Clinical Profiles and Outcomes of Children Admitted to the Pediatric Intensive Care Unit from the Emergency Department

The aim of this study was to describe clinical profiles and outcomes of children admitted directly from the Emergency Room [ER] to the Pediatric Intensive Care Unit [PICU] of academic hospital. The medical records of all children [1 month to 16 years] admitted in PICU from ER, from January 2011 to December 2012 were reviewed. Of the 26, 774 patients seen in the ER during the study period, 468 [1.7%] were admitted to the PICU which constituted about 41.5% [468/1127] of all the total PICU admissions. Sixty three percent [n=294] were under-five; males were 60.9% [285], 82.3% [385] were in medical category. Neurological and respiratory illnesses were the most common groups [> 50% of all ER admissions]. Multi-organ dysfunction syndrome and co-morbidity were present in 25.2% [n=118] and 23.5% [n=110] respectively. The mean length of stay was 5 +/- 3.7 hours. The case-fatality rate was 20.3% [n=95] as compared to the overall PICU mortality rate of 11.9% [n=135]. Key Words: Pediatric intensive care unit [PICU]. Emergency room [ER]. Children. Outcome.

Improving outcome in pediatric intensive care unit in academic hospital in Pakistan

To assess the impact on the clinical outcome of critically ill children before and after introduction of pediatric intensivist in an academic pediatric intensive care unit [PICU] in Pakistan. This is a retrospective audit of children [age from one month to 14 years] admitted in the PICU during two 12-month periods in PICU of Aga Khan University Hospital [AKUH]. Patients in cohort one were managed by pediatric intensivist while in cohort two were managed by general pediatricians. Patients were compared during the two 12-month cohort period. During the study, in cohort one, 314 patients were admitted, mean age was 24 months [range, one month -14 year], 37% were less than 1 -year old, 66% were male, mean PRISM Score was 13.2[3- 39] while in cohort 2, 99 patients were admitted; mean age was 29 months and 60% were male. There were similar medical diagnostic categories in both cohorts. There were significant differences in two cohort for mortality [35% vs. 14%], length of stay [7.5 days vs. 3.2 days] [p<0.01] and number of admissions [314 vs. 99]. Our data showed that implementation of full-time trained pediatric intensivist in a tertiary-care PICU of university hospital was associated with improve outcome of critically ill children

Clinical profile and outcome in a paediatric intensive care unit in Pakistan

Paediatric critical care medicine is a relatively new subspecialty in Pakistan. The clinical profile and outcomes of children admitted in the PICU [paediatric intensive care unit] were retrospectively reviewed from January to December 2007. Mean age of the studied 314 patients was 24 months; 37% were less than one-year-old and 66% was male. Mean PRISM score was 13.2. There were almost equal distribution of medical [46%] and surgical [54%] cases. Ninety percent of patients received mechanical ventilation, while more than 50% received vasoactive drugs. The rate of nosocomial infection was 4.7%. The average length of PICU stay was 3.2 [1-49] days. The overall mortality rate was 14%. The results are encouraging and efforts should be made to establish more PICUs