiotic sensitivity. Catheter-related bloodstream infection was diagnosed based on bacterial growth in both the cannula tip and blood culture. Results: Out of the 256 children recruited in the study, 57% were males and 13% were undernourished. The most common primary illness was respiratory disease. Cannula tip growth was noted in 8.5%. The PVC colonization rate was 37.9/1000 catheter days. Multivariate analysis showed significant association between the primary illness, multiple attempts for insertion, longer duration of IV fluid use, retention of cannula beyond 96 h, and higher VIP scores >2 and cannula colonization. Conclusions: Apart from strict adherence to infection prevention techniques, disposal of cannula after one failed attempt, changing IV cannula after 96 h, inspection of cannula site to identify phlebitis early, and removal of the cannula when the VIP score is >2 may help to minimize cannula-related colonization and infection.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45869444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pankaj Agarwal, Saurabh Maheshwari, A. Tripathi, Karan Raheja, R. Goel, S. Dubey
Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the neck. The thyroglossal duct is an embryological structure which connects the base of the tongue to the thyroid gland, which when fails to obliterate results in this anomaly. The incidence of this anomaly is approximately 7%, representing about 75% of the congenital masses of the neck. This cystic lesion is usually mobile and nontender in nature and usually presents with respiratory distress in infants. A lingual TDC is the rarest form of a TDC, and differs from a classical thyroglossal cyst totally in presentation and management. We present here a rare case of 2-month infant presenting with respiratory distress due to lingual TDC extending up to the suprathyroid region.
{"title":"Rare case of lingual thyroglossal cyst presenting in infant with respiratory distress","authors":"Pankaj Agarwal, Saurabh Maheshwari, A. Tripathi, Karan Raheja, R. Goel, S. Dubey","doi":"10.4103/jpcc.jpcc_43_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_43_22","url":null,"abstract":"Thyroglossal duct cyst (TDC) is the most common congenital anomaly of the neck. The thyroglossal duct is an embryological structure which connects the base of the tongue to the thyroid gland, which when fails to obliterate results in this anomaly. The incidence of this anomaly is approximately 7%, representing about 75% of the congenital masses of the neck. This cystic lesion is usually mobile and nontender in nature and usually presents with respiratory distress in infants. A lingual TDC is the rarest form of a TDC, and differs from a classical thyroglossal cyst totally in presentation and management. We present here a rare case of 2-month infant presenting with respiratory distress due to lingual TDC extending up to the suprathyroid region.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42650195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thrombosis of the internal jugular vein (IJV) is common postoperatively and various factors are attributed to the development of thrombosis. Central venous catheters, protein C, S deficiency, and hypercoagulable state are few to mention. Although thrombosis of IJV due to malposition chest drain is a rare entity, we report the case of an 11-month-old male case of tetralogy of Fallot postintracardiac repair presented with swelling of the right side of the face and neck.
{"title":"Thrombosis of the internal jugular vein by malpositioned thoracostomy tube","authors":"Manzoor Ali, K. Alok, Joshi Ankur, T. Nikhil","doi":"10.4103/jpcc.jpcc_65_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_65_22","url":null,"abstract":"Thrombosis of the internal jugular vein (IJV) is common postoperatively and various factors are attributed to the development of thrombosis. Central venous catheters, protein C, S deficiency, and hypercoagulable state are few to mention. Although thrombosis of IJV due to malposition chest drain is a rare entity, we report the case of an 11-month-old male case of tetralogy of Fallot postintracardiac repair presented with swelling of the right side of the face and neck.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48280008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Improving complex discharge process: It's all about parental education and empowerment","authors":"Hari Gourabathini, U. Bhalala","doi":"10.4103/jpcc.jpcc_67_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_67_22","url":null,"abstract":"","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44951826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Functional assessment scales and their use in the pediatric intensive care unit","authors":"J. Hendy, M. Sundaram","doi":"10.4103/jpcc.jpcc_66_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_66_22","url":null,"abstract":"","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49173815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Tiwari, K. Krishnamurthy, Ajay Kumar, J. Chaturvedi, Jeevan Divakaran, N. Kissoon, S. Kinthala
Autoresuscitation, also referred to as Lazarus phenomenon, is a rare occurrence whereby a patient may experience restoration of spontaneous circulation and signs of life after a diagnosis of “death” following unsuccessful cardiopulmonary resuscitation. “Found alive after declared dead” has often appeared as sensational news on print, electronic, and social media, and the medical fraternity falls prey to media trials and court enquiry, but this rare phenomenon remains underreported in the medical literature. In this article, we review the reports of Lazarus phenomenon in the medical literature and discuss possible explanations to throw some light on the medicolegal and social implications of this condition.
