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Predictors of outcome in children with hydrocarbon poisoning receiving intensive care

M Jayashree1, S Singhi, A Gupta

  • 1Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. medinst@pgi.chd.nic.in

Indian Pediatrics
|September 5, 2006
PubMed

Insights

Hypoxemia in pediatric intensive care unit (PICU) patients was linked to prior gastric lavage and severe respiratory distress. These factors, along with need for ventilation, predicted poor outcomes in children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Physiology
  • Infectious Diseases

Background:

  • Hypoxemia is a critical condition in pediatric intensive care units (PICUs).
  • Understanding predictors of hypoxemia and associated outcomes is vital for patient management.

Purpose of the Study:

  • To investigate the characteristics and outcomes of hypoxemic children admitted to a pediatric intensive care unit.
  • To identify factors associated with hypoxemia and poor prognosis in this pediatric population.

Main Methods:

  • Retrospective study of 48 children (8.5 months–10 years) admitted to a tertiary care hospital PICU in northern India (1995–2001).
  • Analysis of clinical data, including hypoxemia on arrival, need for mechanical ventilation, respiratory distress, leucocytosis, and development of secondary pneumonia.
  • Statistical analysis including Odds Ratio (OR) and multiple regression to identify predictors and associations.

Main Results:

  • 38% of patients were hypoxemic on arrival, with 45% requiring mechanical ventilation.
  • Hypoxemic patients were more likely to have received prior gastric lavage (OR 23.2) and presented with severe respiratory distress and leucocytosis (OR 8.0).
  • Secondary pneumonia occurred in 33.3%, prolonging PICU stay (144 vs 72 hours). Prior lavage, hypoxemia, ventilation need, sepsis, and ventilator complications correlated with poor outcomes.

Conclusions:

  • Prior gastric lavage and severe respiratory distress are significant indicators associated with hypoxemia in pediatric PICU admissions.
  • Hypoxemia at admission, need for ventilation, secondary infections, and ventilator-associated complications are linked to adverse outcomes.
  • No single variable reliably predicted hypoxemia via multiple regression analysis in this cohort.

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