Document Detail


Epidemiology and peculiarities of pediatric multiple organ dysfunction syndrome in New Delhi, India.
MedLine Citation:
PMID:  16977482     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Most pediatric studies on multiple organ dysfunction syndrome derive from developed countries. There is little information regarding the etiologies and outcomes of multiple organ dysfunction syndrome in critically ill children from developing countries. The objective of this study was to examine the differences in epidemiology of multiple organ dysfunction syndrome and the relationship of the Organ Failure Index (OFI) to outcomes from multiple organ dysfunction syndrome in critically ill children from a developing country. DESIGN: Prospective observational study. SETTING: A 10-bed tertiary pediatric intensive care unit. PATIENTS: A total of 1722 children (1 month to 16 years of age) admitted to a pediatric intensive care unit during the study period from January 1998 to June 2003. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of all the patients admitted to the pediatric intensive care unit, 184 patients (10.6%) had persistent multiple organ dysfunction syndrome. During the study period 136 deaths (7.9%) occurred in the ICU. Multiple organ dysfunction syndrome was associated with nearly half of these deaths, 67/136 (49.2%). Overall survival of all patients with persistent multiple organ dysfunction syndrome was 64% (117/184). In addition to sepsis, falciparum malaria, fulminant hepatic failure, dengue shock syndrome, severe poisonings, post cardiopulmonary bypass, and post cardiac arrest were significant antecedents of multiple organ dysfunction syndrome . Patients with OFI scores of 2, 3, 4-5, and >5 exhibited mortalities of 9%, 29%, 58%, and 100% respectively. CONCLUSIONS: In addition to "traditional" sepsis, common etiologies of multiple organ dysfunction syndrome included falciparum malaria, fulminant hepatic failure, and dengue shock syndrome. In developing countries like India, multiple organ dysfunction syndrome carries a significant risk of mortality which is directly related to the OFI.
Authors:
Praveen Khilnani; Devajit Sarma; Jerry Zimmerman
Publication Detail:
Type:  Journal Article     Date:  2006-09-15
Journal Detail:
Title:  Intensive care medicine     Volume:  32     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-20     Completed Date:  2007-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1856-62     Citation Subset:  IM    
Affiliation:
Pediatric Critical Care Services, Institute of Pediatrics, Max Health Care Hospitals Saket, New Delhi, India. pkhilnani@vsnl.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Dengue Hemorrhagic Fever / complications
Female
Humans
Incidence
India / epidemiology
Infant
Intensive Care Units, Pediatric
Malaria, Falciparum / complications
Male
Multiple Organ Failure / epidemiology*,  mortality,  physiopathology,  therapy
Prospective Studies
Severity of Illness Index
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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