{"title":"Found alive after declared dead: Scientific basis underlying Lazarus phenomenon","authors":"L. Tiwari, K. Krishnamurthy, Ajay Kumar, J. Chaturvedi, Jeevan Divakaran, N. Kissoon, S. Kinthala","doi":"10.4103/jpcc.jpcc_70_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_70_22","url":null,"abstract":"Autoresuscitation, also referred to as Lazarus phenomenon, is a rare occurrence whereby a patient may experience restoration of spontaneous circulation and signs of life after a diagnosis of “death” following unsuccessful cardiopulmonary resuscitation. “Found alive after declared dead” has often appeared as sensational news on print, electronic, and social media, and the medical fraternity falls prey to media trials and court enquiry, but this rare phenomenon remains underreported in the medical literature. In this article, we review the reports of Lazarus phenomenon in the medical literature and discuss possible explanations to throw some light on the medicolegal and social implications of this condition.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47110308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bubai Mandal, Satyabrata Roychowdhoury, Pinki Barui, M. Konar, S. Bhakta, M. Nandi, Mohammad Uz Zaman, M. Sarkar, M. Mahapatra
Background: After the peak of the second wave of COVID-19 pandemic, we faced a surge of respiratory syncytial virus (RSV) infection. This study was aimed to estimate the severity, clinical course, and outcome of RSV-infected children admitted in pediatric intensive care unit and to identify the predictors of development of acute respiratory distress syndrome (ARDS). Subjects and Methods: This retrospective study included children below 5 years with influenza-like illnesses (ILI) due to RSV infection. The clinical, laboratory, treatment, and outcome-related parameters were assessed and a compared between ARDS and non-ARDS group. Results: Out of 44 ILI patients, 36 had RSV infection. Most of them (88.9%) were infants. Twenty-four (66.7%) patients developed ARDS and 9 (25%) were ventilated. Infants below 6 months, low birth weight (LBW) babies, consolidations (≥3 zones), interstitial edema (≥3 zones) in lung ultrasound, high pediatric sequential organ failure assessment (pSOFA), and Pediatric Risk of Mortality III score were significantly associated with ARDS. Conclusions: RSV-infected children with young age (1–6 months), LBW, higher lung ultrasound, and pSOFA score should alert physicians for progression to ARDS.
{"title":"Outbreak of respiratory syncytial virus infection in Eastern India during COVID-19 pandemic: An observational study from a single pediatric intensive care unit","authors":"Bubai Mandal, Satyabrata Roychowdhoury, Pinki Barui, M. Konar, S. Bhakta, M. Nandi, Mohammad Uz Zaman, M. Sarkar, M. Mahapatra","doi":"10.4103/jpcc.jpcc_27_22","DOIUrl":"https://doi.org/10.4103/jpcc.jpcc_27_22","url":null,"abstract":"Background: After the peak of the second wave of COVID-19 pandemic, we faced a surge of respiratory syncytial virus (RSV) infection. This study was aimed to estimate the severity, clinical course, and outcome of RSV-infected children admitted in pediatric intensive care unit and to identify the predictors of development of acute respiratory distress syndrome (ARDS). Subjects and Methods: This retrospective study included children below 5 years with influenza-like illnesses (ILI) due to RSV infection. The clinical, laboratory, treatment, and outcome-related parameters were assessed and a compared between ARDS and non-ARDS group. Results: Out of 44 ILI patients, 36 had RSV infection. Most of them (88.9%) were infants. Twenty-four (66.7%) patients developed ARDS and 9 (25%) were ventilated. Infants below 6 months, low birth weight (LBW) babies, consolidations (≥3 zones), interstitial edema (≥3 zones) in lung ultrasound, high pediatric sequential organ failure assessment (pSOFA), and Pediatric Risk of Mortality III score were significantly associated with ARDS. Conclusions: RSV-infected children with young age (1–6 months), LBW, higher lung ultrasound, and pSOFA score should alert physicians for progression to ARDS.","PeriodicalId":34184,"journal":{"name":"Journal of Pediatric Critical Care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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