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Author: search.filters.author.Cawood, Shannon KimSubject: search.filters.subject.Mechanical Ventilation

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    Paediatric patients ventilated in a high care area in a low resource setting: their characteristics and mortality outcomes
    (2017) Cawood, Shannon Kim
    Background. The paediatric department at Chris Hani Baragwanath Academic Hospital (CHBAH) in South Africa is able to ventilate patients in a high care area (HCA). Studies have shown that this practice increases patient mortality. Objectives. To describe patients ventilated in the HCA and their outcomes. Methods. Retrospective descriptive record review of all children (0-16 years) receiving mechanical ventilation in the HCA of CHBAH between 01 February 2015 and 31 October 2015. Results. 214 patients were admitted to the HCA for mechanical ventilation. The majority of patients, 116 (54.2%) were infants with a median age of 2.35 months (IQR: 28 days - 8.6 months). Eight-point-nine percent of patients were HIV positive. 28.4% of patients were severely underweight, 29.6% severely stunted and 15.7% severely wasted. Acute lower respiratory tract infections were the most common cause for ventilation. In terms of intensive care unit (ICU) candidacy, there was no significant difference in terms of weight-for-age, height-for-age, weight-for-height or HIV status Of the 214 patients, 69% were ultimately accepted into an ICU. Reasons for ICU refusal included lack of beds or poor candidacy. Sixty-eight (31.8%) patients died, with 36 of these deaths (52.9%) occurring in HCA. The mortality rate in HCA was higher than ICU (45.57% vs. 23.70%). Conclusions. Mortality is increased when patients are ventilated outside of an ICU.