Journal of Pediatric Intensive Care最新文献

{"title":"Environment and Culture, a Cross-Sectional Survey on Drivers of Burnout in Pediatric Intensive Care.","authors":"Nupur N Dalal,&nbsp;Laura M Gaydos,&nbsp;Scott E Gillespie,&nbsp;Christina J Calamaro,&nbsp;Rajit K Basu","doi":"10.1055/s-0041-1730917","DOIUrl":"https://doi.org/10.1055/s-0041-1730917","url":null,"abstract":"<p><p>Very little data is available to understand the drivers of burnout amongst health care workers in the pediatric intensive care unit. This is a survey-based, cross-sectional, point-prevalence analysis within a single children's health system with two free-standing hospitals (one academic and one private) to characterize the relationship of demographics, organizational support, organizational culture, relationship quality, conflict and work schedules with self-reported burnout. Burnout was identified in 152 (39.7%) of the 383 (38.7%) respondents. No significant relationship was identified between burnout and demographic factors or work schedule. A more constructive culture (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.77-0.90; <i>p</i>  < 0.001), more organizational support (OR, 0.94; 95% CI, 0.92-0.96; <i>p</i> <0 0.001), and better staff relationships (OR, 0.54, 95% CI, 0.43-0.69; <i>p</i>  < 0.001) reduced odds of burnout. More conflict increased odds (OR, 1.25; 95% CI, 1.12-1.39; <i>p</i>  < 0.001). Less organizational support ( <i>Z</i> _β  = 0.425) was the most important factor associated with burnout overall. A work environment where staff experience defensive cultures, poor relationships, more frequent conflict, and feel unsupported by the organization is associated with significantly higher odds of burnout in pediatric critical care. The effect of targeted interventions to promote constructive cultures, collegiality, and organizational support on burnout in pediatric intensive care should be studied.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897953/pdf/10-1055-s-0041-1730917.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10662335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic.","authors":"Jennifer L van Helmond,&nbsp;Brittany Fitts,&nbsp;Jigar C Chauhan","doi":"10.1055/s-0041-1727249","DOIUrl":"https://doi.org/10.1055/s-0041-1727249","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (-16%, <i>p</i> < 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, <i>p</i> < 0.001). When separated by type, intentional (+55%, <i>p</i>  = 0.012) and accidental ingestions (+94%, <i>p</i>  = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894694/pdf/10-1055-s-0041-1727249.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Factors of High-Flow Nasal Cannula Oxygen Success in Children.","authors":"Gokce Iplik,&nbsp;Dincer Yildizdas,&nbsp;Ahmet Yontem","doi":"10.1055/s-0041-1730915","DOIUrl":"https://doi.org/10.1055/s-0041-1730915","url":null,"abstract":"<p><p>This study was aimed to evaluate the success rate of high-flow nasal cannula (HFNC) oxygen therapy and factors causing therapy failure. This prospective observational study included 131 children who received HFNC oxygen and followed-up in the pediatric emergency department, pediatric clinics, and pediatric intensive care unit between March 2018 and December 2019. The median age was 23.0 months (interquartile range [IQR]: 9.0-92.0) and 65 patients were male (49.6%). The most common reason for requiring HFNC oxygen therapy was pneumonia ( <i>n</i>  = 75, 57.3%). A complex chronic condition was present in 112 (85.5%) patients. Therapy success was achieved in 116 patients (88.5%). The reason for requiring treatment and the patients' complex chronic condition did not affect the success of the therapy ( <i>p</i>  = 0.294 and 0.091, respectively). In the first 24 hours of treatment, a significant improvement in pulse rate, respiratory rate, pH, and lactate level were observed in successful HFNC oxygen patients ( <i>p</i>  < 0.05). In addition, these patients showed a significant improvement in SpO ₂ and SpO ₂ /FiO ₂ ratio, and a significant decrease in FiO ₂ and flow rate ( <i>p</i>  < 0.05). HFNC oxygen success rate was 95.6% in patients with SpO ₂ /FiO ₂ ≥ 150 at the 24th hour; it was 58.0% in those with SpO ₂ /FiO ₂  < 150 ( <i>p</i>  < 0.001). Caution should be exercised in terms of HFNC oxygen failure in patients with no significant improvement in vital signs and with SpO ₂ /FiO ₂  < 150 during treatment.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894699/pdf/10-1055-s-0041-1730915.