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Intensive care needs of children with acute bacterial meningitis: a developing country perspective

Sunit C Singhi1, Rajan Khetarpal, Arun K Baranwal

  • 1Advanced Paediatrics Centre, Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh 160-012, India. drsinghi@glide.net.in

Annals of Tropical Paediatrics
|June 10, 2004
PubMed

Insights

Prioritize children with acute bacterial meningitis (ABM) for paediatric intensive care (PIC) if they show severe symptoms like coma or respiratory distress. Early intervention in PICU is crucial for better outcomes in critically ill children.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Paediatric intensive care (PIC) facilities are scarce in developing nations.
  • Effective resource allocation requires identifying children who would benefit most from PIC.

Purpose of the Study:

  • To identify clinical indicators for intensive care in children with acute bacterial meningitis (ABM).
  • To guide prioritization for PIC admission in resource-limited settings.

Main Methods:

  • Retrospective, descriptive analysis of 220 children (1 month–12 years) with ABM.
  • Data collected from July 1993 to December 1996 at a tertiary-care hospital in India.
  • Analysis focused on clinical indicators, interventions, and outcomes in children admitted to or considered for PICU.

Main Results:

  • 88 children were transferred to the PICU.
  • Common indicators for PICU transfer included coma (Glasgow Coma Score <8, 59%), raised intracranial pressure (44%), shock (24%), and respiratory distress/failure (42%).
  • Refractory seizures, need for intubation/ventilation, and multiple system involvement were associated with higher mortality; no deaths occurred in children not transferred to PICU.

Conclusions:

  • Children with ABM presenting with Glasgow Coma Score <8, signs of raised ICP, refractory status epilepticus, shock, or respiratory compromise should be prioritized for PIC.
  • Timely PICU admission and intervention are critical for improving survival rates in severe ABM cases.

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