Clinical features and outcomes of children admitted to the pediatric intensive care unit due to posterior reversible encephalopathy syndrome

Gün, Emrah; Akova, Birsel Şen; Çelik, Dilara Beşli; Balaban, Burak; Özen, Hasan; Gençay, Ali Genco; Bektaş, Ömer; Fítöz, Suat; Kendirli, Tanıl

doi:10.1016/j.clineuro.2022.107476

Cited by 3 publications

(1 citation statement)

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“…Renal dysfunction can lead to the accumulation of metabolic waste products and electrolyte imbalances, which can cause systemic inflammations and organ dysfunction, contributing to or failures in multiple systems [23][24][25]. Additionally, renal disease may serve as a marker of overall disease severity or susceptibility to other risk factors for MODS, as supported by multiple literatures [26][27][28][29][30][31][32][33].…”

Section: Plos Onementioning

confidence: 94%

Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study

Teshager,

Amare,

Tamirat

et al. 2024

PLoS ONE

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Background Traditional herbal medicine (THM) is frequently used in pediatric populations in many low-income countries as a form of healthcare and has been associated with a range of adverse events, including liver toxicity, renal failure, and allergic reactions. Despite these concerns, its impact on multi-organ dysfunction syndrome (MODS) risk has not been thoroughly investigated. Objective This study aimed to investigate the incidence and predictors of MODS in a pediatric intensive care unit (PICU) in Ethiopia, with a focus on the association between THM use and the risk of MODS. Methods This was a single-center prospective cohort study conducted at a PICU in the university of Gondar Comprehensive Specialized hospital, Northwest Ethiopia. The study enrolled eligible patients aged one month to 18 years admitted to the PICU during the study period. Data on demographic characteristics, medical history, clinical and laboratory data, and outcome measures using standard case record forms, physical examination, and patient document reviews. The predictors of MODS were assessed using Cox proportional hazards models, with a focus on the association between traditional herbal medicine use and the risk of MODS. Results A total of 310 patients were included in the final analysis, with a median age of 48 months and a male-to-female ratio of 1.5:1. The proportion and incidence of MODS were 30.96% (95% CI:25.8, 36.6) and 7.71(95% CI: 6.10, 9.40) per 100-person-day observation respectively. Renal failure (17.74%), neurologic failure (15.16%), and heart failure (14.52%) were the leading organ failures identified. Nearly one-third of patients (32.9%) died in the PICU, of which 59.8% had MODS. The rate of mortality was higher in patients with MODS than in those without. The Cox proportional hazards model identified renal disease (AHR = 6.32 (95%CI: 3.17,12.61)), intake of traditional herbal medication (AHR = 2.45, 95% CI:1.29,4.65), modified Pediatric Index of Mortality 2 (mPIM 2) score (AHR = 1.54 (95% CI: 1.38,1.71), and critical illness diagnoses (AHR = 2.68 (95% CI: 1.77,4.07)) as predictors of MODS. Conclusion The incidence of MODS was high. Renal disease, THM use, mPIM 2 scores, and critical illness diagnoses were independent predictors of MODS. A more than twofold increase in the risk of MODS was seen in patients who used TMH. Healthcare providers should be aware of risks associated with THM, and educate caregivers about the potential harms of these products. Future studies with larger sample sizes and more comprehensive outcome measures are needed.

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Section: Plos Onementioning

confidence: 94%

Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study

Teshager,

Amare,

Tamirat

et al. 2024

PLoS ONE

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show abstract

Multiple drugs

2022

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Traditional Herbal Medicine Use Tripled the Risk of Multi-organ Dysfunction Syndrome in a Pediatric Intensive Care Unit in Ethiopia: A Prospective Cohort Study

Teshager

Amare

Tamirat

et al. 2023

Preprint

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ObjectiveThis study aimed to investigate the incidence and predictors of MODS in a Pediatric Intensive Care Unit in Ethiopia, with a focus on the association between traditional herbal medicine (THM) use and the risk of MODS.MethodsThis was a single-center prospective cohort study conducted at a PICU in Ethiopia. The study enrolled eligible patients aged one month to 18 years admitted to the PICU during the study period. Recruitment was made at the time of admission to the PICU. Data on demographic characteristics, medical history, clinical and laboratory data, and outcome measures using standard case record forms, physical examination, and patient document reviews. The predictors of MODS were assessed using Cox proportional hazards models, with a focus on the association between traditional herbal medicine use and the risk of MODS.ResultsA total of 310 patients were included in the final analysis, with a median age of 48 months and a male-to-female ratio of 1.5:1. The proportion and incidence of MODS were 30.96% (95% CI:25.8, 36.6) and 7.71(95% CI: 6.10, 9.40) per 100-person-day observation respectively. Renal failure (17.74%), neurologic failure (15.16%), and heart failure (14.52%) were the leading organ failures identified. Nearly one-third of patients (32.9%) died in the PICU, of which 59.8% had MODS. The rate of mortality was higher in patients with MODS than in those without.The Cox proportional hazards model identified renal disease (AHR=6.32 (95%CI: 3.17,12.61)), intake of traditional herbal medication (AHR=2.45, 95% CI:1.29,4.65), modified Pediatric Index of Mortality 2 (mPIM 2) score (AHR=1.54 (95% CI: 1.38,1.71), and critical illness diagnoses (AHR=2.68 (95% CI: 1.77,4.07)) as predictors of MODS. Patients who used THM had a threefold increased risk of MODS (AHR) of 2.45 (95% CI: 1.29, 4.65).ConclusionThe incidence of MODS was high. Renal disease, THM use, mPIM 2 scores, and critical illness diagnoses were independent predictors of MODS. A threefold increase in the risk of MODS was seen in patients who used TMH. Healthcare providers should be aware of risks associated with THM, and educate caregivers about the potential harms of these products. Future studies with larger sample sizes and more comprehensive outcome measures are needed.

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Clinical features and outcomes of children admitted to the pediatric intensive care unit due to posterior reversible encephalopathy syndrome

Cited by 3 publications

References 14 publications

Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study

Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study

Multiple drugs

Traditional Herbal Medicine Use Tripled the Risk of Multi-organ Dysfunction Syndrome in a Pediatric Intensive Care Unit in Ethiopia: A Prospective Cohort Study

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