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A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life
Background: Prematurity is a major risk factor for morbidity and mortality in children. Rehospitalisation with paediatric intensive care unit (PICU) admission constitutes significant morbidity. There is a paucity of literature regarding rehospitalisations of premature infants in South Africa. Ob...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2019
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| _version_ | 1867613189164761088 |
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| access_status_str | Open Access |
| author | Mathew, Grace |
| author2 | Rossouw, Beyra |
| author_browse | Mathew, Grace Rossouw, Beyra |
| author_facet | Rossouw, Beyra Mathew, Grace |
| author_sort | Mathew, Grace |
| collection | Thesis |
| description | Background: Prematurity is a major risk factor for morbidity and mortality in children.
Rehospitalisation with paediatric intensive care unit (PICU) admission constitutes
significant morbidity. There is a paucity of literature regarding rehospitalisations of
premature infants in South Africa.
Objective: To describe the outcomes, clinical course and characteristics of premature
infants admitted to a South African PICU, and to identify any predictors of mortality.
Methods: This prospective observational study analysed unplanned PICU admissions of
premature and ex-premature infants in the first six months of life, over a six-month
period. The primary and secondary outcomes were mortality and length of PICU stay,
respectively. Data were analysed using standard descriptive and inferential statistics.
Results: 29 infants (65% male; median (IQR) birth weight (BW) and gestational age (GA)
1715 (1130 - 2340) g and 32 (29 - 34) weeks respectively) in 33 admissions were included.
Five (17.2%) infants died in PICU.
Apnoea (39.4%), respiratory failure (24.2%) and shock (24.2%) were the commonest
reasons for PICU admission, secondary to pneumonia (33.3%), sepsis (27.3%) and
meningitis (12.1%). 72.4% of infants were mechanically ventilated and 48.3% received
blood transfusions.
Higher revised Paediatric Risk of Mortality (PIM2) score (p = 0.03), inotrope use (p <
0.0001), longer duration of mechanical ventilation (p = 0.03), and cardiac arrest in PICU (p
< 0.0001) were associated with mortality on univariate analysis with no independent
predictors of mortality.
Conclusion: Infections leading to apnoea, respiratory failure and shock are common
indications for PICU readmission in premature infants. Mechanical ventilation and blood
transfusion were frequently required. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/30164 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:11.035Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/30164 A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life Mathew, Grace Rossouw, Beyra Background: Prematurity is a major risk factor for morbidity and mortality in children. Rehospitalisation with paediatric intensive care unit (PICU) admission constitutes significant morbidity. There is a paucity of literature regarding rehospitalisations of premature infants in South Africa. Objective: To describe the outcomes, clinical course and characteristics of premature infants admitted to a South African PICU, and to identify any predictors of mortality. Methods: This prospective observational study analysed unplanned PICU admissions of premature and ex-premature infants in the first six months of life, over a six-month period. The primary and secondary outcomes were mortality and length of PICU stay, respectively. Data were analysed using standard descriptive and inferential statistics. Results: 29 infants (65% male; median (IQR) birth weight (BW) and gestational age (GA) 1715 (1130 - 2340) g and 32 (29 - 34) weeks respectively) in 33 admissions were included. Five (17.2%) infants died in PICU. Apnoea (39.4%), respiratory failure (24.2%) and shock (24.2%) were the commonest reasons for PICU admission, secondary to pneumonia (33.3%), sepsis (27.3%) and meningitis (12.1%). 72.4% of infants were mechanically ventilated and 48.3% received blood transfusions. Higher revised Paediatric Risk of Mortality (PIM2) score (p = 0.03), inotrope use (p < 0.0001), longer duration of mechanical ventilation (p = 0.03), and cardiac arrest in PICU (p < 0.0001) were associated with mortality on univariate analysis with no independent predictors of mortality. Conclusion: Infections leading to apnoea, respiratory failure and shock are common indications for PICU readmission in premature infants. Mechanical ventilation and blood transfusion were frequently required. 2019-05-16T13:27:53Z 2019-05-16T13:27:53Z 2018 2019-05-16T10:39:53Z Master Thesis Masters MMed (Paediatrics) http://hdl.handle.net/11427/30164 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences |
| spellingShingle | Mathew, Grace A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| thesis_degree_str | Master's |
| title | A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| title_full | A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| title_fullStr | A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| title_full_unstemmed | A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| title_short | A description of premature and ex-premature infants admitted to a Paediatric Intensive Care Unit in the first six months of life |
| title_sort | description of premature and ex premature infants admitted to a paediatric intensive care unit in the first six months of life |
| url | http://hdl.handle.net/11427/30164 |
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