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Cornell Assessment of Pediatric Delirium Scale in Mechanically Ventilated Children.","authors":"Neha Gupta,&nbsp;Saurabh Talathi,&nbsp;Allison Woolley,&nbsp;Stephanie Wilson,&nbsp;Mildred Franklin,&nbsp;Johanna Robbins,&nbsp;Candice Colston,&nbsp;Leslie Hayes","doi":"10.1055/s-0041-1728784","DOIUrl":"https://doi.org/10.1055/s-0041-1728784","url":null,"abstract":"<p><p>Accuracy of delirium diagnosis in mechanically ventilated children is often limited by their varying developmental abilities. The purpose of this study was to examine the performance of the Cornell Assessment of Pediatric Delirium (CAPD) scale in these patients. This is a single-center, prospective, observational study of patients requiring sedation and mechanical ventilation for 2 days or more. CAPD scale was implemented in our unit for delirium screening. Each CAPD assessment was accompanied by a physician assessment using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Sensitivity analysis was performed to determine the best cut-off score in our target population. We also evaluated ways to improve the accuracy of this scale in patients with and without developmental delay. A total of 837 paired assessments were performed. Prevalence of delirium was 19%. Overall, CAPD score ≥ 9 had sensitivity of 81.8% and specificity of 44.8%. Among typically developed patients, the sensitivity and specificity were 76.7 and 65.4%, respectively, whereas specificity was only 16.5% for developmentally delayed patients. The best cut-off value for CAPD was 9 for typically developed children and 17 for those with developmental delay (sensitivity 74.4%, specificity 63.2%). Some CAPD questions do not apply to patients with sensory and neurocognitive deficits; upon excluding those questions, the best cut-off values were 5 for typically developed and 6 for developmentally delayed children. In mechanically ventilated patients with developmental delay, CAPD ≥ 9 led to a high false-positive rate. This emphasizes the need for either a different cut-off score or development of a delirium scale specific to this patient population.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894695/pdf/10-1055-s-0041-1728784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9229781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of Pediatric Palliative Care Consults in Hospitalized Patients with Heart Disease.","authors":"Danielle J Green,&nbsp;Erin Bennett,&nbsp;Lenora M Olson,&nbsp;Sarah Wawrzynski,&nbsp;Stephanie Bodily,&nbsp;Dominic Moore,&nbsp;Kelly J Mansfield,&nbsp;Victoria Wilkins,&nbsp;Lawrence Cook,&nbsp;Claudia Delgado-Corcoran","doi":"10.1055/s-0041-1730916","DOIUrl":"https://doi.org/10.1055/s-0041-1730916","url":null,"abstract":"<p><p>Pediatric palliative care (PPC) provides an extra layer of support for families caring for a child with complex heart disease as these patients often experience lifelong morbidities with frequent hospitalizations and risk of early mortality. PPC referral at the time of heart disease diagnosis provides early involvement in the disease trajectory, allowing PPC teams to longitudinally support patients and families with symptom management, complex medical decision-making, and advanced care planning. We analyzed 113 hospitalized pediatric patients with a primary diagnosis of heart disease and a PPC consult to identify timing of first PPC consultation in relation to diagnosis, complex chronic conditions (CCC), and death. The median age of heart disease diagnosis was 0 days with a median of two CCCs while PPC consultation did not occur until a median age of 77 days with a median of four CCCs. Median time between PPC consult and death was 33 days (interquartile range: 7-128). Death often occurred in the intensive care unit ( <i>n</i>  = 36, 67%), and the most common mode was withdrawal of life-sustaining therapies ( <i>n</i>  = 31, 57%). PPC referral often occurred in the context of medical complexity and prolonged hospitalization. Referral close to the time of heart disease diagnosis would allow patients and families to fully utilize PPC benefits that exist outside of end-of-life care and may influence the mode and location of death. PPC consultation should be considered at the time of heart disease diagnosis, especially in neonates and infants with CCCs.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894702/pdf/10-1055-s-0041-1730916.