Mechanical Ventilation practices in a Paediatric Intensive Care Unit located at rural tertiary care teaching hospital of Gujarat – A retrolective descriptive study
Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 3
Abstract
Objective: It is common to see many NICU across India but well equipped separate PICU is rarity especially in smaller cities and rural hospitals. Our aim is to share our experience of PICU from a rural background catering services to 1 month to 18 years patients. Material and Methods: In this retrospective study, we present data (retrieved from medical records) of 216 mechanically ventilated children from total of 1084 PICU admissions in 3 years period. Results: Mechanical Ventilation (MV) rate was 31%. Male: Female ratio was 1.8:1 with 37.04% infants. Majority (77%) were referred cases, of which 67% required immediate endotracheal intubation on arrival at our ED. Patients who were transported in ambulance with staff and facility (22.2%) showed improved outcome in terms of mortality (6.25% Vs 14.88%: Proper Vs Improper transport). Indications for MV were Respiratory-32.4%, Neurological-29.16%, Circulatory failure-14.81% and others-23.6%. Pressure SIMV and Pressure A/C were the most preferred initial modes (80%) whereas CPAP/PSV was preferred weaning mode (75.7%). Prolonged (>7days) MV required in 14%. Endotracheal intubation and MV related events were 35% including Pneumothorax in 0%, VAP in1.85%, Atelectasis in 2.78%, Postextubation stridor in 15.74%. Vasopressors, Central line insertion and RRT were offered in 73%, 12.96% and 2.3% cases respectively. Among nosocomial infections (Culture proven) BSI, VAP and CAUTI were 7%, 2% and 0.9% respectively. Overall Mean ventilator days were 3.98 (4.3 in discharged patients). Successful extubation was achieved in 107/216 (49.53%). Death rate was 12.5%. Conclusion: Our study offers comprehensive information which may assist paediatrician in the decision-making process to allow better resource allocation in rural settings.
Authors and Affiliations
Hemal Dave, Vandan H Kumar, Krutika R Tandon, Rahul K Tandon
Keywords
Related Articles
- EP ID EP335833
- DOI 10.21304/2017.0403.00190
- Views 342
- Downloads 0
Scrub Typhus : A Literature Review
Scrub typhus is a mite-borne acute febrile illness caused by Orientia tsutsugamushi. Recently a surge in pediatric cases is noted across the country. This review focuses on the pathogenesis, clinical profi le, diagnosis,...
Practical Guidelines on Fluid Therapy in Children
Fluid and electrolytes management is key to pediatric critical care. These disorders may be primary or secondary to illness, drugs, iatrogenic, or as a result of medical error. The electrolyte disturbances are seen frequ...
Effectiveness of 7% versus 3% hypertonic saline nebulization in infants with acute bronchiolitis : A randomized controlled trail
Acute bronchiolitis, the most common lower respiratory tract infection,is the leading cause of hospitalization among infants. The objective of the study is to compare the effect of 7% hypertonic saline (HS) with 3% HS am...
Predictors of Success of High Flow Nasal Cannula (HFNC) Therapy in Children with Respiratory Distress in Pediatric Intensive care Unit
Objective: To identify clinical and laboratory variables that predict success of High Flow Nasal Canula (HFNC) therapy in children presenting to Pediatric Intensive Care Unit (PICU) with respiratory distress of varied et...
Acute liver failure
Out of various etiology involved in liver pathology viral and metabolic causes are important in children. Hypoxic and ischemic liver injury are commonly seen in PICU. Hepatic failure involves multiple organs and hepatic...