Outcome of Infants with Unrepaired Heart Disease Admitted to the Pediatric Intensive Care Unit: Single-center Developing Country Perspective

Mohsin, Shazia; Haque, Anwarul; Shaikh, Attiya; Bano, Surraiya; Hasan, Babar

doi:10.1111/chd.12075

Cited by 10 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In developing countries, children with congenital heart defects (CHDs) are one of the major risk groups 10 . Frequently the delay in the surgical repair is associated with a higher mortality (around 60%) in children admitted to the intensive care unit, with diagnosis of sepsis or pneumonia in 74% of cases, most of them with a CHD lesion with increased pulmonary blood flow, similar to this cohort 11 .…”

Section: Discussionsupporting

confidence: 62%

Pneumococcal Conjugate Vaccine and Pneumonia Prevention in Children with Congenital Heart Disease

Solórzano-Santos

Espinoza-García

Aguilar-Martínez

et al. 2017

RIC

View full text Add to dashboard Cite

Background: A successful strategy to prevent Streptococcus pneumoniae infections is the administration of pneumococcal conjugate vaccines (PCVs). Objective: To analyze the effectiveness of the 7-and 13-valent PCV for the prevention of all-cause pneumonia. Materials and Methods: A retrospective cohort of children younger than 5 years of age, with congenital heart disease (CHD) and different vaccination schedules, was analyzed. History of vaccination was confirmed with verifiable records. The outcome measure was all-cause pneumonia or bronchopneumonia. Protocol was approved by the Institutional Review Board. For comparisons, we used inferential statistics with Chi-square and Fisher's exact test; a p ≤ 0.5 was considered statistically significant. Relative and absolute risks reduction and number needed to treat were also calculated. Results: A total of 348 patients were included: 196 with two or more doses of PCV (considered the vaccinated group), and 152 in the unvaccinated group. There was a statistically significant difference for pneumonia events (p < 0.001) between the vaccinated (26/196) and unvaccinated (51/152) groups. The relative risk reduction was 60.5%, and the absolute risk reduction, 20.3%. There were no differences between patients who received two, three or four doses. The number needed to vaccinate to prevent one event of pneumonia was 5 children. Conclusions: At least two doses of PCV in children with CHD reduced the risk of all-cause pneumonia.

show abstract

Section: Discussionsupporting

confidence: 62%

Pneumococcal Conjugate Vaccine and Pneumonia Prevention in Children with Congenital Heart Disease

Solórzano-Santos

Espinoza-García

Aguilar-Martínez

et al. 2017

RIC

View full text Add to dashboard Cite

show abstract

“…CHD patients in LMICs are considered to have a very different spectrum of disease (2,5,6,18,19). These patients present late and majority of the time have associated co-morbidities like infections, severe malnourishment, and significant lung injury (especially in shunt lesions) due to repeated pneumonia (20)(21)(22)(23)(24)(25). These patients thus have different physiological states than similar patients presenting in HIR (i.e., advanced pulmonary vascular obstructive disease, significantly elevated filling pressures due to prolonged volume load etc.)…”

Section: Discussionmentioning

confidence: 99%

Performance of a Risk Analytic Tool (Index of Tissue Oxygen Delivery “IDO2”) in Pediatric Cardiac Intensive Care Unit of a Developing Country

