Chaurasiya Om S, Rana Sachin, Chhabra Kawalpreet, Singh Mayank
Paediatrics, Maharani Laxmi Bai Medical College, Jhansi, IND.
Cureus. 2024 Dec 6;16(12):e75252. doi: 10.7759/cureus.75252. eCollection 2024 Dec.
Introduction The pediatric intensive care unit (PICU) is a specialized area for treating critically ill infants and children. However, some of these children may experience poor outcomes, including death. However, it is necessary to predict the prognosis for critically ill patients as early as possible to commence triage as well as an early and effective intervention to prevent mortality. The objective was to evaluate C-reactive protein (CRP) to albumin ratio and fluid overload as predictors of mortality in critically ill children and adolescents (one month to 18 years). Methodology This was a prospective, observational study conducted on 100 critically ill cases admitted to the PICU in a tertiary care hospital. Demographic profiles and clinical manifestations were noted, and baseline investigations were carried out. Children were provided treatment according to PICU protocols. CRP and serum albumin levels were measured, and fluid intake and output were documented in detail. Results The mean CRP/albumin ratio in the survivor group was 16.39±14.161, while in the non-survivor group, it was reported to be 12.95±11.905. The mean CRP/albumin ratio among the patients who required ventilation for <3 days, 3-5 days, and >5 days were 16.91±14.35, 12.90±10.80, and 2.0±0.321, respectively. The mean value for fluid overload in the survivor group was 10.90±7.44 and in the non-survivor group was 20.54±18.727. The mean fluid overload among the patients who required ventilation for <3 days, 3-5 days, and >5 days were 14.61±9.639, 19.30±13.21, and 20.74±19.81, respectively. CRP/albumin ratio was directly related to increased ventilation in critically ill patients, inversely proportional to ventilatory stay. Fluid overload was directly associated with the development of multiple organ dysfunction syndrome (MODS). Conclusion It was concluded that fluid overload can be used as a predictor of poor outcome though CRP/albumin ratio still warrants further studies.
引言 儿科重症监护病房（PICU）是治疗重症婴幼儿和儿童的专业区域。然而，这些儿童中的一些可能预后不佳，包括死亡。然而，有必要尽早预测重症患者的预后，以便进行分诊以及早期有效的干预以预防死亡。目的是评估C反应蛋白（CRP）与白蛋白的比值以及液体超负荷情况，作为重症儿童和青少年（1个月至18岁）死亡的预测指标。方法 这是一项对一家三级护理医院PICU收治的100例重症病例进行的前瞻性观察研究。记录人口统计学资料和临床表现，并进行基线检查。根据PICU方案为儿童提供治疗。测量CRP和血清白蛋白水平，并详细记录液体出入量。结果 存活组的平均CRP/白蛋白比值为16.39±14.161，而非存活组据报告为12.95±11.905。需要通气<3天、3 - 5天和>5天的患者的平均CRP/白蛋白比值分别为16.91±14.35、12.90±10.80和2.0±0.321。存活组的液体超负荷平均值为10.90±7.44，非存活组为20.54±18.727。需要通气<3天、3 - 5天和>5天的患者的平均液体超负荷分别为14.61±9.639、19.30±13.21和20.74±19.
