scholarly journals Pattern of Neonatal Admissions and Outcome in an Intensive Care Unit (ICU) of a Tertiary Care Paediatric Hospital in Bangladesh – A One-Year Analysis

2014 ◽  
Vol 31 (3) ◽  
pp. 134-139
Author(s):  
MS Hoque ◽  
S Alam ◽  
ASMNU Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bacterial Infections ◽  
Oesophageal Atresia ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Fatality ◽  
Paediatric Hospital ◽  
Number Of Patients ◽  
Surgical Conditions

Objective: To describe the characteristics of neonates admitted to intensive care unit (ICU) and their outcome in a tertiary care paediatric hospital in Bangladesh. Study Design: Retrospective, descriptive study. Setting and Duration of Study: Paediatric intensive care unit in Dhaka Shishu Hospital from January to December 2011. Methods: Data was retrieved from file records of all admitted neonates regarding age, gender, gestational age, birth and admission weight, reason for admission and outcome. Results: During this study period, the total number of patients admitted was 191; most of them were neonates (146, 76.4%). Among the 146 neonates, the highest number comprised of birth asphyxia (55, 37.7%), followed by serious bacterial infections (sepsis, pneumonia, meningitis) (30, 20.5%) preterm low birth weight (LBW) babies (28, 19.2%), surgical conditions (congenital diaphragmatic hernia, oesophageal atresia with trachea-oesophageal fistula, Hirschsprung disease and anorectal malformations) (18, 12.3%), respiratory distress syndrome (RDS) (9, 6.2%), and congenital heart disease (6, 4.1%). Out of 146 patients, 42 expired (28.8%). Most of the expiries were due to sepsis (35.7%); followed by prematurity (21.4%), perinatal asphyxia (19.0%) and surgical conditions (14.3%). Conclusion: Birth asphyxia, septicaemia, and prematurity were the main reasons for neonatal admissions in ICU, while case fatality was highest for septicaemia. Regular antenatal visits, safe delivery practice and timely referral to tertiary care hospitals may result in decreased burden in ICU and also better outcome. DOI: http://dx.doi.org/10.3329/jbcps.v31i3.20979 J Bangladesh Coll Phys Surg 2013; 31: 134-139

scholarly journals Clinical Profile and Outcome of Neonates Admitted to Neonatal Intensive Care Unit (NICU) at a Tertiary Care Centre in Eastern Nepal

2013 ◽  
Vol 33 (3) ◽  
pp. 177-181 ◽  
Author(s):  
Gauri Shankar Shah ◽  
Satish Yadav ◽  
Anil Thapa ◽  
Lokraj Shah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity ◽  
Development Goals

Introduction: Neonatal period is the most susceptible period of life due to different causes, which in most cases are preventable. Every year millions of neonates are born and a large proportion of them are admitted to the neonatal intensive care unit (NICU) for various indications. One of the Millennium Development Goals is to reduce under five mortality by two thirds by 2015. Therefore, this study was conducted to identify the clinical profile, pattern of diseases and common causes of mortality and morbidity in neonates admitted to NICU. Materials and Methods: A retrospective study was conducted at level III Neonatal NICU of a tertiary -care teaching hospital from January, 2012 to December, 2012. Results: Total of 361 neonates were admitted in NICU. Eighty six neonates (23.8%) were admitted due to prematurity and 73 (20.2%) with birth asphyxia. Among birth asphyxia, 40(54.8%)were in HIE III, 27.4% and 17.8% in HIE II and HIE I, respectively. One hundred eighteen (32.6%) cases were diagnosed as sepsis. The overall mortality was 20.2% during hospital stay. Conclusions: Sepsis, prematurity and birth asphyxia were major causes for admission in NICU. All these etiologies are preventable up to some extent and, if detected earlier, can be effectively treated in order to reduce morbidity and mortality. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8447   J. Nepal Paediatr. Soc. 2013;33(3):177-181

scholarly journals An audit of hepatobiliary diseases in a tertiary level intensive care unit in Nepal

2017 ◽  
Vol 4 (1) ◽  
pp. 42-45
Author(s):  
Pramesh Sunder Shrestha ◽  
Subhash Prasad Acharya ◽  
Gentle Sunder Shrestha ◽  
Diptesh Aryal ◽  
Rejin Kumar Udaya ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Significant Proportion ◽  
Care Facility ◽  
Hepatobiliary Disease ◽  
Number Of Patients ◽  
Hepatobiliary Diseases ◽  
Surgical Conditions

