Admission, discharge and triage guidelines for paediatric intensive care units in Spain

Oliva, P. De La; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Galán, Corsino Rey; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; Carlos-Vicente, Juan Carlos de; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodrı́guez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis Enrique Bruno

doi:10.1016/j.medine.2017.10.009

Cited by 2 publications

(2 citation statements)

References 29 publications

(24 reference statements)

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“…Several guidelines have been proposed in the literature describing discharge criteria of critically ill patients to the ward, 25 26 although most of the recommended criteria are nonspecific and are subjective. Few risk-predictive tools in pediatric population have been described in identifying risk factors for unplanned readmission, 5 11 while their validation and discrimination ability are questionable.…”

Section: Discussionmentioning

confidence: 99%

Validity of Pediatric Early Warning Score in Predicting Unplanned Pediatric Intensive Care Unit Readmission

Zoham

Mohammadpour

Yaghmaie

et al. 2021

J Pediatr Intensive Care

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Despite the fact that unscheduled readmission to pediatric intensive care units (PICUs) has significant adverse consequences, there is a need for a predictive tool appropriate for use in the clinical setting. The aim of this study was to assess the ability of the modified Brighton pediatric early warning score (PEWS) to identify children at high risk for early unplanned readmission. In this retrospective cohort study, all patients aged 1 month to 18 years of age discharged from PICUs of two tertiary children's hospitals during the study interval were enrolled. Apart from demographic data, the association between PEWS and early readmission, defined as readmission within 48 hours of discharge, was analyzed by multivariable logistic regression. From 416 patients, 27 patients had early PICU readmission. Patients who experienced readmission were significantly younger than the controls. (≤12 months, 70.4 vs. 39.1%, p = 0.001) Patients who were admitted from the emergency room (66.7 and 33.3% for emergency department (ED) and floor, respectively, p = 0.012) had higher risk of early unplanned readmission. PEWS at discharge was significantly higher in patients who experienced readmission (3.07 vs. 0.8, p < 0.001). A cut-off PEWS of 2, with sensitivity 85.2% and specificity 78.1%, determined the risk of unplanned readmission. Each 1-point increase in the PEWS at discharge significantly increases the risk of readmission (odds ratio [OR] = 3.58, 95% confidence interval [CI]: [2.42–5.31], p < 0.001). PEWS can be utilized as a useful predictive tool regarding predicting unscheduled readmission in PICU. Further large-scale studies are needed to determine its benefits in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Validity of Pediatric Early Warning Score in Predicting Unplanned Pediatric Intensive Care Unit Readmission

Zoham

Mohammadpour

Yaghmaie

et al. 2021

J Pediatr Intensive Care

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“…It is the simplest means of evaluating the acid-base status of patients. It helps to identify the presence and causes of metabolic acidosis (4,5) .…”

Section: Abg Is Traditionally Onementioning

confidence: 99%

ABG in the Patients admitted on the Pediatric Intensive Care Unit, Minia University Hospital.

Farouk

Salam

Emad

2020

Minia Journal of Medical Research

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Background: Acid base disorders are frequently present in critically ill patients. Metabolic acidosis is associated with increased mortality, but it is unclear whether as a marker of the severity of the disease process or as a direct effector. The understanding of the metabolic component of acid base derangements has evolved over time, and several theories and models for precise quantification and interpretation have been postulated during the last century. Unmeasured anions are the footprints of dissociated fixed acids and may be responsible for a significant component of metabolic acidosis. Their nature, origin, and prognostic value are incompletely understood. This review provides a historical overview of how the understanding of the metabolic component of acid base disorders has evolved over time and describes the theoretical models and their corresponding tools applicable to clinical practice, with an emphasis on the role of ABG in general and several specific settings. Objectives: Aim of the study : to determine the value of ABG on mortality and morbidity in Pediatric Intensive Care Unit in minia university hospital. Methods: This was a retrospective study done over 2 years. There were total 653 patients (1 month to18 years), who were divided into survivals and non survivals groups. All data were collected and analyzed retrospectively including: Name, Age, sex, , length of stay in PICU, underlying etiology, cause of admission, and requirement for mechanical ventilation. laboratory investigations; from the patients' records, we obtained the results of routine blood samples on patients' admission to PICU which were immediately transported to the central laboratory in the hospital. These samples were arterial blood gases, Data retrieved from the medical files and statistically analyzed after permission from the ethical committee. Results: There were significant difference in the outcome of patients admitted to the PICU regarding the age group, sex, length of stay in PICU, requiring mechanical ventilation, respiratory failure P-value were (<0.001, <0.001, 0.007, <0.001, and <0.001 respectively). Conculsion:. There is no consensus regarding preferred methodology for the evaluation of acidebase derangements in critically ill patients. The physicalechemical approach by Stewart does not have a clear advantage over the traditional bicarbonate-based method. Both should be regarded as complementary for optimal understanding of acidebase disorders. Keywords; ABG, metabolic acidosis, outcome in children admitted on PICU.

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Admission, discharge and triage guidelines for paediatric intensive care units in Spain

Cited by 2 publications

References 29 publications

Validity of Pediatric Early Warning Score in Predicting Unplanned Pediatric Intensive Care Unit Readmission

Validity of Pediatric Early Warning Score in Predicting Unplanned Pediatric Intensive Care Unit Readmission

ABG in the Patients admitted on the Pediatric Intensive Care Unit, Minia University Hospital.

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