Online ISSN: 2515-8260

Keywords : PICU

To compare clinical profile and outcome of pediatric patients with sepsis admitted in pediatric and neonatal intensive care unit in a tertiary care hospital of central India

Jyotsna Mishra, Shashikant Patidar, Chayan Chakma, Naresh Bajaj

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 517-524

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
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.

A Hospital Based Prospective Study to Assess the Risk Factors Contributing to Increased Mortality in Children Admitted with Shock in PICU

Mamta Meena, Ramesh Chand Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10502-10506

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.