• Users Online: 220
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
EDITORIAL
Year : 2018  |  Volume : 2  |  Issue : 4  |  Page : 57

Outcomes and prediction


Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Dr. Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia

Date of Web Publication28-Dec-2018

Correspondence Address:
Rina Triasih
Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Dr. Sardjito Hospital, Universitas Gadjah Mada, Jl. Kesehatan 1, Yogyakarta
Indonesia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2543-0343.249003

Rights and Permissions

How to cite this article:
Triasih R. Outcomes and prediction. Pediatr Respirol Crit Care Med 2018;2:57

How to cite this URL:
Triasih R. Outcomes and prediction. Pediatr Respirol Crit Care Med [serial online] 2018 [cited 2019 Jan 21];2:57. Available from: http://www.prccm.org/text.asp?2018/2/4/57/249003



Understanding the short-term and long-term outcomes of diseases is of importance for clinicians. Moreover, recognizing factors that predict the outcomes may assist the clinicians to make a clinical decision in choosing investigations, providing treatment, and considering ethical issues and economic strategies. In this issue, three articles discussing outcomes of diseases and conditions related to respiratory problems and intensive care for children with different point of views are presented.

One of the significant adverse outcomes of obstructive sleep-disordered breathing (SDB) in children is neurocognitive dysfunction and behavioral problems.[1],[2] This is thought as a result of recurrent nocturnal hypoxia and sleep fragmentation that occur during SDB. In the first article of this issue, Walter and Horne present a comprehensive review, compiling recent studies evaluating the effect of SDB in the child brain, which used near-infrared spectroscopy or functional magnetic resonance imaging of the brain.[3] From a limited number of studies, it was shown that children with SDB are better in maintaining cerebral oxygenation than adults, but SDB leads to adverse outcomes on the autonomic control, respiration, behavior, and neurocognition.

Lung is one of the major organs affected in sickle cell anemia (SCA).[4] Children with SCA are prone to have recurrent and chronic pulmonary diseases, which cause lung damage and may result in long-term outcomes of abnormalities of the lung function. In this issue, Kuti and Adegoke reported that restrictive lung function abnormalities were more common among Nigerian children with SCA compared to healthy children.[5] They also documented that children who were at adolescent age and had previous acute chest syndrome are more likely to have the lung function abnormalities. For clinicians, information of at which age is the lung function impairments is started is also important; hence, we can start aggressive treatment at that age to prevent chronic lung damage.

The short-term outcomes of children admitted to pediatric intensive care unit (PICU) are varied, but they are at high risk for mortality. A simple and objective tool to characterize the disease severity at admission and to predict mortality among these children is needed. The ideal tool should be simple, easy to use, low cost, easy to reproduce, minimally invasive, and accurate and does not require sophisticated tool. The Pediatric Risk of Mortality (PRISM) III is one of the scoring systems that has been used widely and had a good prediction for mortality.[6] Nevertheless, this scoring system needs arterial blood gas analysis as one of the variables, which is invasive and sometimes is not feasible to be performed in critically ill patients. Ruangnapa et al. developed and validated a modified PRISM III score, by removing blood gas analysis and added a number of clinical features.[7] This modified scoring system showed as good as the PRISM III performance in predicting mortality in PICU, not only in the first 2 days of hospitalization but also in 7-day mortality and overall mortality. The more simple and less invasive of the modified PRISM III will be more feasible for resource-limited settings such as in many countries in Asia.



 
  References Top

1.
Kohler MJ, Lushington K, Kennedy JD. Neurocognitive performance and behavior before and after treatment for sleep-disordered breathing in children. Nat Sci Sleep 2010;2:159-85.  Back to cited text no. 1
    
2.
Bourke RS, Anderson V, Yang JS, Jackman AR, Killedar A, Nixon GM, et al. Neurobehavioral function is impaired in children with all severities of sleep disordered breathing. Sleep Med 2011;12:222-9.  Back to cited text no. 2
    
3.
Walter LM, Horne RS. Obstructive sleep-disordered breathing in children: Impact on the developing brain. Pediatr Respirol Crit Care Med 2018;2:58-64.  Back to cited text no. 3
  [Full text]  
4.
Knight J, Murphy TM, Browning I. The lung in sickle cell disease. Pediatr Pulmonol 1999;28:205-16.  Back to cited text no. 4
    
5.
Kuti BP, Adegoke SA. Pulmonary function abnormalities in Nigerian children with sickle cell anaemia: Prevalence, pattern and predictive factors. Pediatr Respirol Crit Care Med 2018;2:73-9.  Back to cited text no. 5
  [Full text]  
6.
Pollack MM, Patel KM, Ruttimann UE. PRISM III: An updated pediatric risk of mortality score. Crit Care Med 1996;24:743-52.  Back to cited text no. 6
    
7.
Ruangnapa K, Sucheewakul S, Liabsuetrakul T, McNeil E, Lim K, Anantaseree W. Validation of a modified Pediatric Risk of Mortality III model in a pediatric intensive care unit in Thailand. Pediatr Respirol Crit Care Med 2018;2:65-72.  Back to cited text no. 7
  [Full text]  




 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References

 Article Access Statistics
    Viewed186    
    Printed11    
    Emailed0    
    PDF Downloaded47    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]