Abstract P-264: GASTROINTESTINAL COMPLICATIONS IN CRITICALLY ILL CHILDREN: A PROSPECTIVE OBSERVATIONAL STUDY POTENTIALLY AVOIDABLE DEATHS IN PEDIATRIC INTENSIVE CARE UNIT; LEARNING FROM A RETROSPECTIVE MORTALITY ANALYSIS.

Abstract

Aims & Objectives: To describe the frequency of gastrointestinal complications (GIC) and its association with outcome in critically ill children. Methods Design: A prospective, observational cohort study Setting: A closed multidisciplinary Pediatric intensive care unit (PICU) of an academic hospital of a developing country Subjects: All children (aged 1month to 16 years) admitted in Pediatric Intensive Care Unit PICU during the study period. Patients admitted with GIC or after laparotomy and stayed less than 24 hours were excluded. Results The frequency of the defined GIC: vomiting, high gastric residue volume (GRV), diarrhea, constipation, gastrointestinal bleed, intra-abdominal hypertension were recorded on daily basis for first week of PICU stay. Of total 190 patients, 78 (41%) patients had one or more GIC. GIC in our cohort were high GRV in 37/190 patients (19.4%), constipation in 31/190 patients (16.3%), vomiting in 18/190 patients (9.4%), abdominal distension in 13/190 (6.8%), diarrhea in 12/190 (6.3%), gastro-intestinal bleed in 9/190 (4.7%) and intra-abdominal hypertension in 4/190 (2.1%) patients. The children receiving mechanical ventilation (88%) and those with multiorgan dysfunction syndrome (MODS) (47%) were more likely to develop GIC (p<0.05). Patients with GIC had length of stay of 6.2 ± 3.74 days compared to 4.3 ± 2.84 days in those without GIC (p <0.05). There was no mortality difference observed between GIC and non GIC group (p = 0.14). Conclusions The frequency of GIC was high in our cohort, was observed more frequently in children on mechanical ventilation and patients with MODS. GIC was not associated with mortality.