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Abstract
Objectif. Décrire les aspects épidémiologiques, cliniques et évolutifs des enfants admis en réanimation polyvalente au Centre Hospitalier Universitaire de Brazzaville. Matériels et méthodes. Il agit d’une étude transversale rétrospective, descriptive réalisée en réanimation polyvalente du Centre Hospitalier Universitaire de Brazzaville du 1er décembre 2014 au 28 février 2018 (39 mois). Ont été inclus tous les enfants de moins de 16 ans admis dans le service. Les variables suivantes ont été analysées : âge, sexe, provenance, motif d’admission, évolution, durée de séjour. Résultats. Durant la période d’étude, 86 enfants ont été admis sur 2112 patients soit une fréquence de 4,1 %. Leur âge moyen était de 8,9 ± 5,5 ans. Le sex ratio était de 1,52. Dans 48,8 % des cas, les patients provenaient du bloc opératoire et dans 24,4% du service de soins intensifs pédiatriques. Le motif d’admission le plus fréquent était la surveillance postopératoire (26,7 %), suivi de la détresse respiratoire (18,6%) et de l’état de mal convulsif (16,3%). Le taux de mortalité était de 38,4 %. La durée moyenne de séjour était de 3,1 ±1,4 jours. Conclusion. Les admissions pédiatriques représentent environ 4 % des admissions totales. Elles proviennent majoritairement du bloc opératoire et du service de soins intensifs pédiatriques. Le taux de mortalité est élevé. Une formation spécifique du personnel à l’anesthésie-réanimation pédiatrique, ainsi qu’un plateau technique adéquat pourraient permettre de réduire ce taux de mortalité.
ABSTRACT
Aim. To describe the epidemiology, clinical features and outcome of children admitted to polyvalent intensive care unit at the University Teaching Hospital of Brazzaville. Materials and methods. This was a cross sectional retrospective, descriptive study carried out in polyvalent intensive care unit at the University Hospital of Brazzaville from december 1, 2014 to february 28, 2018 (39 months). All children under the age of 16 admitted to the service were included. The following variables were studied: age, sex, origin, reason for admission, outcomes, length of stay. Results. During our study period, 86 children were admitted out of 2112 patients (4.1%). Their mean age was 8.9± 5.5 years. The sex ratio was 1.52. The patients came from the operating room in 48.8% of cases and from the pediatric intensive care unit in 24.4%. The most common reason for admission was postoperative monitoring (26.7%) followed by respiratory distress (18.6%) and seizure (16.3%). The mortality rate was 38.4%. The mean length of stay was 3.1± 1.4 days. Conclusion. Pediatric admissions represented 4.1% of total admissions. They come mainly from the operating room and the pediatric intensive care unit. The mortality rate is high. Specific training of staff in pediatric resuscitation, as well as an adequate technical platform will undoubtedly reduce this mortality rate.
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References
- Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet 2005 ; 365 (9465) :1147-1152.
- Young MP, Birkmeyer JD: Potential reduction in mortality rates using an intensivist model to manage intensive care units. Eff Clin Pract. 2000, 3: 284-289.Ramesh S. Paediatric intensive care- update. Indian J Anaesth 2003; 47: 338-44.
- Ramesh S. Paediatric intensive care- update. Indian J Anaesth 2003; 47: 338-44.
- Sima Zué A, Chani M, Ngaka Nsafu D, Carpentier JP. Le contexte tropical influence-il la morbidité et la mortalité? Med Trop 2002; 62 : 256-259
- Abhulimhen-Iyoha BI, Tobi KU. Profile and Outcome Analysis of Paediatric Admissions into a General Intensive Care Unit in Nigeria: Is There a Need for a Paediatric Intensive Care Unit ? Annals of Biomedical Sciences 2014 ; 13(2).
- Mahoungou-Guimbi KC, Ekouya Bowassa G, Ellenga Mbola, Oko A, Mabiala Babela JR, Okocko A, et al. Morbidité et mortalité pédiatrique dans un service de réanimation polyvalente adulte. Ann Afr Med 2012; 12 (2): 1004-1009.
- McHugh GJ, Hicks PR. Paediatric admissions to the general intensive care unit at palmerston north hospital. Crit Care Resusc 1999; 1(3): 234-8.
- Poluyi EO, Fadiran OO, Poluyi CO, et al. Profile of Intensive Care Unit Admissions and Outcomes in a Tertiary Care Center of a Developing Country in West Africa: A 5 Year Analysis. J Intensive & Crit Care 2016 ; 2 (3): 1-7.
- Abubakar AS, Saad YM, Ahmed HG, et al. An Audit of Paediatrics Admissions and Outcomes into a General Intensive Care Unit at a Tertiary Teaching Hospital: A Five-Year Review. SOJ Anesthesiol Pain Manag 2017 ; 4 (2): 1-4.
