Limited data exist about the international burden of severe sepsis in critically ill children.To characterize global prevalence, therapies, and outcomes pediatric intensive care units to better inform interventional trials.A point prevalence study was conducted on 5 days throughout 2013-2014 at 128 sites 26 countries. Patients younger than 18 years age with as defined by consensus criteria were included. Outcomes therapies used, new or progressive multiorgan dysfunction, ventilator-...

Abstract Aim To report the natural history and clinical course of zygomycosis from a single tertiary care centre in India where doctors maintain an institutional registry. Methods The laboratory data collected prospectively patients with antemortem diagnosis for invasive zygomycosis, retrospectively autopsy diagnosed cases, over 18 month period (July 2006–December 2007) were combined analysed. Results During 75 cases (50 cases/year) reported. Antemortem could be made 81% 9% had nosocomial...

According to World Health Organization estimates, sepsis accounts for 60%-80% of lost lives per year in childhood. Measures appropriate resource-scarce and resource-abundant settings alike can reduce deaths. In this regard, the Federation Pediatric Intensive Care Critical Societies Board Directors announces Global Sepsis Initiative, a quality improvement program designed improve care children with sepsis.To announce global initiative; justify some bundles that are included; show preliminary...

We compared efficacy of dopamine and epinephrine as first-line vasoactive therapy in achieving resolution shock fluid-refractory hypotensive cold septic shock.Double-blind, pilot, randomized controlled study.Pediatric emergency ICU a tertiary care teaching hospital.Consecutive children 3 months to 12 years old, with shock, were enrolled between July 2013 December 2014.Enrolled receive either (in incremental doses, 10 15 20 μg/kg/min) or (0.1 0.2 0.3 till end points achieved. After reaching...

Neurocysticercosis is a major cause of neurologic illness worldwide. Its manifestations are variable, and somewhat different when it occurs in children. Controversy exists regarding anticysticercal therapy. The clinical, laboratory, radiographic features 500 consecutive children with neurocysticercosis were studied; the then followed prospectively their response to albendazole therapy was analyzed. Diagnosis based primarily on neuroimaging. Computed tomographic (CT) scans, serology, chest...

Single small enhancing computerized tomographic (CT) lesions (SSECTLs) are common in children with focal seizures. These considered to represent solitary cysticercus granulomas. Controversy exists regarding their treatment.To evaluate the efficacy of albendazole cases seizures SSECTLs.Randomized, placebo-controlled, double blind trial.Pediatric service Nehru Hospital, PGIMER, an urban tertiary care teaching hospital.63 between 2 and 12 years age for <3 months SSECTLs.All were randomly...

The objective of this study was to compare the efficacy continuous midazolam and diazepam infusion for control refractory status epilepticus. An open-label, randomized undertaken at Pediatric Emergency Intensive Care Service a multidisciplinary teaching referral hospital. Subjects included 40 children, 2 12 years age, with epilepticus (motor seizures uncontrolled after two doses diazepam, 0.3 mg/kg per dose, phenytoin infusion, 20 mg/kg). Either (n = 21) or 19) in incremental administered....

Owing to a rise in frequency and change pattern of cases with fungaemia at our tertiary care centre, we conducted prospective study for 4 months understand the epidemiology outcome this infection. Detailed case histories including management protocol outcomes were noted. Records 140 (27.1% adult 72.9% paediatric patients) analysed. Although C. tropicalis was most common yeast isolated, significantly higher isolation guilliermondii (30.4%) pelliculosa (17.6%) noted patients; albicans (26.3%)...

An open-label, randomized controlled study was conducted at a tertiary care teaching hospital to compare efficacy and safety of intravenous sodium valproate versus diazepam infusion for control refractory status epilepticus. Forty children with epilepticus were receive either or infusion. Refractory in 80% the 85% patients. The median time less group (5 minutes) than (17 minutes; P < .001). None patients required ventilation developed hypotension, whereas 60% 50% hypotension after starting...

