Pattern and burden of respiratory diseases in pediatric intensive care unit.

Abstract

Objective: To assess the pattern and burden of respiratory illnesses admitted in Pediatric Intensive Care Unit and their outcome. Study Design: Retrospective Cohort study. Setting: A closed multidisciplinary PICU with 4-S framework [system, space, stuff and staff] of a newly opened public-sector children hospital in Karachi. Period: January 1, 2023 to June 30, 2023. Methods: We retrospectively reviewed the medical records of children (1month-15yrs) with acute respiratory illnesses admitted in PICU of a newly opened public-sector children hospital during six months. Demographic data (age and gender), clinical variables (types, severity of respiratory failure, type of respiratory support and clinical outcome as alive or expired were extracted from medical records. Results: Total respiratory cases were 274(15.1%) during this study period. The median age was 9 months (IQR6-15) and 179(65.3%) were male. Acute bronchiolitis 160(58.4%) and pneumonia 50(18.2%) were the most common admitting diagnosis. Respiratory failure was observed in 42(15.3%) and needed positive pressure ventilation either as High Flow nasal cannula 32(11.7%) and MV 10(3.6%). Predictor of respiratory failure in this cohort was non-vaccination, malnutrition, abnormal chest X-ray and use of vasoactive drugs (p=0.017, p=0.418, p<0.001, p=<0.001). Mortality is associated with clinical severity (p <0.001). The case specific mortality rate was 2(0.08%). Conclusion: Acute bronchiolitis and Pneumonia were the leading respiratory illnesses with marginal mortality rate. Effective management strategies lead to significant improved outcome of children with respiratory diseases.