Paediatric patients ventilated in a high care area in a low resource setting: their characteristics and mortality outcomes

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dc.contributor.authorCawood, Shannon Kim
dc.date.accessioned2018-07-11T11:42:42Z
dc.date.available2018-07-11T11:42:42Z
dc.date.issued2017
dc.descriptionThis research report is submitted in partial fulfilment of requirements for the degree of Master of Medicine in the Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg Johannesburg 2017en_ZA
dc.description.abstractBackground. 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.en_ZA
dc.description.librarianDM2018en_ZA
dc.identifier.urihttps://hdl.handle.net/10539/24919
dc.language.isoenen_ZA
dc.subjectMechanical Ventilation
dc.subject.meshIntensive Care Units
dc.subject.meshPediatrics
dc.subject.meshMortality
dc.titlePaediatric patients ventilated in a high care area in a low resource setting: their characteristics and mortality outcomesen_ZA
dc.typeThesisen_ZA
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