Abstract:
OBJECTIVE:To determine how many children are admitted to paediatric intensive care unit (PICU) with life-limiting conditions (LLCs) and their outcomes. DESIGN:National cohort, data-linkage study. SETTING:PICUs in England. PATIENTS:Children admitted to a UK PICU (1 January 2004 and 31 March 2015) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to hospital episodes statistics enabled identification of children with a LLC using an International Classification of Diseases (ICD10) code list. MAIN OUTCOME MEASURES:Random-effects logistic regression was undertaken to assess risk of death in PICU. Flexible parametric survival modelling was used to assess survival in the year after discharge. RESULTS:Overall, 57.6% (n=89 127) of PICU admissions and 72.90% (n=4821) of deaths in PICU were for an individual with a LLC.The crude mortality rate in PICU was 5.4% for those with a LLC and 2.7% of those without a LLC. In the fully adjusted model, children with a LLC were 75% more likely than those without a LLC to die in PICU (OR 1.75 (95% CI 1.64 to 1.87)).Although overall survival to 1 year postdischarge was 96%, children with a LLC were 2.5 times more likely to die in that year than children without a LLC (OR 2.59 (95% CI 2.47 to 2.71)). CONCLUSIONS:Children with a LLC accounted for a large proportion of the PICU population. There is an opportunity to integrate specialist paediatric palliative care services with paediatric critical care to enable choice around place of care for these children and families.
journal_name
Arch Dis Childjournal_title
Archives of disease in childhoodauthors
Fraser LK,Parslow Rdoi
10.1136/archdischild-2017-312638subject
Has Abstractpub_date
2018-06-01 00:00:00pages
540-547issue
6eissn
0003-9888issn
1468-2044pii
archdischild-2017-312638journal_volume
103pub_type
杂志文章abstract::Two siblings were born with congenital heart block, and one suffered from severe hydrops fetalis, although maintaining a higher heart rate than the other. The association of hydrops fetalis with disorders of cardiac rhythm is unlikely to be simply a manifestation of congestive cardiac failure in the fetus. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.55.6.479
更新日期:1980-06-01 00:00:00
abstract::Persistent daytime incontinence is a fairly uncommon but important problem. Videourodynamic studies were carried out in 215 children presenting with this problem in whom there were no neurological signs and who had not responded to simple measures. Over 90% of symptomatic children were shown to have an abnormality, of...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.2.128
更新日期:1987-02-01 00:00:00
abstract::Preterm infants with symptomatic patent ductus arteriosus had considerably raised plasma concentrations of atrial natriuretic peptide. Surgical ligation of the patent ductus arteriosus was associated with an immediate fall in plasma atrial natriuretic peptide concentration. Thus left to right shunting and left atrial ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.62.11.1165
更新日期:1987-11-01 00:00:00
abstract::Non-accidental injury should be suspected and excluded in any infant found to have intracranial and retinal haemorrhage of unknown aetiology. This can be a sensitive issue for both medical staff and parents. We present a case in which the underlying cause of intracranial and retinal haemorrhage was fibromuscular dyspl...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.84.3.263
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:To assess the natural history of respiratory symptoms not labelled as asthma in primary schoolchildren. DESIGN:Repeat questionnaire survey of subgroups identified from a previous questionnaire survey after a two year delay. SUBJECTS:The original population of 5321 Sheffield children aged 8-9 years yielded 4...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.5.385
更新日期:1996-11-01 00:00:00
abstract::The sodium intake of preschool children in their home environment was investigated and the major sources of sodium other than added table salt identified. Thirty five children from a Southampton general practice were studied. Twenty four hour urinary sodium excretion was measured as a reliable indicator of daily total...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.61.2.159
更新日期:1986-02-01 00:00:00
abstract::Infantile liver disease with deficiency of serum alpha1-antitrypsin is illustrated by a description of the clinical, biochemical, and pathological findings in two affected families. The simplicity of the diagnostic tests is emphasized. Review of 61 biopsies of liver from children and adolescents provided a further 3 c...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.51.8.584
更新日期:1976-08-01 00:00:00
abstract:METHODS:A total of 43 children with neurological signs and symptoms were enrolled in the study. All children were suspected of having meningitis, and lumbar punctures were performed. Human herpesvirus 6 (HHV-6) and HHV-7 DNA was detected in cerebrospinal fluid (CSF) and peripheral blood mononuclear cells (PBMC) by nest...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.83.2.170
更新日期:2000-08-01 00:00:00
abstract::Circulating erythroid progenitors (BFU-E) in five anaemic preterm infants (haemoglobin less than 100 g/l) were about 2 and 4.4 times as abundant as in 10 preterm infants who were not anaemic and five healthy adults, respectively, and were significantly more responsive to low concentrations of recombinant human erythro...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.66.7_spec_no.810
更新日期:1991-07-01 00:00:00
abstract::We describe a prospective study in which we investigated why children fail to get vaccinated against whooping cough, including an assessment of the attitudes of parents and professionals and the impact of different views of the contraindications. There was considerable disagreement among the professionals on the inter...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.61.4.382
更新日期:1986-04-01 00:00:00
abstract::A cohort of schoolchildren was followed up over 6 years from 1996 to 2001. In the final year, 315 of 500 targeted children were measured. Body mass index (BMI) increased substantially over time (p<0.001), indicating a further rise in obesity into the secondary school years. Two new indicators of obesity were also meas...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2002.020552
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To examine the prevalence of dysnatraemias among children admitted for paediatric surgery before and after a change from hypotonic to isotonic intravenous maintenance fluid therapy. DESIGN:Retrospective consecutive time series intervention study. SETTING:Paediatric surgery ward at the Children's Hospital in...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2019-318555
更新日期:2020-10-28 00:00:00
abstract::Three cases of pseudoparalysis in infancy are reported in which the appearance of localized infection in the affected limb was delayed for a variable period after the onset of pseudoparalysis. Blood cultures on admission in all cases were positive, and bacteraemia due to the three organisms isolated is discussed. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.50.12.953
更新日期:1975-12-01 00:00:00
abstract::Four child-protection scenarios were sent to 200 named/designated and non-named/non-designated doctors. The respondents judged each scenario as abuse or accident and indicated their degree of certainty. There was a 71% response rate. There were no significant differences in judgement or degrees of certainty of judgeme...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.105528
更新日期:2008-07-01 00:00:00
abstract::An indirect fluorescent antibody test for Bartonella henselae, B quintana, and B elizabethae was performed in all 18 children who presented to our paediatric outpatient clinic with cat scratch disease over a six year period. Serum samples were taken on admission, after 15 days, and after six months. Diagnosis was conf...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.78.1.64
更新日期:1998-01-01 00:00:00
abstract::Fundamental to appropriate nutritional prescription is an understanding of the conditions necessary for growth that include the requirements for energy in health and illness. Energy requirements need to be met by the dietary intake to prevent weight loss. A positive energy balance will result in weight gain. Energy re...
