Poster ID: 40.097

2005-2006 M ortality and intubation ofIC U patients w ith single diagnosis ofpneum onia 0 5 10 15 20 25 m ortality Intubation p ercen tag e o f p atien ts 2005 2006 CPAP protocol reduces intubation and mortality in resource limited settings Author(s):Y. Pagnarith 1 , S. Chhomrath 1 , J. Reynolds 2 , V. Kumar 1 Affiliation: 1 Angkor Hospital for Children, Siem Reap, Cambodia, 2 Blank Children's Hospital, Des Moines, IA, USA Poster ID: 40.097 CPAP Set-up (total cost = $30) Tube to oxygen source (O 2 tank) Plastic tubing to transmit pressure Water bottle to provide pressure Background: Pneumonia is a leading cause of mortality in the developing world. Many recent studies have suggested that low-cost and minimally invasive interventions are critical in reducing mortality in severely ill infants and children in resource- limited settings. We hypothesize that CPAP, used aggressively, will decrease intubations and improve the mortality of patients diagnosed with severe pneumonia who are admitted to the intensive care unit (ICU) of Angkor Hospital for Children (AHC) in Cambodia Results: In 2005 and 2006, 101 and 151 patients were admitted respectively with a sole diagnosis of pneumonia. In 2006 compared to 2005, intubations among these patients decreased by 47% and mortality decreased by 77%. Methods: AHC’s ICU patient log book was reviewed for the year 2005 and all patients were placed in a database according to diagnosis, intubation, and mortality. The available evidence was reviewed and an evidence-based protocol for CPAP was developed by AHC staff. The protocol was implemented in January 2006 and data was collected prospectively on diagnosis, intubation, CPAP use, and mortality for the year 2006. Conclusion: Early intervention with a minimally invasive, low-cost, evidence based CPAP protocol reduces intubation and improves mortality in patients with pneumonia presenting to a children’s hospital in a resource-limited setting. AHC CPAP Protocol Nasal prongs to patient Depth of tubing determines level of CPAP (i.e. 6 cm H 2 O) AHC PICU diagnosis 7% 15% 31% 7% 6% 5% 29% Pneum onia Sepsis Meningitis Neonatal Infection Congenital HeartDisease D engue Hem orrhagic Fever Other

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Poster ID: 40.097. CPAP protocol reduces intubation and mortality in resource limited settings Author(s):Y. Pagnarith 1 , S. Chhomrath 1 , J. Reynolds 2 , V. Kumar 1 Affiliation: 1 Angkor Hospital for Children, Siem Reap, Cambodia, 2 Blank Children's Hospital, Des Moines, IA, USA. - PowerPoint PPT Presentation

Transcript of Poster ID: 40.097

2005-2006 Mortality and intubation of ICU patients with single diagnosis of pneumonia

mortality Intubation

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2005

2006

CPAP protocol reduces intubation and mortality in resource limited settings

Author(s):Y. Pagnarith1, S. Chhomrath1, J. Reynolds2, V. Kumar1

Affiliation:1Angkor Hospital for Children, Siem Reap, Cambodia, 2Blank Children's Hospital, Des Moines, IA, USA

Poster ID: 40.097

CPAP Set-up (total cost = $30)

Tube to oxygen source (O2 tank)

Plastic tubing to transmit pressure

Water bottle to provide pressure

Background: Pneumonia is a leading cause of mortality in the developing world. Many recent studies have suggested that low-cost and minimally invasive interventions are critical in reducing mortality in severely ill infants and children in resource-limited settings. We hypothesize that CPAP, used aggressively, will decrease intubations and improve the mortality of patients diagnosed with severe pneumonia who are admitted to the intensive care unit (ICU) of Angkor Hospital for Children (AHC) in Cambodia

Results: In 2005 and 2006, 101 and 151 patients were admitted respectively with a sole diagnosis of pneumonia. In 2006 compared to 2005, intubations among these patients decreased by 47% and mortality decreased by 77%.

Methods: AHC’s ICU patient log book was reviewed for the year 2005 and all patients were placed in a database according to diagnosis, intubation, and mortality. The available evidence was reviewed and an evidence-based protocol for CPAP was developed by AHC staff. The protocol was implemented in January 2006 and data was collected prospectively on diagnosis, intubation, CPAP use, and mortality for the year 2006.

Conclusion: Early intervention with a minimally invasive, low-cost, evidence based CPAP protocol reduces intubation and improves mortality in patients with pneumonia presenting to a children’s hospital in a resource-limited setting.

AHC CPAP Protocol

Nasal prongs to patient

Depth of tubing determines level

of CPAP (i.e. 6 cm H2O)

AHC PICU diagnosis

15%

31%

7%6%

29%

Pneumonia

Sepsis

Meningitis