What is the course of secondary pancreatitis in pediatric intensive care unit?

Öz

Purpose: Acute pancreatitis is diagnosed frequently in the pediatric population. Course of acute pancreatitis in children is usually mild. However, severe pancreatitis may develop in some patients with the local or systemic complications. Course of secondary acute pancreatitis in children in the pediatric intensive care unit is unknown.
Aim of this study is to evaluate the clinical characteristics and outcome of children who developed secondary acute pancreatitis in a tertiary pediatric intensive care unit.
Material and methods: Children hospitalized in pediatric intensive care unit for different causes and developed secondary acute pancreatitis were included into this retrospective study. Demographic features of the patients, duration of hospitalization in intensive care unit, primary disease causing hospitalization, other underlying diseases, duration of mechanical ventilation, pediatric mortality risk score III and nutritional status were conducted from hospital records.
Results: Seventy-seven children (58.4%male and mean age: 6.7 years) were included in the study. The most common underlying disease was neurological diseases (19.5%). Majority (46.7%) of the secondary pancreatitis was severe. 68.8% of the children with secondary pancreatitis were on mechanical ventilation. Duration of hospitalization and time on mechanical ventilator was significantly longer in patients with severe pancreatitis. The mean pediatric mortality risk III score was also significantly higher in this group.
Conclusion: Although acute pancreatitis in children has a mild course, secondary acute pancreatitis is often severe and has a high mortality rate in children in the pediatric intensive care unit.

Anahtar Kelimeler

• Children
• secondary pancreatitis
• pediatric intensive care unit

Pediatrik yoğun bakım ünitelerinde gözlenen sekonder pankreatitlerin seyri nasıldır?

Öz

Amaç: Akut pankreatit pediatrik popülasyonda sıklıkla teşhis edilir. Çocuklarda akut pankreatitin seyri genellikle hafiftir. Ancak bazı hastalarda lokal veya sistemik komplikasyonları olan ciddi pankreatit gelişebilir. Pediatrik yoğun bakım ünitesindeki çocuklarda sekonder akut pankreatitin seyri bilinmemektedir. Bu çalışmanın amacı, üçüncü basamak bir pediatrik yoğun bakım ünitesinde sekonder akut pankreatit gelişen çocukların klinik özelliklerini ve sonuçlarını değerlendirmektir.
Gereç ve yöntem: Bu retrospektif çalışmaya çocuk yoğun bakım ünitesine farklı nedenlerle yatırılan ve sekonder akut pankreatit gelişen çocuklar dahil edildi. Hastaların demografik özellikleri, yoğun bakım ünitesinde yatış süreleri, yatışa neden olan birincil hastalıkları, altta yatan diğer hastalıklar, mekanik ventilasyon süresi, pediatrik mortalite risk skoru III ve beslenme durumları hastane kayıtlarından alındı.
Bulgular: Yetmiş yedi çocuk (%58,4 erkek ve ortalama yaş: 6,7 yıl) çalışmaya dahil edildi. En sık altta yatan hastalık nörolojik hastalıklardı (%19,5). Sekonder pankreatitin çoğunluğu (%46,7) şiddetli idi. Sekonder pankreatitli çocukların %68,8'i mekanik ventilatördeydi. Ağır pankreatitli hastalarda hastanede kalış süresi ve mekanik ventilatörde geçirilen süre anlamlı olarak daha uzundu. Ortalama pediatrik mortalite risk skoru III de bu grupta anlamlı olarak daha yüksekti.
Sonuç: Çocuklarda akut pankreatit hafif seyirli olmasına rağmen, sekonder akut pankreatit, çocuk yoğun bakım ünitesindeki çocuklarda sıklıkla şiddetlidir ve mortalite oranı yüksektir.

Anahtar Kelimeler

• Çocuk
• sekonder pankreatit
• pediatrik yoğun bakım ünitesi

Kaynakça

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