ABSTRACT
OBJECTIVES: To explore the etiology composition and outcomes of pediatric chronic critical illness (PCCI) in the pediatric intensive care unit (PICU). METHODS: The children who were hospitalized in the PICU of Dongguan Children's Hospital Affiliated to Guangdong Medical University and met the diagnostic criteria for PCCI from January 2017 to December 2022 were included in the study. The etiology of the children was classified based on their medical records and discharge diagnoses. Relevant clinical data during hospitalization were collected and analyzed. RESULTS: Among the 3 955 hospitalized children in the PICU from January 2017 to December 2022, 321 cases (8.12%) met the diagnostic criteria for PCCI. Among the 321 cases, the most common etiology was infection (71.3%, 229 cases), followed by unintentional injury (12.8%, 41 cases), postoperation (5.9%, 19 cases), tumors/immune system diseases (5.0%, 16 cases), and genetic and chromosomal diseases (5.0%, 16 cases). Among the 321 cases, 249 cases (77.6%) were discharged after improvement, 37 cases (11.5%) were discharged at the request of the family, and 35 cases (10.9%) died in the hospital. Among the deaths, infection accounted for 74% (26/35), unintentional injury accounted for 17% (6/35), tumors/immune system diseases accounted for 6% (2/35), and genetic and chromosomal diseases accounted for 3% (1/35). From 2017 to 2022, the proportion of PCCI in PICU diseases showed an increasing trend year by year (P<0.05). Among the 321 children with PCCI, there were 148 infants and young children (46.1%), 57 preschool children (17.8%), 54 school-aged children (16.8%), and 62 adolescents (19.3%), with the highest proportion in the infant and young children group (P<0.05). The in-hospital mortality rates of the four age groups were 14.9% (22/148), 8.8% (5/57), 5.6% (3/54), and 8.1% (5/62), respectively. The infant and young children group had the highest mortality rate, but there was no statistically significant difference among the four groups (P>0.05). CONCLUSIONS: The proportion of PCCI in PICU diseases is increasing, and the main causes are infection and unintentional injury. The most common cause of death in children with PCCI is infection. The PCCI patient population is mainly infants and young children, and the in-hospital mortality rate of infant and young children with PCCI is relatively high.
Subject(s)
Child, Hospitalized , Critical Illness , Adolescent , Infant , Child, Preschool , Humans , Child , Prognosis , Chronic Disease , Intensive Care Units, PediatricABSTRACT
AIM: Through observing the change of Nitric Oxide (NO) in the peripheral blood and gingival tissue, to explore the mechanism of Emodin (EMD) in the therapy of periodontal disease. METHODS: SD rats were randomly divided into four groups of thirty (group N, group P, group PL and the group PH). The periodontitis model was made and EMD was administered at PL and PH. At the 4th, 6th, 8th weeks after the animal models were established, the rats were killed respectively and the maxilla and the peripheral blood were collected. A side of maxilla was stained with HE for histological examination and the other side of gingival tissue surround ligated tooth was collected for the measurement of NO. Also, it was measured in the peripheral blood. GLM method using SPSS was used to compare changes in each of the variables over time. RESULTS: The levels of NO in the peripheral blood and gingival tissue in PL and PH groups were significantly lower than that in P groups(P<0.05). CONCLUSION: Emodin can take effect on periodontitis by reducing the levels of NO in the peripheral blood and gingival tissue.
