European Journal of Molecular & Clinical Medicine

Background: This study was carried out with the objectives to study the clinical profile and to find the outcome of children admitted to paediatrics intensive care unit (PICU) of IMS & SUM Hospital, BBSR.
Methods: A retrospective study was carried in children aged more than 28 days to 14 years admitted in PICU from January 2020 to June 2021 (18 months).
Results: Total 199 patients were admitted. Out of them 136 (68.3%) were males, whereas 63 (31.7%) were females. 88(44%). The mean length of stay was 4.2±4.6 days (range 1- 29 days, median 3 days). 47 patients were intubated and mechanically ventilated during this period. The mean day of mechanical ventilation was 4.1±4.6 days. Of the 15 patients died 7 patients (47%) had malignancies. Other causes of death included 2 septic shock (13.3%), 2(13.3%) ARDS. The mean duration of the PICU stay of the patients who died was 4.2±3.6 days (range 1-11 days).
Conclusions: The mortality rate at the PICU was 7.5%. Malignancies, septic shock, ARDS were the common cause of death and the maximum deaths has happened in less than 2 days of admission.

The objective of this study is to look for various and common electrolyte imbalances in critically ill children admitted to Paediatric Intensive Care Unit(PICU) and to study the outcome among those cases. Methods: This was a prospective observational study done on 84 critically ill children  in the age group of 1 month to 12 years admitted in PICU of a tertiary care hospital. Under aseptic conditions venous samples were obtained for estimating serum levels of sodium, potassium, chloride, magnesium and phosphorus. The commonly occurring electrolyte imbalance was observed and the outcome is compared by morbidity, cure and mortality. Results: Electrolyte abnormalities were observed in 84 children(100%). Most common electrolyte abnormality observed was hypocalcemia in 70.2% cases (n=59). Morbidity was seen in 35.7% cases (n=30) and mortality associated with dyselectrolytemia was seen in 25.1% cases(n=21). Conclusion: This study showed increased incidence of dyselectrolytemia in critically ill children admitted to PICU. But the signs and symptoms are often difficult to recognize an electrolyte imbalance as the imbalances may be primary or secondary to underlying systemic illness. Early recognition and prompt management of electrolyte imbalances can lead to decrease in morbidity and mortality
Dyselectrolytemia, Critically ill, PICU, Mortality, Morbidity 

Background: The study is done to have a better understanding of the morbidity profile and outcome in a Paediatric Intensive Care Unit (PICU) of a rural-based tertiary care centre which can enable the caretakers to plan and plant possible interventions to enhance patient care. The study was carried out in a retrospective manner.
Methods: This retrospective study was carried out in the department of paediatrics in children aged 1 month to 12 years, who were admitted to the PICU during the period of 1st September 2021 to 31st August 2022. A total of 925 children were admitted and data were collected from PICU records using predesigned proforma and analysed accordingly.
Results A total of 925 children were admitted during the study period. The 61.62% of children were male and the rest 38.38% were female. The male to female ratio was 1.6:1. The infants excluding neonates constituted 59.89% of total admission.  The mean age of presentation was 2.63 ± 3.41 years. 67.46% of children were admitted with infections of different organ systems and the rest 32.54% with diseases of non-infectious aetiology. So far outcome is concerned, 13.62%, 56.10%, 3.24%, 3.78%, and 23.24% of children were discharged, transferred to the paediatric ward, referred out to elsewhere, left against medical advice (LAMA) and death respectively. Infants excluding neonates constituted 69.30% of total death and the most common aetiology of death being documented was infections (84.19%).
Conclusion: In our study, most of the admitted children were found to have died of infective causes and most of them were infants. This puts a much necessary focus on the control of infections among infants by various means and should be addressed promptly and meticulously.

Background: Sepsis and septic shock cases in the Neonatal intensive care unit (NICU)
and Pediatric intensive care unit (PICU) remain one of the most significant causes of
morbidity and mortality in pediatric patients. Therefore, studying and comparing the
clinical features and outcomes of pediatric patients with sepsis in ICUs are important,
especially in developing countries.
Methods: From 1st July 2021 to 31st December 2021, we have collected data from both of
our pediatric ICU and neonatal ICU of Shyam Shah Medical College using a preformed
proforma. Complete blood count, C - reactive protein and culture sensitivity reports
were used to diagnose or screen sepsis. We compared clinical features, laboratory data,
microbiologic results, and final outcome for patients with sepsis in both NICU and
PICU.
Results: A total 1509 and 236 cases with sepsis from both NICU and PICU respectively
are included in the study (mean duration of stay in NICU 8.9 days±4.3; in PICU 12.5
days±5.3). Among these cases, culture positive cases with sepsis were 66% and 28% in
NICU and PICU respectively. Common pathogens isolated from blood cultures were E.
coli and pseudomonas in NICU and E.coli and S. aureus in PICU. Mortality, discharges,
refers and Left against medical advice cases were compared as outcomes in our study.
Comparing with NICU (n=24, 10.1%), mortality due to sepsis in PICU (n=111, 7.3%)
was less.
Conclusion: Sepsis in children both in NICU and PICU is associated with high mortality
despite aggressive treatment strategies, but more in NICU. Early recognition and
prompt treatment is the key to improve outcome of sepsis.

Background: Shock is one of the most dramatic, dynamic and life-threatening problems
faced by the physician in critical care setting.The mortality rate of shock in pediatric
patients has declined as a consequence of educational efforts (pediatric advance life
support), which emphasize early recognition and intervention and rapid transfer of
critically ill patients to a PICU via a transport service. To know about the risk factors in
a critically ill child with shock and its association with outcome, will give us an early
clue in identifying and prioritizing management strategies.
Material & Methods: A descriptive study done on 100 children in the age group of one
month to 12 years presenting with shock (or) who later develop shock during PICU stay
at RUHS College of Medical Sciences, Jaipur, Rajasthan, India during one year period.
Children who had received inpatient treatment prior to admission in PICU, post
cardiac arrest shock and traumatic shock / Burns were excluded in our study. During
the PICU stay periodic vital signs and other measures like urine output and oxygen
saturation were recorded. IV fluid therapy, rate and duration of inotrope and other
organ support like ventilatory support were documented.
Results: In present study the frequency of shock was found to be 1.64%.Undernutrition,
decompensated shock, cardiogenic shock, duration of shock more than 6 hours,
leucopenia, hypocalcemia, inotrope requirement, ventilator support & MODS was
present in higher proportion of children who died(36.11%, 69.44%, 27.77%, 72.22%,
22.22%, 38.88%, 94.44%, 97.23% & 69.45 respectively) when compared to those who
had survived (20.32%, 14.06%, 9.37%, 26.56%, 4.68%, 10.93%, 57.82%, 47.25% &
15.62% respectively). Oddsof different variables were measure among the children who
died, when compared tothose who had survived (2.17, 13.78, 3.56, 7.45, 5.89, 5.11, 13.87,
104.2 & 12.78 respectively.
Conclusion: We concluded that under nutrition, decompensated shock, inotrope
requirement, MODS, leucopenia and ventilatory support are independently associated
with poor outcome.