Background: Hepatobiliary diseases account for significant proportion of admission in our intensive care unit, a semi-closed, 11 bedded mixed medical-surgical unit. This study was conducted to study the profile of patients with various hepatobiliary diseases who required intensive care unit admissions with the aim of identifying the need for a hepatobiliary critical care facility. Methods: A retrospective study was designed and all consecutive patients admitted with hepatobiliary problems from January 2013 till December 2013 were enrolled in the study.Results: Out of 467 patients admitted, there were 61 (13.06%) patients with hepatobiliary diseases. Out of 61 patients, there were 24 (39.3%) patients with medical cause for hepatobiliary disease and 37 (60.7%) patients with a surgical cause. The majority of the patients 52.45% were male. The overall mortality in these patients was 37.70%. The mortality in patients with surgical cause for the hepatobiliary disease was less (27.02%). Encephalopathy was a common condition leading to ICU admission. The common medical conditions were Cirrhosis secondary to Alcoholic Liver disease and Acute Fulminant Hepatic Failure. The commonest surgical conditions were Severe Pancreatitis, Post-Whipple's surgery, postoperative sepsis after Cholecystectomy, Liver Injury secondary to Road Traffic Accidents and Severe Cholangitis. Conclusion: The number of patients presenting to our multidisciplinary unit with hepatobiliary diseases is high and this group of patients have a high mortality. Though the numbers do not suggest an immediate need for a Hepatobiliary intensive care unit, the increasing trend suggests such a facility would be the need of time in near future.

A PROSPECTIVE DESCRIPTIVE STUDY OF REFERRED NEONATES ADMITTED TO A TERTIARY CARE CENTER OF NORTH INDIA

2021 ◽  
pp. 219-221
Author(s):  
Divya Mishra ◽  
Arun Kumar Thakur ◽  
Rashmi Kispotta ◽  
Neeraj Neeraj
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Observational Study ◽  
Care Center ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
North India ◽  
Tertiary Care Centre ◽  
Neonatal Transport ◽  
One Year

Objectives: The Study was conducted with an objective to analyze the important contributors of neonatal mortality and outcome of referred neonates admitted to intensive care unit of a tertiary care centre. Methods: In this prospective observational study conducted over one year period included extramural neonates only. Respiratory and hemodynamic status of all neonates at admission was assessed and outcome was evaluated. Results: At admission 80 % of neonates were hypothermic, hypoxic – 37 %, prolonged capillary lling time (CFT)- 85% and hypoglycemic – 28 %. Sepsis was the most common nal diagnosis followed by birth asphyxia and neonatal jaundice. 39% of neonates had poor outcome whereas 61% had good outcome. Culture positivity was 40 % for at risk neonates for sepsis. Among these, most common organism was klebsiella pneumoniae followed by Staph aureus. Conclusion: This prospective study reveals the need of better neonatal transport facility from labor room to intensive care unit and from periphery to tertiary centers.

scholarly journals Patterns of Neonatal Admission and Outcome in Neonatal Intensive Care Unit of a Tertiary Care Hospital

2019 ◽  
Vol 13 (2) ◽  
pp. 49-53
Author(s):  
Jesmin Sultana ◽  
Nure Ishrat Nazme ◽  
Nurun Nahar Fatema Begum
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Military Hospital ◽  
Care Hospital ◽  
Female Ratio

Introduction: Analyzing the neonatal admission pattern helps the policymakers to make better strategies for healthcare provider to deliver better service. Objective: To demonstrate the admission pattern and outcome of patients in the Neonatal Intensive Care Unit (NICU) in a tertiary care hospital of Bangladesh. Materials and Methods: This retrospective descriptive study was conducted on all neonates admitted to the NICU of Combined Military Hospital (CMH), Dhaka from January to December 2015. Data were collected from file records of the patients regarding age, gender, mode of delivery, working diagnosis, length of stay in NICU and immediate outcome. Results: A total of 502 neonates were admitted during the study period. Majority of the patients (77.3%) were admitted on the 1st day of life. There were 279(55.6%) males with a male to female ratio 1.2:1. The major cause of admission was prematurity (23.1%) and other leading causes were birth asphyxia (BA)14.9%, infant of a diabetic mother (IDM) 13.5%, neonatal sepsis 12.5%. Most of the neonates (82.7%) were delivered by caesarean section. About 84.1% were discharged after improvement, 65(12.94%) died and 15(3%) were referred to other specialties for further management. Within the first 24 hours of admission, 9.4% deaths occurred and two common causes of neonatal death were preterm (49.18%) and birth asphyxia (23%). Conclusion: Good outcome of a neonate depends on adequate management, monitoring and good nursing care in an intensive care unit. By paying good attention to perinatal services and improving the facilities in the unit, morbidity and mortality in neonates can be reduced. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 49-53