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9550179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Associated with a Pediatric Intensive Care Unit Sedation Weaning Protocol","authors":"Kimberley Harper, Jessica Anderson, Julie S. Pingel, K. Boyle, Li Wang, C. Lindsell, A. Sweeney, Kristina A. Betters","doi":"10.1055/s-0043-1769119","DOIUrl":"https://doi.org/10.1055/s-0043-1769119","url":null,"abstract":"Abstract Objective  This article compares patient outcomes before and after implementation of a risk stratified pediatric sedation weaning protocol. Methods  This observational cohort study, in a 30-bed tertiary care pediatric intensive care unit (PICU), included patients requiring opioid, benzodiazepine, and/or dexmedetomidine infusions. Outcomes (duration of wean, PICU length of stay [LOS], and Withdrawal Assessment Tool [WAT-1] scores) were collected by retrospective chart review for 12 months before and after protocol implementation. The influence of the protocol was assessed using an interrupted time series (ITS) analysis. Results  There were 49 patients before and 47 patients after protocol implementation. Median opioid wean duration preprotocol was 10.5 days (interquartile range [IQR]: 4.25, 20.75) versus 9.0 days (IQR: 5.0, 16.75) postprotocol ( p  = 0.66). Median benzodiazepine wean duration was 11.5 days (IQR: 3.0, 19.8) preprotocol versus 5.0 days (IQR: 2.0, 13.5) postprotocol ( p  = 0.31). Median alpha-agonist wean duration was 7.0 days (IQR: 3.5, 17.0) preprotocol versus 3 days (IQR: 1.0, 14.0) postprotocol ( p  = 0.03). The ITS indicated a reduction in opioid wean by 6.7 days ( p  = 0.35), a reduction in benzodiazepine wean by 13.4 days ( p  = 0.12), and a reduction in alpha-agonist wean by 12.9 days ( p  = 0.06). WAT-1 scores > 3 (12.6% preprotocol vs. 9.9% postprotocol, p  = 0.569) and PICU LOS (16.0 days [IQR: 11.0, 26.0] vs. 17.0 days [IQR: 11.0, 26.5], p  = 0.796) did not differ between groups. Conclusion  Implementation of a risk stratified sedation weaning protocol in the PICU was associated with a significant reduction in alpha-agonist wean duration without a significant increase in withdrawal symptoms.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83000450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Fluid Responsiveness Using Noninvasive Hemodynamic Monitoring in Pediatric Shock: A Review","authors":"N. Shah, Radha B. Patel, Pranali Awadhare, Tracy McCallin, U. Bhalala","doi":"10.1055/s-0043-1771347","DOIUrl":"https://doi.org/10.1055/s-0043-1771347","url":null,"abstract":"Abstract Noninvasive hemodynamic monitoring devices have been introduced to better quantify fluid responsiveness in pediatric shock; however, current evidence for their use is inconsistent. This review aims to examine available noninvasive hemodynamic monitoring techniques for assessing fluid responsiveness in children with shock. A comprehensive literature search was conducted using PubMed and Google Scholar, examining published studies until December 31, 2022. Articles were identified using initial keywords: [noninvasive] AND [fluid responsiveness]. Inclusion criteria included age 0 to 18, use of noninvasive techniques, and the emergency department (ED) or pediatric intensive care unit (PICU) settings. Abstracts, review papers, articles investigating intraoperative monitoring, and non-English studies were excluded. The methodological index for nonrandomized studies (MINORS) score was used to assess impact of study bias and all study components were aligned with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Our review yielded 1,353 articles, 17 of which met our inclusion criteria, consisting of 618 patients. All were prospective observational studies performed in the ED ( n  = 3) and PICU ( n  = 14). Etiologies of shock were disclosed in 13/17 papers and consisted of patients in septic shock (38%), cardiogenic shock (29%), and hypovolemic shock (23%). Noninvasive hemodynamic monitors included transthoracic echocardiography (TTE) ( n  = 10), ultrasonic cardiac output monitor (USCOM) ( n  = 1), inferior vena cava ultrasonography ( n  = 2), noninvasive cardiac output monitoring (NICOM)/electrical cardiometry ( n  = 5), and >2 modalities ( n  = 1). To evaluate fluid responsiveness, most commonly examined parameters included stroke volume variation ( n  = 6), cardiac index (CI) ( n  = 6), aortic blood flow peak velocity (∆ V peak ) ( n  = 3), and change in stroke volume index ( n  = 3). CI increase >10% predicted fluid responsiveness by TTE in all ages; however, when using NICOM, this increase was only predictive in children >5 years old. Additionally, ∆SV of 10 to 13% using TTE and USCOM was deemed predictive, while no studies concluded distensibility index by transabdominal ultrasound to be significantly predictive. Few articles explore implications of noninvasive hemodynamic monitors in evaluating fluid responsiveness in pediatric shock, especially in the ED setting. Consensus about their utility remains unclear, reiterating the need for further investigations of efficacy, accuracy, and applicability of these techniques.