RESUMEN
Objective: to study the clinical and laboratory parameters of children extubated from ambu bag and endotracheal tube after being manually ventilated for at least more than 24 hours
Methods: various clinical and laboratory parameters were evaluated initially at the time of intubation and then at the time of extubating. The clinical parameters evaluated included the heart rate and respiratory rate, Glasgow coma scale, spontaneous respiratory effort, respiratory distress and pupillary reaction. The Laboratory parameters evaluated included TLC, CRP, and arterial blood pH, HCO3, PO2 and PCO2, CXR, flow rate of oxygen required to maintain oxygen saturation and the dose of cardiac support in the form of dopamine infusion
Results: total 24 patients were included in the study, 11[46%] male and 13[54%] female. Age range was from 0 to 36 months with mean of 6.5 months. The mean values of Laboratory parameters at the time of intubation included a pH of 7.13, HCO3 17, 02 sat 64, PCO2 52, and rate of oxygen flow 3.5 liters/min. The mean values of same parameters at the time of successful weaning were, pH 7.36, HCO318, 02 sat 94, PCO2 29, and rate of flow of oxygen 3.5 liters/min. Regarding clinical parameters the mean value for GCS at intubation was 5 which later improved to 13 at extubating. Similarly the pupillary reaction at intubation showed constriction of pupils in 6[25%] and mid-dilated with sluggish reaction in remaining 18[75%], while almost 95% cases had reactive pupils at extubating
Conclusion: ambu-bagging though crude but is a successful tool for respiratory support in the absence of ventilator. Clinical and lab parameters can predict the outcome in children who are solely intubated and ve11tilated by ambu bag
RESUMEN
Objective: to assess frequency of various clinical presentations of dengue fever in pediatric age group at a tertiary care hospital in Lahore
Methods: a cross sectional survey was conducted from Dec 2012 to Sep 2013 in pediatrics department of Jinnah hospital Lahore. 150 patients were enrolled as per inclusion criteria. Clinical features were abstracted on a standardized Performa and investigations were done, including complete blood count, hematocrit, anti-dengue lgM [If fever more than 5 days], NS1 antigen [If fever less than 5 days] by Elisa and ultrasound scan of abdomen to document free fluid in abdominal or thoracic cavity. Data was analyzed using SPSS Version 17
Results: one hundred and fifty patients with mean age of 8.4 years [SD of+/- 2.8 years] were enrolled. 86 patients [57.3%] were males with male to female ratio of 1.3: 1. High grade fever was present in all the 150 patients [100%] and Diarrhea in 21[14 %] patients. Other clinical features included: petechial in 25 [16.3%], epistaxis in 20 [13.3%], hematemesis in 8 [5.3%], hepatomegaly in 33[22%] and splenomegaly in 15 [10%] subjects. The evidence of dengue hemorrhagic fever was seen in 23 patients [15 %], while there was no case of Dengue Shock Syndrome
Conclusion: most of dengue fever cases were from 5 to 10 years of age group. High grade fever was the most common clinical manifestation of dengue fever, followed by hepatomegaly, petechial, diarrhea, epistaxis, splenomegaly and hematemesis. Dengue fever was more common in males as compared to females, and about one in six cases had dengue hemorrhagic fever