scholarly journals Pattern of morbidity and mortality among neonates admitted to neonatal intensive care unit in tertiary care centre, western Nepal

2021 ◽  
Vol 14 (1) ◽  
pp. 24-28
Author(s):  
Namrata K.C. ◽  
Bandana Shrestha ◽  
Arjun Bhattarai ◽  
Shankar Paudel ◽  
Nabraj Subedi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
College Teaching ◽  
Study Data ◽  
Tertiary Care Centre ◽  
Mortality And Morbidity

Background: The objective of this study was to determine the disease pattern and outcome of diseases in neonatal intensive care unit (NICU) as the common causes of mortality and morbidity in our region are preventable. Methods: The retrospective study was carried out in 1041 newborns admitted from 1st August 2019 to 30th July 2020 in Gandaki Medical College Teaching Hospital in Western Nepal. Age, sex, gestational age, diagnosis at admission, outcome of admitted newborns were the main variables under study. Data was entered and analyzed using SPSS 20 version. Result: Among 1041 newborns, 599 (57.54%) were male and 442(42.46%) were female. 1028(98.75%) were born in hospital while 8(0.77%) were born at home and 5(0.48%) in ambulance. The majority 610 newborns were admitted during the first 24 hours of life. Infection and hyperbilirubinemia were the main reasons for admission (44.96% and 23.15 % respectively), followed by prematurity (9.51%) and Birth Asphyxia (9.13%). A total of 831patients (79.83%) were improved and discharged, 79(7.59%) were discharged on request, 61(7.59%) left against medical advice, 34 (3.26) were referred and 36 (3.46%) expired. The major causes for neonatal mortality were prematurity (44.45%), Sepsis (27.78%), and Birth Asphyxia (13.89%) respectively. Among the expired neonates, 24(66.67%) were outborns and 12(33.33%) were inborns and majority 27(75%) expired at the age between 24-48 hours of life. Conclusions: Infection was the leading cause of morbidity and prematurity the leading cause of mortality in the neonatal care unit. This is preventable with antenatal care, training of manpower and procurement of necessary equipments.

scholarly journals Pattern of Admission and Outcome in a Neonatal Intensive Care Unit (NICU) of a Tertiary Care Hospital in Dhaka, Bangladesh

2019 ◽  
Vol 10 (2) ◽  
pp. 150-158
Author(s):  
Gule Tajkia ◽  
Syed Khairul Amin ◽  
M Ekhlasur Rahman ◽  
Mumtahina Setu ◽  
Kuntal Roy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
Medical College ◽  
Disease Pattern

Background: The neonatal period is a highly vulnerable time for an infant completing many of the  physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity  and mortality. To reduce morbidity and mortality it is essential to know the neonatal disease pattern.  Neonatal disease pattern changes from time to time and place. Analyzing the neonatal admission pattern  helps the policy makers to make the better strategies and health care givers to serve better. Objectives: This study aimed to determine the disease patterns and outcome of patients admitted to the  Neonatal Intensive Care Unit (NICU) of Anwer khan Modern Medical College Hospital, a tertiary care  hospital in Dhaka, between January 2017 to December 2018. Methods: Retrospective data from the medical records of all neonates admitted during the study period  were reviewed and analyzed for age, weight, sex, reason for admission, duration of hospital stay,  diagnosis and final outcome. Results: The total number of neonates admitted during the study period was 262; 164 were male (62.6%), and  98 were female (37.4%). A total of 223 patients (85.12%) wereborn in the hospital while 39 (12.88%) were  born at home. The majority were admitted during the first 48 hours of life (72.2%). A total of 5 patients (2%)  weighed <1000 gm; 53(20.2%) weighed 1000-1500 gm, and 89 (34%) between 1600-2499 gm. Prematurity  and infection were the main reasons for admission (52.7% and 20%, respectively), followed by birth asphyxia  (12%) and neonatal jaundice (6.8%). A total of 206 patients (78.6%) were improved and discharged, 43 left  against medical advice (16.4%), 3 were referred for urgent cardiac intervention (1.1%) and 10 (3.9%) died. Conclusion: Prematurity, neonatal infection and birth asphyxia were the major causes of neonatal  morbidity and mortality. Anwer Khan Modern Medical College Journal Vol. 10, No. 2: July 2019, P 150-158