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91188800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Bedside Nurse Staffing on Patient Outcomes and Throughput in a Pediatric Cardiac Intensive Care Unit","authors":"Michael P. Fundora, Jiayi Liu, D. Kc, C. Calamaro","doi":"10.1055/s-0043-1769118","DOIUrl":"https://doi.org/10.1055/s-0043-1769118","url":null,"abstract":"Abstract Health care throughput is the progression of patients from admission to discharge, limited by bed occupancy and hospital capacity. This study examines heart center throughput, cascading effects of limited beds, transfer delays, and nursing staffing on outcomes utilizing elective surgery cancellation during the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic wave. This study was a retrospective single-center study of staffing, adverse events, and transfers. The study period was January 1, 2018 to December 31, 2020 with the SARS-CoV-2 period March to May 2020. There were 2,589 patients, median age 5 months (6 days–4 years), 1,543 (60%) surgical and 1,046 (40%) medical. Mortality was 3.9% ( n  = 101), median stay 5 days (3–11 days), median 1:1 nurse staffing 40% (33–48%), median occupancy 54% (43–65%) for step-down unit, and 81% (74–85%) for cardiac intensive care unit. Every 10% increase in step-down unit occupancy had a 0.5-day increase in cardiac intensive care unit stay ( p  = 0.044), 2.1% increase in 2-day readmission ( p  = 0.023), and 2.6% mortality increase ( p  < 0.001). Every 10% increase in cardiac intensive care unit occupancy had 3.4% increase in surgical delay ( p  = 0.016), 6.5% increase in transfer delay ( p  = 0.020), and a 15% increase in total reported adverse events ( p  < 0.01). Elective surgery cancellation is associated with reduced high occupancy days (23–10%, p  < 0.001), increased 1:1 nursing (34–55%, p  < 0.001), decreased transfer delays (19–4%, p  = 0.008), and decreased mortality (3.7–1.5%, p  = 0.044). In conclusion, Elective surgery cancellation was associated with increased 1:1 nursing and decreased mortality. Increased cardiac step-down unit occupancy was associated with longer cardiac intensive care unit stay, increased transfer, and surgical delays.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74924735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributing Reviewers in 2022.","authors":"","doi":"10.1055/s-0043-1761465","DOIUrl":"10.1055/s-0043-1761465","url":null,"abstract":"","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as Predictors of Disease Severity and Mortality in Critically Ill Children: A Retrospective Cohort Study","authors":"S. Shenoy, S. Patil","doi":"10.1055/s-0043-1768661","DOIUrl":"https://doi.org/10.1055/s-0043-1768661","url":null,"abstract":"Abstract The aim of this study was to determine the ability of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) to predict the severity of illness as assessed by two scoring systems, namely, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) and Pediatric Risk of Mortality-III (PRISM-III) and outcome. This was a retrospective cohort study wherein all critically ill children aged 1 month to 18 years admitted in the pediatric intensive care unit from January 2021 to October 2022 were included. Children with chronic systemic diseases and hematological illness were excluded from the study. Demographic details, diagnosis, PRISM-III-24 and PELOD-2 scores at admission, and outcome were retrieved from the hospital case records. NLR and PLR values were compared among high and normal PRISM-III and PELOD-2 groups as well as among survivors and nonsurvivors. A total of 325 patients with critical illness were included with a mean (standard deviation) age of 7(5) years and a male: female ratio of 3:2. The values of NLR were significantly higher among the patients with high PRISM-III (2.2 vs. 1.3, p -value = 0.006) and PELOD-2 (2 vs. 1.4, p -value = 0.015) groups compared with normal. The NLR and PLR were significantly higher among the nonsurvivors compared with the survivors (2.3 vs. 1.4, p -value = 0.013, and 59.4 vs. 27.3, p -value = 0.016 for NLR and PLR, respectively). The area under the receiver operating characteristics curve for NLR and PLR was 0.617 and 0.609, respectively. A high PLR, PRISM-III, and PELOD-2 were the factors found to be independently associated with mortality on multiple logistic regression analysis. Patients with high NLR are associated with more severe illness at admission. NLR and PLR are useful parameters to predict mortality.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80506431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}