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Báo cáo y học: "Differences in organ dysfunctions between neonates and older children: a prospective, observational, multicenter study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Differences in organ dysfunctions between neonates and older children: a prospective, observational, multicenter study. | Bestati et al. Critical Care 2010 14 R202 http ccforum.eom content 14 6 R202 c CRITICAL CARE RESEARCH Open Access Differences in organ dysfunctions between neonates and older children a prospective observational multicenter study 1 12 3 4 3 Nawar Bestati Stéphane Leteurtre Alain Duhamel Franpois Proulx Bruno Grandbastien Jacques Lacroix Francis Leclerc1 Abstract Introduction The multiple organ dysfunction syndrome MODS is a major cause of death for patients admitted to pediatric intensive care units PICU . The Pediatric Logistic Organ Dysfunction PELOD score has been validated in order to describe and quantify the severity of organ dysfunction OD . There are several physiological differences between neonates and older children. The objective of the study was to determine whether there are differences in incidence of ODs and mortality rate between full-term neonates age 28 days and older children. Methods In a prospective observational study 1806 patients admitted to seven PICUs between September 1998 and February 2000 were included. The PELOD score which includes six organ dysfunctions and 12 variables was recorded daily. For each variable the most abnormal value was used to define the daily OD. For each OD the most abnormal value each day and that during the entire stay were used in calculating the daily PELOD and PELOD scores respectively. The relationships between OD daily OD PELOD daily PELOD and mortality were compared between the two strata neonates older children based on the discrimination power logistic and multiple regression analyses. Results Of the 1806 enrolled patients 171 9.5 were neonates. Incidence of MODS and mortality rate were higher among neonates than in older children 14.6 vs. 5.5 P 10-7 75.4 vs. 50.9 P 10-4 respectively . Daily PELOD scores were significantly higher in neonates from day 1 to day 4. Daily cardiovascular respiratory and renal dysfunction scores from day 1 to day 4 as well as the PELOD score for the entire pediatric intensive .