scholarly journals Quality of Care in a Paediatric Intensive Care Unit of a Tertiary Care Teaching Hospital in New Delhi

2018 ◽  
Vol 37 (2) ◽  
pp. 168-173
Author(s):  
Vijaydeep Siddharth ◽  
Shakti Kumar Gupta ◽  
Rakesh Lodha ◽  
Sidhartha Satpathy
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Paediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pulmonary Haemorrhage ◽  
Paediatric Intensive Care ◽  
New Delhi ◽  
Number Of Patients

Introduction: This research aimed to study the outcome of patient care being rendered in Paediatric Intensive Care Unit (PICU) of an apex public sector teaching hospital of North India.Material and methods: A descriptive and observational study was carried out in PICU. Medical records of all admitted patients from January to June 2011 were analysed. Demographic, morbidity and mortality parameters were studied. PIM II score was calculated to assess the severity of illness.Results: In PICU, from January to June 2011, 110 patients were admitted. Almost equal number of patients got admitted in PICU through emergency ward/casualty and other inpatient areas. Of the total patients, 66% (62) were male. Mean age of the patients admitted to PICU was 4.56 years. Three fourth patients admitted in PICU required mechanical ventilation and 652 days of mechanical ventilation was given. Patient’s required mechanical ventilation on an average of 7.01 days. Almost one third, [36.61% (21)] patients were reintubated. Majority (78.7%) of the patients required oxygen support, while 72.3% (68) required vasopressor support. Prevalence of bed sore rate was 2.1%. Only 2.1% patients required readmission within 72 hours. Mean hospital and PICU length of stay was 16.82 and 8.7 days respectively. Mean PIM 2 score of patients was 14.13% (range 0.2% to 86.9%).Conclusion: 43.6% of patients died in PICU, while hospital mortality in PICU admitted patients was 47.2%. Sepsis with septic shock was the major cause of mortality followed by pulmonary haemorrhage, disseminated intravascular coagulation. Standardised mortality was calculated to be 3.09.

An Outbreak ofAcinetobacter baumannii:The Importance of Cross-Transmission

2000 ◽  
Vol 21 (9) ◽  
pp. 588-591 ◽  
Author(s):  
Erika M.C. D'Agata ◽  
Valerie Thayer ◽  
William Schaffner
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infections ◽  
Attack Rate ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Number Of Patients ◽  
Cross Transmission

AbstractObjective:To investigate an outbreak of nosocomial infections due to multidrug-resistant (MDR)Acinetobacter baumanniiand to analyze the contribution of cross-transmission in the rise in infection rates.Design:Epidemiological investigation; molecular typing using pulsed-field gel electrophoresis (PFGE); matched case-control study to identify risk factors for infection.Setting:A 34-bed surgical intensive care unit at a tertiary-care hospital.Patients:Eighteen patients who developed MDRA baumanniinosocomial infection were matched to 36 patients who were admitted to the same surgical intensive care unit (SICU) room and did not develop an infection during the outbreak period.Results:Prior to the outbreak, the baseline attack rate of MDRA baumanniinosocomial infections was 3 per 100 patients per month. From February 1 through March 22, 1998, the attack rate rose to 16 per 100 patients per month, with a total of 18 infections. All isolates had indistinguishable PFGE patterns. Seventy environmental cultures were negative for MDRA baumannii. Following intense infection control education, the attack rate decreased to 4 per 100 patients per month. By conditional logistic regression, cases were exposed to a significantly higher number of patients with MDRA baumanniiinfections compared to controls (odds ratio, 1.1; 95% confidence interval, 1.01-1.2;P=.02), even after adjusting for length of SICU admission and exposure to antibiotics and invasive devices.Conclusion:Cross-transmission between patients contributed to the rise in rates of MDRA baumanniiinfections. A common environmental source was not detected.