journal_title:Archives of disease in childhood
pub_type: 杂志文章,评审
doi:10.1136/adc.2009.158303
更新日期:2011-06-01 00:00:00
abstract::Growth was studied in 83 children with cleft lip and/or palate aged 0-4 years attending a specialist regional centre. Information was collected by a personal interview, postal questionnaire, and record review. The group as a whole grew relatively poorly in early infancy but subsequently recovered, attaining both expec...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.4.327
更新日期:1996-10-01 00:00:00
abstract:AIM:To reduce the overall expenditure on melatonin for the local health economy by working collaboratively with the CCG's. To ensure that all paediatric patients prescribed melatonin have been clinically assessed by a specialist and the most appropriate formulation is dispensed. METHOD:Evaluation of GP melatonin presc...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.49
更新日期:2016-09-01 00:00:00
abstract::The bowel habits in 844 preterm infants were observed during the first 56 days after birth. Delay in the passage of meconium beyond the second day occurred in 32%, and there was an inverse relation between gestational age and the day of first bowel action. Thereafter the increase in frequency of stools passed each day...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.68.3_spec_no.317
更新日期:1993-03-01 00:00:00
abstract:AIM:To determine the impact of displacement values on doses in paediatric patients when using parenteral. To assess the option of using average displacement values (DV) in the preparation of parenteral medicines. METHOD:Over 500 Medusa1 monographs were analysed and 42 medicines were identified with a displacement valu...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2016-311535.30
更新日期:2016-09-01 00:00:00
abstract::Six children with congenital heart disease are described in whom poor growth was found to be due to small-bowel villous atrophy; none was in heart failure and only one was severely cyanosed. Growth improved in all 6 on a gluten-free diet. Gluten enteropathy may be more common than is realised in children with congenit...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::A case of partial trisomy of the long arm of chromosome 3 (3q21 leads to qter) is described. The clinical findings are compared with those in 5 previously reported cases. There is hirsutism and characteristic facial dysmorphism, the common features of which are a square-shaped face, prominent nasal bridge, everted nos...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.54.2.135
更新日期:1979-02-01 00:00:00
abstract:OBJECTIVE:To review the work of one tertiary paediatric palliative care service in facilitating planned withdrawal of ventilatory support outside the intensive care setting, with the purpose of developing local guidance for practice. METHODS:Retrospective 10-year (2003-2012) case note review of intensive care patients...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/archdischild-2013-305492
更新日期:2014-09-01 00:00:00
abstract::Of 80 children with proved coeliac disease, 2 presented with an associated disease of the distal portion of the large intestine. In one child the family history and the extension, localisation, and characteristics of intestinal lesions made us suspect ulcerative colitis; in the other we made a diagnosis of milk-induce...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.53.8.645
更新日期:1978-08-01 00:00:00
abstract::Growth velocity of head circumference was studied longitudinally in different gestational age groups of 222 appropriate-weight-for-dates (AFD) and 94 small-for-dates (SFD) healthy infants during the first 5 months of life. Term AFD and SFD infants showed a steady slowing of growth rate of head circumference from birth...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.52.2.105
更新日期:1977-02-01 00:00:00
abstract:PURPOSE:To examine the experiences and concerns of young people and their parents regarding the management of medication for asthma or diabetes whilst at school. METHODS:Face-to-face semi-structured interviews were conducted with 69 young people aged 8-15 years (43 with asthma and 26 with diabetes) and their parents (...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2006.110536
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Timing of referral to subspecialists may be a major determinant for access to adequate treatment. Kidney transplantation is the preferred modality of renal replacement therapy (RRT) in children. In adults, delayed referral from general physicians to nephrologists reduced access to kidney transplantation. Thi...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2009.174581
更新日期:2010-08-01 00:00:00
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journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.75.2.115
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Rectal measurement is considered a gold standard in many healthcare systems for body temperature measurement in children. Although this method has several disadvantages, an ideal alternative thermometer has not yet been introduced. However tympanic and infrared skin thermometers are potential alternatives. ...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.2010.185801
更新日期:2010-12-01 00:00:00
abstract::An infant with chronic cytomegalovirus hepatitis and a child with atypical Alagille's syndrome had vitamin D deficiency rickets due to malabsorption. Both received ultraviolet irradiation. This treatment corrected biochemical abnormalities and healed the rickets. In the infant use of a sunlamp at home maintained norma...
journal_title:Archives of disease in childhood
pub_type: 杂志文章
doi:10.1136/adc.64.4.617
更新日期:1989-04-01 00:00:00