et al. 2022

View full text Add to dashboard Cite

ObjectiveTo determine the performance of a commercially available risk analytic tool (IDO2) to estimate the risk for SVO2 < 40% in patients admitted in cardiac intensive care unit (CICU).MethodsMedical and T3 records of all patients (aged 1 day to 12 years, weight >2 kg) who received care in the CICU between October 1st, 2019 and October 1st, 2020, had SvO2 lab(s) drawn during CICU course and whose data was transmitted to T3, were included. The average IDO2 Index was computed in the 30-min period immediately prior to each SvO2 measurement and used as a predictor score for SvO2 < 40%.ResultsA total of 69 CICU admissions from 65 patients, median age 9.3 months (interquartile range 20.8) were identified. Surgical and medical patients were 61 (88%) and 8 (12%) respectively; 4 (5.7%) patients had single ventricle physiology. Tetralogy of Fallot n = 23 (33.3%) and ventricular septal defects 17 (24.6%) were major cardiac diagnosis. Sixty-one (89.9%) of the admissions were successfully discharged from the hospital. Of the 187-total included SvO2 labs, 17 (9%) were <40%. The AUC of estimating SvO2 < 40% IDO2 was 0.87 [confidence interval (CI): 0.79–0.94]. Average IDO2 above 75 had the highest absolute risk (42.11, CI: 20.25–66.50) and highest RR (4.63, CI: 2.31–9.28, p-value < 0.0001) of SvO2 < 40%.ConclusionIDO2 performed well in estimating low SvO2 (<40%) in pediatric patients presenting to a CICU in a low resource setting. Future work is needed to determine the effect of this risk analytic tool on clinical outcomes in such a setting.

show abstract

“…Studies have assessed outcomes at discrete follow-up intervals [ 13 , 19 , 20 , 21 , 22 , 23 ], but few have followed children longitudinally. Other studies have been limited to follow-up of survivors with a specific subset of pathophysiology [ 24 , 25 , 26 , 27 ]. In a scoping review of pediatric critical care medicine literature from 1970–2017, over 360 unique instruments were used to evaluate long-term outcomes [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

PICU Survivorship: Factors Affecting Feasibility and Cohort Retention in a Long-Term Outcomes Study

et al. 2022

View full text Add to dashboard Cite

Our understanding of longitudinal outcomes of Pediatric Intensive Care Unit (PICU) survivors is limited by the heterogeneity of follow-up intervals, populations, and outcomes assessed. We sought to demonstrate (1) the feasibility of longitudinal multidimensional outcome assessment and (2) methods to promote cohort retention. The objective of this presented study was to provide details of follow-up methodology in a PICU survivor cohort and not to present the outcomes at long-term follow-up for this cohort. We enrolled 152 children aged 0 to 17 years admitted to the PICU in a prospective longitudinal cohort study. We examined resource utilization, family impact of critical illness, and neurodevelopment using the PICU Outcomes Portfolio (POP) Survey which included a study-specific survey and validated tools: 1. Functional Status Scale, 2. Pediatric Evaluation of Disability Inventory Computer Adaptive Test, 3. Pediatric Quality of Life Inventory, 4. Strengths and Difficulties Questionnaire, and 5. Vanderbilt Assessment Scales for Attention Deficit-Hyperactivity Disorder. POP Survey completion rates were 89%, 78%, and 84% at 1, 3, and 6 months. Follow-up rates at 1, 2, and 3 years were 80%, 55%, and 43%. Implementing a longitudinal multidimensional outcome portfolio for PICU survivors is feasible within an urban, tertiary-care, academic hospital. Our attrition after one year demonstrates the long-term follow-up challenges in this population. Our findings inform ongoing efforts to implement core outcome sets after pediatric critical illness.

show abstract

Outcome of Infants with Unrepaired Heart Disease Admitted to the Pediatric Intensive Care Unit: Single-center Developing Country Perspective

Abstract: Patients with CHD awaiting surgery and who admitted to the PICU with acute illness are at high risk for mortality. Stringent criteria to diagnose pneumonia or sepsis should be used in these patients.

Cited by 10 publications

References 23 publications

Pneumococcal Conjugate Vaccine and Pneumonia Prevention in Children with Congenital Heart Disease

Pneumococcal Conjugate Vaccine and Pneumonia Prevention in Children with Congenital Heart Disease

Performance of a Risk Analytic Tool (Index of Tissue Oxygen Delivery “IDO2”) in Pediatric Cardiac Intensive Care Unit of a Developing Country

PICU Survivorship: Factors Affecting Feasibility and Cohort Retention in a Long-Term Outcomes Study

Contact Info

Product

Resources

About