scholarly journals Correlation of PeradeniyaOrganophosphorus Poisoning Scale (POP) and outcome of Organophosphorus poisoning

2020 ◽  
Vol 5 (1) ◽  
pp. 986-989
Author(s):  
Gunjan Regmi ◽  
Batsalya Arjyal ◽  
Kanak Khanal ◽  
Kumud Pyakurel ◽  
Rejina Shahi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Assessment Tool ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Intensive Care Admission ◽  
Icu Stay ◽  
Number Of Patients ◽  
Organophosphorus Poisoning

Introduction: Organophosphorus poisoning is one of the common causesfor the intensive care admission in the developing countries.This study was conducted to assess the correlation between Peradeniya Organophosphorus Poisoning (POP) scale and the outcomes in poisoningin a tertiary care hospital in Eastern Nepal. Objective: To assess the severity and outcome of OP compound poisoning with the correlation of POP score. Methodology: This was a prospective observational study conducted over 6 months in the intensive care unit at tertiary care hospital in the eastern part of Nepal. The study includedall OP poisoning patients presenting in the emergency department and finally admitted to intensive care unit who fulfilled the inclusion criteria.Correlation was made between POP scores and outcomes in terms of intensive care unit(ICU) stay, need of ventilation and mortality was assessed. Result: Fifty patients with OP poisoning wereincluded in the study. Suicide attempt was the most common reason for poisoning. The incidence of poisoning was more common among males(72%)and significant majority were aged younger than 35 years (84%). On admission, the number of patients in mild, moderate and severepoisoning group were 52%, 30% and 18% respectively. Rates for ICU stay, respiratory failure requiring ventilator and mortality was significantly (p<0.001) higher in severe POP scale. Conclusion: The POP scale is a useful clinical assessment tool to assess and categorize patients with OP poisoning according to severity and in predicting their clinical outcomes.

Predictors of Severity of Scrub Typhus in Children Requiring Pediatric Intensive Care Admission

2021 ◽  
Author(s):  
Arpita Khemka ◽  
Mihir Sarkar ◽  
Ankika Basu ◽  
Partha Pratim Dey ◽  
Satyabrata Roy Chowdhoury ◽  
...  
Keyword(s):  
Intensive Care ◽  
Urine Output ◽  
Scrub Typhus ◽  
Tertiary Care ◽  
Case Fatality ◽  
Pediatric Intensive Care ◽  
Age Group ◽  
Intensive Care Admission ◽  
Altered Sensorium ◽  
Number Of Patients

AbstractObjective of our study was to determine the clinical characteristics and laboratory profile of scrub typhus patients requiring pediatric intensive care admission and to find out risk factors for the severity of illness. This was a cross-sectional observational study conducted on 1-month to 12-year-old children admitted with scrub typhus in a tertiary care pediatric intensive care unit (PICU). Relevant demographic, clinical, laboratory, treatment, and outcome-related data were documented. The severity of the disease was measured in the form of multiple organ dysfunction syndrome (MODS). With further correlation, and univariate and multivariate analyses, factors associated with severe disease were identified. During the study period, out of 586 PICU admission, 62 patients (10.6%) were diagnosed with scrub typhus. The mean age was 63.85 ± 52.78 months, where infants constituted 32.3% of the total population. Fever was present in 100% of the cases. Common indications of PICU admission were: respiratory distress 42 (67.7%), altered sensorium 41 (66.1%), convulsion 37 (59.7%), and shock 31 (50%). Total number of patients with MODS was 40 (64.5%). The case fatality rate was 8%. On multivariate analysis, infant age group (p = 0.02), altered sensorium (p = 0.001), reduced urine output (p = 0.02), thrombocytopenia (p = 0.001), raised C-reactive protein (p = 0.004), hyponatremia (p = 0.005), hypoalbuminemia (p = 0.01), deranged international normalized ratio (p = 0.02), and hyperferritinemia (p = 0.02) came out to be independent factors in predictability for development of MODS. Multiorgan dysfunction is a life-threatening manifestation of scrub typus in children, which necessitates PICU admission. Infant age group, presence of altered sensorium, reduced urine output, thrombocytopenia, elevated inflammatory markers, coagulopathy, hypoalbuminemia, and hyponatremia predict risk for MODS.

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