Acute gut injury: prevalence and impact on outcome in critically ill children
Objectives: Primary: To estimate prevalence of acute gut injury (AGI) in critically ill children during first week. Secondary: To estimate impact of AGI on mortality in critically ill children. Material and Methods: Current study is a part of larger prospective cohort study which includes all childr...
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2018-01-01
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Series: | Journal of Pediatric Critical Care |
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doaj-e54c133e742a4abf8391f02147decc042020-11-25T03:33:55ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992018-01-0158787810.21304/2018.0506.00463Acute gut injury: prevalence and impact on outcome in critically ill childrenNitin DhochakRakesh LodhaSushil K KabraJhuma SankarKana Ram JatRohan MalikGovind MakhariaObjectives: Primary: To estimate prevalence of acute gut injury (AGI) in critically ill children during first week. Secondary: To estimate impact of AGI on mortality in critically ill children. Material and Methods: Current study is a part of larger prospective cohort study which includes all children aged between 1 month to 18 years admitted to pediatric intensive care unit. Current study analyzed children admitted during December 2017 to April 2018. Children with chronic gastrointestinal symptoms were excluded. European Society of Intensive Care Medicine classification was used to classify for AGI into four categories. Clinical details and outcome parameters were recorded. Results: Thirty-one children were included in the analysis. Median (IQR) age of the children was 32.5 (7.5-96) months; 32% of patients were male. Thirteen (42%) children died. Prevalence of AGI, gut dysfunction (AGI≥2), and gut failure (AGI≥3) was 64.5%, 41.9% and 22.6% respectively. Mortality was significantly increased in patients with AGI, gut dysfunction and gut failure (18% vs 82%, p = 0.047; 22.5% vs 77.8%, p= 0.009 and 29.1% vs 70.9%, p=0.008 respectively). Area under curve of receiver operating curve (AUC-ROC) for prediction of mortality of worst AGI and worst PELOD-2 score in first week were not significantly different (76.4 % and 81.3% respectively, p=0.67). Conclusion: Acute gut injury and gut dysfunction are significant among critically ill children and are associated with increased mortality. With new objective AGI classification, gut dysfunction should be included as measure of organ dysfunction among pediatric organ dysfunction scores.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2018;volume=5;issue=8;spage=78;epage=78;aulast=Dhochak;type=0 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nitin Dhochak Rakesh Lodha Sushil K Kabra Jhuma Sankar Kana Ram Jat Rohan Malik Govind Makharia |
spellingShingle |
Nitin Dhochak Rakesh Lodha Sushil K Kabra Jhuma Sankar Kana Ram Jat Rohan Malik Govind Makharia Acute gut injury: prevalence and impact on outcome in critically ill children Journal of Pediatric Critical Care |
author_facet |
Nitin Dhochak Rakesh Lodha Sushil K Kabra Jhuma Sankar Kana Ram Jat Rohan Malik Govind Makharia |
author_sort |
Nitin Dhochak |
title |
Acute gut injury: prevalence and impact on outcome in critically ill children |
title_short |
Acute gut injury: prevalence and impact on outcome in critically ill children |
title_full |
Acute gut injury: prevalence and impact on outcome in critically ill children |
title_fullStr |
Acute gut injury: prevalence and impact on outcome in critically ill children |
title_full_unstemmed |
Acute gut injury: prevalence and impact on outcome in critically ill children |
title_sort |
acute gut injury: prevalence and impact on outcome in critically ill children |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Pediatric Critical Care |
issn |
2349-6592 2455-7099 |
publishDate |
2018-01-01 |
description |
Objectives: Primary: To estimate prevalence of acute gut injury (AGI) in critically ill children during first week.
Secondary: To estimate impact of AGI on mortality in critically ill children.
Material and Methods: Current study is a part of larger prospective cohort study which includes all children aged between 1 month to 18 years admitted to pediatric intensive care unit. Current study analyzed children admitted during December 2017 to April 2018. Children with chronic gastrointestinal symptoms were excluded. European Society of Intensive Care Medicine classification was used to classify for AGI into four categories. Clinical details and outcome parameters were recorded.
Results: Thirty-one children were included in the analysis. Median (IQR) age of the children was 32.5 (7.5-96) months; 32% of patients were male. Thirteen (42%) children died. Prevalence of AGI, gut dysfunction (AGI≥2), and gut failure (AGI≥3) was 64.5%, 41.9% and 22.6% respectively. Mortality was significantly increased in patients with AGI, gut dysfunction and gut failure (18% vs 82%, p = 0.047; 22.5% vs 77.8%, p= 0.009 and 29.1% vs 70.9%, p=0.008 respectively). Area under curve of receiver operating curve (AUC-ROC) for prediction of mortality of worst AGI and worst PELOD-2 score in first week were not significantly different (76.4 % and 81.3% respectively, p=0.67).
Conclusion: Acute gut injury and gut dysfunction are significant among critically ill children and are associated with increased mortality. With new objective AGI classification, gut dysfunction should be included as measure of organ dysfunction among pediatric organ dysfunction scores. |
url |
http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2018;volume=5;issue=8;spage=78;epage=78;aulast=Dhochak;type=0 |
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