ABSTRACT
Objective: To determine the characteristics and outcome of ventilated patients in the paediatric medical intensive care unit (PICU) of Lady Ridgeway Hospital for Children (LRH), Colombo. Design: Prospective descriptive study Method: The study population consisted of all ventilated paediatric patients admitted to PICU, LRH from 1st March to 31st August, 2009. The factors studied included demographic profile (age, sex, residence, transfer), length of stay on ventilator, indication for ventilation, details of organ dysfunction and the final outcome. Results: There were 152 patients ventilated over the study period of six months. Seventy three were under one year of age. Male to female ratio was 1.17:1. A significant proportion (n=105) were from the Western province. Eighty five patients were transferred from medical wards of LRH. Median duration of ventilation was six days (IRQ 4-10). Indications for ventilation included respiratory problems (85), neurological disorders (13), cardiac causes (5), hepatic problem (1) and miscellaneous diseases (48) including 32 from dengue syndromes. There were 42 deaths among ventilated patients giving an overall mortality rate of 27.6%. Multi-organ dysfunction syndrome (MODS) on admission accounted for 81% of the deaths. Bronchopneumonia (16) and dengue haemorrhagic fever (12) were the main underlying causes of death. Thirty two (21%) had anaemia while in the PICU, 15 of them having anaemia on admission. Nosocomial infection was present in 17 (11%) patients. Children transferred from other provinces had a higher risk of death than those from the Western province (OR=1.5, 95% CI: 0.7 – 3.3). Conclusions: MODS on admission accounted for 81% of the deaths. Bronchopneumonia and dengue haemorrhagic fever were the main underlying causes of death. Children transferred from other provinces had a higher risk of death compared to those from the Western province.
ABSTRACT
Objective To study the BCG vaccination scars of under 5 year old children who were admitted to a tertiary care hospital Design Cross sectional descriptive study Setting Ward 3, Lady Ridgeway Hospital for Children (LRH) Method All children between 6 and 60 months of age, admitted to ward 3 LRH from October 15th to December 30th 2006, were included in the study. The interviewer-administered questionnaire and examination of the child for BCG scar were the methods used to collect the data. Results: Of 1010 patients admitted to ward 3 LRH during the study period, 923 were analysed. BCG vaccine had been given to all patients. Whilst 821 (89%) patients had the BCG scar, 102 (11%) did not have it. Among patients with the BCG scar, 20% had received BCG vaccine in non tertiary care hospitals, whereas in patients with absent BCG scar, this figure was 35% (p=0.003; p < 0.05). In the Child Health Development Record (CHDR), the BCG scar column had been marked in only 554 (64%). Among 102 patients with absent BCG scar, revaccination was not indicated in 20 (21%) because the BCG scar had been marked as positive in the CHDR. However, 96 had not been revaccinated. Common reasons for non revaccination were: unawareness of mothers regarding absent BCG scar (38.5%) and postponement of revaccination (24%). Conclusion There was a significant number of patients with absent BCG scars indicating need for larger scale studies.