Dataset Information

Adverse drug events in a paediatric intensive care unit: a prospective cohort.

ABSTRACT:

Objectives

To describe adverse drug events (ADEs) in children under intensive care, identify risk factors and tools that can detect ADEs early, and the impact on length of stay (LOS).

Design

A prospective observational study.

Setting

Paediatric intensive care unit of a tertiary care teaching hospital.

Patients

239 patients with a mean age of 67.5 months representing 1818 days of hospitalisation in intensive care unit.

Interventions

Active search of charts and electronic patient records using triggers. The statistical analysis involved linear and logistic regression.

Measurements and main results

The average LOS was 7.6 days. There were 110 proven, probable and possible ADEs in 84 patients (35.1%). We observed 138 instances of triggers. The major classes of drugs associated with events were: antibiotics (n=41), diuretics (n=24), antiseizures (n=23), sedatives and analgesics (n=17) and steroids (n=18). The number of drugs administered was most related to the occurrence of ADEs and also to the LOS (p<0.001). The occurrence of an ADE may result in an increase in the LOS by 1.5 days per event, but this was not statistically significant in this sample. Patients aged less than 48 months also proved to be at a significant risk for ADEs, with an OR of 1.84 (95% CI 1.07 to 3.15, p=0.025). The number of drugs administered also correlated with the number of ADEs (p<0.0001). The chance of having at least one ADE increased linearly as the patient was administered more drugs.

Conclusions

The use of multiple drugs as well as lower patient age favours the occurrence of ADEs. The active search described here provides a systematic approach to this problem.

SUBMITTER: Silva DC

PROVIDER: S-EPMC3586175 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Adverse drug events in a paediatric intensive care unit: a prospective cohort.

Silva Dafne C B DC Araujo Orlei Ribeiro OR Arduini Rodrigo G RG Alonso Carolina F R CF Shibata Audrey R O AR Troster Eduardo J EJ

BMJ open 20130219 2

<h4>Objectives</h4>To describe adverse drug events (ADEs) in children under intensive care, identify risk factors and tools that can detect ADEs early, and the impact on length of stay (LOS).<h4>Design</h4>A prospective observational study.<h4>Setting</h4>Paediatric intensive care unit of a tertiary care teaching hospital.<h4>Patients</h4>239 patients with a mean age of 67.5 months representing 1818 days of hospitalisation in intensive care unit.<h4>Interventions</h4>Active search of charts and ...[more]

PMID: 23427200

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Project description:The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens. Our results showed that both 24-hour average indoor particle mass (PM10) (0.6-2.2μgm-3, median: 0.9μgm-3) and submicrometer particle number (PN) (0.1-2.8×103pcm-3, median: 0.67×103pcm-3) concentrations were significantly lower (p<0.01) than the outdoor concentrations (6.7-10.2μgm-3, median: 8.0μgm-3 for PM10 and 12.1-22.2×103pcm-3, median: 16.4×103pcm-3 for PN). In general, we found that indoor particle concentrations in the PICU were mainly affected by indoor particle sources, with outdoor particles providing a negligible background. We identified strong indoor particle sources in the PICU, which occasionally increased indoor PN and PM10 concentrations from 0.1×103 to 100×103pcm-3, and from 2μgm-3 to 70μgm-3, respectively. The most substantial indoor particle sources were nebulization therapy, tracheal suction and cleaning activities. The average PM10 and PN emission rates of nebulization therapy ranged from 1.29 to 7.41mgmin-1 and from 1.20 to 3.96pmin-1×1011, respectively. Based on multipoint measurement data, it was found that particles generated at each location could be quickly transported to other locations, even when originating from isolated single-bed rooms. The most commonly isolated bacterial genera from both primary and broth cultures were skin commensals while viruses were rarely identified. Based on the findings from the study, we developed a set of practical recommendations for PICU design, as well as for medical and cleaning staff to mitigate aerosol generation and transmission to minimize infection risk to PICU patients.

Dataset Information

Adverse drug events in a paediatric intensive care unit: a prospective cohort.

Objectives

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

Publications

Adverse drug events in a paediatric intensive care unit: a prospective cohort.

Similar Datasets

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