- Embu HY, Yiltok SJ, Isamade ES, Nuhu SI, Oyeniran OO, Uba FA. Paediatric admissions and outcome in a general intensive care unit. Afr J Paediatr Surg 2011; 8: 57-61.
- Hazara A, Singh V, Davoudian P. Paediatric admissions to an adult ICU in a district general hospital in the UK. Crit Care 2011; 15: 488.
- Abebe T, Girmay M. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an ethiopian university hospital. Int J Gen Med 2015; 8: 63-67.
- El Halal MG, Barbieri E, Mombelli Filho R, de Andrade Trotta E, Carvalho PRA. Admission source and mortality in a pediatric intensive care unit. Indian J Crit Care Med. 2012; 16(2): 81-86.
- Baker T. Pediatric emergency and critical care in low-income countries. Paediatr Anaesth 2009; 19 (1): 23–27.
- Wang JN, Wu JM, Chiou YY, Luo CY. Comparison of intensive care of injured children between pediatric-based and non-pediatric-based intensive care units in a University Hospital in Taiwan. Acta Paediatr Taiwan 1999; 40 (6): 400-5.
- Odetola FO, Rosenberg AL, Davies MM, Clarke SJ, Dechert RE, Shanley TP. Do outcomes vary according to the source of admission to the pediatric intensive unit? Paediatr Crit Care Med 2008 ;9 (1): 20-5.
References
Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet 2005 ; 365 (9465) :1147-1152.
Young MP, Birkmeyer JD: Potential reduction in mortality rates using an intensivist model to manage intensive care units. Eff Clin Pract. 2000, 3: 284-289.Ramesh S. Paediatric intensive care- update. Indian J Anaesth 2003; 47: 338-44.
Ramesh S. Paediatric intensive care- update. Indian J Anaesth 2003; 47: 338-44.
Sima Zué A, Chani M, Ngaka Nsafu D, Carpentier JP. Le contexte tropical influence-il la morbidité et la mortalité? Med Trop 2002; 62 : 256-259
Abhulimhen-Iyoha BI, Tobi KU. Profile and Outcome Analysis of Paediatric Admissions into a General Intensive Care Unit in Nigeria: Is There a Need for a Paediatric Intensive Care Unit ? Annals of Biomedical Sciences 2014 ; 13(2).
Mahoungou-Guimbi KC, Ekouya Bowassa G, Ellenga Mbola, Oko A, Mabiala Babela JR, Okocko A, et al. Morbidité et mortalité pédiatrique dans un service de réanimation polyvalente adulte. Ann Afr Med 2012; 12 (2): 1004-1009.
McHugh GJ, Hicks PR. Paediatric admissions to the general intensive care unit at palmerston north hospital. Crit Care Resusc 1999; 1(3): 234-8.
Poluyi EO, Fadiran OO, Poluyi CO, et al. Profile of Intensive Care Unit Admissions and Outcomes in a Tertiary Care Center of a Developing Country in West Africa: A 5 Year Analysis. J Intensive & Crit Care 2016 ; 2 (3): 1-7.
Abubakar AS, Saad YM, Ahmed HG, et al. An Audit of Paediatrics Admissions and Outcomes into a General Intensive Care Unit at a Tertiary Teaching Hospital: A Five-Year Review. SOJ Anesthesiol Pain Manag 2017 ; 4 (2): 1-4.
Embu HY, Yiltok SJ, Isamade ES, Nuhu SI, Oyeniran OO, Uba FA. Paediatric admissions and outcome in a general intensive care unit. Afr J Paediatr Surg 2011; 8: 57-61.
Hazara A, Singh V, Davoudian P. Paediatric admissions to an adult ICU in a district general hospital in the UK. Crit Care 2011; 15: 488.
Abebe T, Girmay M. The epidemiological profile of pediatric patients admitted to the general intensive care unit in an ethiopian university hospital. Int J Gen Med 2015; 8: 63-67.
El Halal MG, Barbieri E, Mombelli Filho R, de Andrade Trotta E, Carvalho PRA. Admission source and mortality in a pediatric intensive care unit. Indian J Crit Care Med. 2012; 16(2): 81-86.
Baker T. Pediatric emergency and critical care in low-income countries. Paediatr Anaesth 2009; 19 (1): 23–27.
Wang JN, Wu JM, Chiou YY, Luo CY. Comparison of intensive care of injured children between pediatric-based and non-pediatric-based intensive care units in a University Hospital in Taiwan. Acta Paediatr Taiwan 1999; 40 (6): 400-5.
Odetola FO, Rosenberg AL, Davies MM, Clarke SJ, Dechert RE, Shanley TP. Do outcomes vary according to the source of admission to the pediatric intensive unit? Paediatr Crit Care Med 2008 ;9 (1): 20-5.