Monday, October 1, 2018

Prognostic Factors of Children Admitted to a Pediatric Intensive Care Unit After an Episode of Drowning

Title: Prognostic Factors of Children Admitted to a Pediatric Intensive Care Unit After an Episode of Drowning
Authors: Ballestin, A, et al.
Journal: Pediatric Emergency Care, July 2018

This articles adds to a group of studies over the past year which have greatly added to the understanding of what initial clinical factors may help predict clinical outcome in pediatric drowning patients.

Study Aim
Evaluate prognostic factors through analyzing the characteristics and clinical course of patients admitted in a pediatric intensive care unit (PICU) after an episode of drowning over the past 24 years.

Study Design
  • Observational study
  • patients admitted to PICU in Spain
Results
  • 131 patients
    • 73% male
    • Mean age 5 years
  • Outcomes
    • Poor outcome (death or severe disability) in 25%
      • 17% mortality
      • 8% significant neuro injury
    • Witnessed status
      • 96% witnessed drowning had good outcome
      • 69% of unwitnessed had good outcome
    • Pupils
      • 90% of patients with non-dilated and reactive pupils had good outcome
      • 87% of patients with dilated/non-reactive pupils had bad outcome
    • pH
      • 91% of patients with pH > 7.1 on admission had good outcome
    • CPR
      • All patients who did not require CPR or had basic CPR (no intubation or meds) had good neuro outcome
      • All but one patient with CPR, endotracheal intubation, and meds had death or poor neuro outcome
Bottom Line

In this study of PICU patients, the most important factor predicting poor outcome was the need for advanced CPR on scene (endotracheal intubation, IV meds).  All patients in the group who needed no CPR or basic CPR survived with good neuro outcome. These results are in line with previous studies.


Reference
Salas Ballestín A, de Carlos Vicente JC, Frontera Juan G, Sharluyan Petrosyan 
A, Reina Ferragut CM, González Calvar A, Clavero Rubio MDC, Fernández de la
Ballina A. Prognostic Factors of Children Admitted to a Pediatric Intensive Care 

Unit After an Episode of Drowning. Pediatr Emerg Care. 2018 Jul 16.

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