ABSTRACT
To determine the rate and the type of ventriculoperitoneal [VP] shunt infections in infants and children admitted to King Fahad Hofuf hospital of AI-Ahsaa area at the Eastern Province of Saudi Arabia. From mid 2003 to end of 2006; VP shunt infection episodes were reviewed. Once infection was suspected, a cerebrospinal fluid [CSF] sample was taken and empirical antibiotics were recommended. Once infection was confirmed, VP shunt was removed and external ventricular drainage [EVD] was inserted until CSF became sterile after which a new shunt was inserted. 25.9% of patients with VP shunts had infections which represents 29.3% of the procedures. 40% of infected patients had recurrent episodes. 59.1% of infections occurred throughout the first two months following insertion. Single pathogen was isolated in each episode. Pseudomonas auerginosa represented 50% of isolated pathogens compared with 18.2% with Staphylococcus epidermidis. There is a high incidence of VP shunt infections in King Fahad Hofuf hospital when compared with other international centres. Gram negative organisms are the most common cause of the infection
Subject(s)
Humans , Male , Female , Ventriculoperitoneal Shunt/methods , Infant, Newborn , Incidence , Hydrocephalus/surgery , Cerebrospinal Fluid Shunts , Retrospective StudiesABSTRACT
To determine predictors for outcomes of traumatic brain injury [TBI] in infants and children younger than twelve years admitted to our pediatric intensive care units [PICU]. This is a retrospective cohort study from 2004-5, done at the PICU of King Fahad Hofuf Hospital, Eastern Province, Saudi Arabia. One hundred and six patients with TBI; 65 boys and 41 girls ages 12 or under, with a mean age of 5.7 years, were included. Of them, 11.3% died [Deaths group], 11% survived with neurological deficits [NDgroup], and 77% survived with no neurological deficits [NND-group]. The potential predictors for death or neurological deficits were examined. 83% of deaths had initial Glascow coma scale [GCS] of = 4/15, 50% of ND had initial GCS = 8 and 27% of NND had GCS < 12. The initial brain CT was abnormal in 92% of deaths and ND groups, but in only 37% of NND. Combined brain pathologies were found in 92% of deaths, 63% of ND and only in 5% of NND. Hypotension was seen in 67% of deaths, 17% ND and only in 1% of NND. Mechanical ventilation was required in all deaths and more than half of ND. Liver enzymes were high in 50% of deaths and 66% of ND but in only 20% of NND. Serum albumin was low in 33% of deaths, 42% of ND and only 1% NND. Glasgow coma score, brain CT findings, combined brain pathologies, hypotension, high liver enzymes and low serum albumin predict outcome after TBI in pediatric age group