AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, ne...AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric 展开更多
Objectives: To describe the epidemiological, clinical and therapeutic aspects of asthma in children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville. Patients and methods: We reviewed the rec...Objectives: To describe the epidemiological, clinical and therapeutic aspects of asthma in children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville. Patients and methods: We reviewed the records of children hospitalized in the Pediatric Intensive Care Unit of University Hospital of Brazzaville from January 1 to December 31, 2015, and retained those from two months to 17 years hospitalized for asthma. The study variables were: age, sex, influence of seasons, history of atopy;the factors triggering the crisis, the type of follow-up, the degree of severity of asthma exacerbation, the type of treatment instituted and the course of the disease. In total, out of 2012 hospitalized children, 65 children met the inclusion criteria. Results: The hospital prevalence of asthma was 3.5%. Among 65 children of study, 42 (59.2%) were male and 29 (40.8%) female. The mean age was 3.9 ± 2.9 years (range from 2 months to 14 years). Children aged 30 months to 5 years were the most represented (40%). They were known as asthmatics, n = 18 (27.7%). Family atopy was found, n = 11 (16.9%). Acute Otorhinolaryngologic infections were in all cases the factors triggering the crisis. The peak frequency of hospitalizations for asthma occurred during the short rainy season. The crisis was moderate n = 46 (70%) and severe n = 19 (29%). Beta 2 mimetics were administered in all cases, by subcutaneous in 18 cases (27.7%) and inhaled in 47 cases (72.3%). The outcome was favorable in all cases with a mean hospital stay of 1.46 ± 0.92 days. Conclusion: Childhood asthma remains a public health challenge and severe asthma is the paradigm of uncontrolled and costly asthma. This first work suggests that a large-scale study be carried out for a better knowledge of it.展开更多
文摘AIM To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome(PICS) in adults, including physical, neurocognitive and psychological morbidities.METHODS A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, Psyc INFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit(PICU) patients. Two reviewers independently screened all titles and abstracts and performed data extraction. From the 3176 articles identified in the search, 252 abstracts were identified for full text review and nineteen were identified for inclusion in the review. All studies reporting characteristics of PICS in PICU patients were included in the final synthesis. RESULTS Nineteen studies meeting inclusion criteria published between 1995 and 2016 were identified and categorized into studies reporting morbidities in each of three categories-physical, neurocognitive and psychological. The majority of included articles reported prospective cohort studies, and there was significant variability in the outcome measures utilized. A synthesis of the studies indicate that morbidities encompassing PICS are well-described in children who have survived critical illness, often resolving over time. Risk factors for development of these morbidities include younger age, lower socioeconomic status, increased number of invasive procedures or interventions, type of illness, and increased benzodiazepine andnarcotic administration.CONCLUSION PICS-related morbidities impact a significant proportion of children discharged from PICUs. In order to further define PICS in children, more research is needed using standardized tools to better understand the scope and natural history of morbidities after hospital discharge. Improving our understanding of physical, neurocognitive, and psychological morbidities after critical illness in the pediatric
文摘Objectives: To describe the epidemiological, clinical and therapeutic aspects of asthma in children at the Pediatric Intensive Care Unit of University Hospital of Brazzaville. Patients and methods: We reviewed the records of children hospitalized in the Pediatric Intensive Care Unit of University Hospital of Brazzaville from January 1 to December 31, 2015, and retained those from two months to 17 years hospitalized for asthma. The study variables were: age, sex, influence of seasons, history of atopy;the factors triggering the crisis, the type of follow-up, the degree of severity of asthma exacerbation, the type of treatment instituted and the course of the disease. In total, out of 2012 hospitalized children, 65 children met the inclusion criteria. Results: The hospital prevalence of asthma was 3.5%. Among 65 children of study, 42 (59.2%) were male and 29 (40.8%) female. The mean age was 3.9 ± 2.9 years (range from 2 months to 14 years). Children aged 30 months to 5 years were the most represented (40%). They were known as asthmatics, n = 18 (27.7%). Family atopy was found, n = 11 (16.9%). Acute Otorhinolaryngologic infections were in all cases the factors triggering the crisis. The peak frequency of hospitalizations for asthma occurred during the short rainy season. The crisis was moderate n = 46 (70%) and severe n = 19 (29%). Beta 2 mimetics were administered in all cases, by subcutaneous in 18 cases (27.7%) and inhaled in 47 cases (72.3%). The outcome was favorable in all cases with a mean hospital stay of 1.46 ± 0.92 days. Conclusion: Childhood asthma remains a public health challenge and severe asthma is the paradigm of uncontrolled and costly asthma. This first work suggests that a large-scale study be carried out for a better knowledge of it.