Journal of Pediatric Critical Care

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Objectives: To study the variation in platelet count in critically ill children and correlate its association with their outcomes Methods: This was a prospective cross-sectional analysis of 150 critically ill children admitted in PICU of tertiary care hospital over period of 1 year. Laboratory data was collected with daily platelet counts from day of admission till death or discharge whichever was earlier in all patients. The study population was grouped as thrombocytopenic (platelet count < 150 χ 10 /L) and nonthrombocytopenic. They were compared with each other with respect to laboratory parameters and risk factors. Survivor and non survivors were compared with variation in platelet count. Decline in platelet count was correlated with mortality. Chi-square test, median test, ROC curve and forward stepwise binary logistic regression was used for statistical analysis. Results: Forty eight (32%) children had thrombocytopenia. They had significantly higher mortality [14(29.16%) vs 14(1372%)] and bleeding tendency [13(28.08%) vs 4(3.92%) than non- thrombocytopenic children. Admission thrombocytopenia was not found to be risk factor for mortality. Though survivors and non-survivors had decline in platelet count in first four days, non-survivors had significantly higher drop. Platelet counts decline >30% at 72 hours was independent risk factor (odds ratio 4.126) for mortality with high sensitivity(91.7%) and specificity (84.4%) with area under ROC curve of 0.898 which was associated with PRISMII. Conclusion: Decline in platelet count can be used as prognostic marker of poor outcome in critically ill children.

Basic pediatric intensive care course (BPICC) is a joint initiative of Pediatric Intensive Care Chapter (IAP) and the Indian Society of Critical Care Medicine, (ISCCM-Pediatrics section). This two day course was started in Critcare Conference 2009-Agra by the founder conveners Dr Praveen khilnani, Dr Rajiv Uttam and Dr Krishan Chugh. Currently more than 25 courses have been administered nation wide and more than 50 national wide instructors are teaching these courses. As the demand for this course has grown exponentially in past 4 years this additional conveners have been added on to the BPICC team as regional leaders. This addition will surely bring about efficient and effective dissemination and nationwide promotion. Following intensivists have agreed to shoulder the responsibility of being additional conveners.

We describe a case of Atypical Kawasaki disease presenting as septic shock in a 3 month old male baby. Atypical Kawasaki disease should be considered in all infants with unexplained fever for > 5 days associated with 2 or 3 of the principal clinical features of Kawasaki disease . Because young infants may present with fever and few clinical features, echocardiography should be considered in any infant aged <6 months with fever of > 7 days’ duration, laboratory evidence of systemic inflammation, and no other explanation for the febrile illness

Online since 27^th January 2020