To compare daily interruption vs. continuous sedative infusions in mechanically ventilated children with respect to lengths of mechanical ventilation and intensive care unit stay.Prospective randomized controlled trial.Pediatric a tertiary teaching referral hospital.One hundred two patients for >48 hrs.Patients were receive either (group 1) or interrupted 2) infusion (midazolam bolus 0.1 mg/kg, followed by infusion, achieve Ramsay score 3-4). Each patient group 2 had at 8:00 AM till he/she...

To evaluate the efficacy of probiotics in prevention Candida colonization a PICU.Prospective double blinded, randomized controlled trial.PICU tertiary care teaching hospital north India.One hundred fifty children (106 boys, 44 girls), 3 months to 12 yrs old, on broad spectrum antibiotics for at least 48 hrs were using computer-generated random numbers receive probiotic mix (EUGI) (n = 75) or placebo 75).Patients received one sachet twice day either 7 days. Probiotics contained Lactobacillus...

Although case series describe benefits of airway pressure release ventilation (APRV), this mode has not been evaluated against the conventional low-tidal volume (LoTV) in children with acute respiratory distress syndrome (ARDS).To compare effect APRV and LoTV on ventilator-free days ARDS.This open-label, parallel-design randomized controlled trial was conducted a 15-bed ICU. Children aged 1 month to 12 years satisfying modified Berlin definition were included. We excluded air leaks,...

Childhood community acquired pneumonia (CAP) is a significant problem in developing countries, and confirmation of microbial etiology important for individual, as well public health. However, there paucity data from large cohort, examining multiple biological specimens diverse pathogens (bacteria viruses). The Community Acquired Pneumonia Etiology Study (CAPES) was designed to address this knowledge gap.We enrolled children with CAP (based on WHO IMCI criteria tachypnea cough or breathing...

Tropical fevers were defined as infections that are prevalent in, or unique to tropical and subtropical regions. Some of these occur throughout the year some especially in rainy post-rainy season. Concerned about high prevalence morbidity mortality caused by infections, overlapping clinical presentations, difficulties arriving at specific diagnoses need for early empiric treatment, Indian Society Critical Care Medicine (ISCCM) constituted an expert committee develop a consensus statement...

Objectives: To evaluate the effect of probiotics on cytokines in children with severe sepsis. Design: Randomized, double-blind, placebo-controlled trial. Setting: ICU a tertiary care teaching hospital North India. Patients: Children 3 months to 12 years old Interventions: Enrolled were randomized probiotic ( n = 50) and placebo groups. Probiotic group received VSL#3 (Danisco-Dupont USA, Madison, WI) Lactobacillus paracasei, L. plantarum, acidophilus, delbrueckii, Bifidobacterium longum, B....

Objectives: To study the outcome and predictors of mortality in children with diabetic ketoacidosis. Design: Retrospective case series. Setting: Pediatric intensive care unit an urban multiple-specialty teaching referral hospital north India. Patients: Sixty-eight patients ketoacidosis treated between 1993 2000. Interventions: Data were retrieved from records respect to patients' age; clinical features; osmolality at admission; blood glucose, serum potassium, arterial pH admission, 6 hrs, 24...

The objective of this prospective study was to examine the effect fluid restriction on body water and outcome children with acute meningitis. Fifty consecutively hospitalized meningitis, divided into two groups (A, without hyponatremia; B, hyponatremia), were randomly assigned receive either normal maintenance (M) or restricted (R subgroup) (65 70% M fluids during first 48 hours. Total water, extracellular (ECW), serum urinary sodium plasma osmolality measured at admission after In both...

An outbreak of nosocomial fungemia due to the unusual yeast, Pichia anomala occurred in pediatric wards our hospital over a period 23 months (April 1996 February 1998). A total 379 neonates and children (4.2% admissions) were infected. The probable index case was admitted emergency ward, with subsequent transmission premature nursery, intensive care units, other wards. Carriage on hands health personnel likely be responsible for dissemination fungus. could only controlled after education...