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An experience with surgical admissions to a paediatric ICU (PICU) in Harare, Zimbabwe
1Department of Paediatrics and Child Health, University of Zimbabwe College of Health Sciences, Avondale, Harare.
Insights
Emergency surgical admissions and hypothermia on arrival significantly impact pediatric intensive care unit outcomes. Simple interventions like maintaining operating room temperature and standardizing transport can improve patient results in resource-limited settings.
Area of Science:
- Pediatric Intensive Care
- Surgical Outcomes
- Critical Care Medicine
Background:
- Patient status upon arrival in the intensive care unit (ICU) may influence immediate outcomes.
- Identifying correctable factors is crucial for improving patient care in resource-limited environments.
Purpose of the Study:
- To determine if patient condition at ICU admission affects immediate ICU outcomes.
- To identify correctable factors influencing these outcomes in pediatric surgical patients.
Main Methods:
- Retrospective survey of 147 pediatric surgical admissions.
- Data collected from January 1997 to December 1998 at a hospital in Harare, Zimbabwe.
- Analysis of factors associated with ICU outcomes.
Main Results:
- Emergency surgical admission, hypothermia on arrival, and need for ventilation were linked to poor ICU outcomes (p<0.001).
- Multivariate analysis confirmed emergency surgical admission and hypothermia as significant predictors of poor outcome.
- All patients were admitted from operating theatres.
Conclusions:
- Simple measures can enhance immediate ICU outcomes for surgical patients in resource-limited settings.
- Improving operating room ambient temperature and standardizing patient transport to the PICU are recommended interventions.
Objective:
To find out if the status of a patient on arrival in the intensive care unit had any bearing on the immediate ICU outcome and if there are any correctable factors.
Design:
A retrospective survey.
Setting:
Paediatric intensive care unit (PICU) at Parirenyatwa Hospital in Harare, Zimbabwe between January 1997 and December 1998.
Subjects:
147 emergency surgical admissions.
Results:
There were 147 surgical patients admitted to the PICU during the period of whom 77 were male and 43 were emergency surgical procedures. All patients were coming from the operating theatres (OT). Factors associated with a poor ICU outcome were emergency surgical admission (p<0.001), hypothermia on arrival in the PICU (p<0.001) and requirement for ventilation (p<0.001). On multivariate analysis only the first two were associated with a poor ICU outcome.
Conclusion:
Some simple measures could be undertaken to improve immediate ICU outcome in surgical patients in a resource limited environment, such as improving the ambient temperature in OT during surgery and standardising transportation to PICU.
