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Okafor Ugochukwu, Azike Jerome. An audit of intensive care unit admission in a pediatric cardio-thoracic population in Enugu, Nigeria. The Pan African Medical Journal. 2010;6:10 Key words: Audit, cardio-thoracic surgery, intensive care unit, anaesthesia, developing country, Nigeria Permanent link: http://www.panafrican-med-journal.com/content/article/6/10/full Received: 19/03/2010 - Accepted: 08/08/2010 - Published: 18/08/2010 © Okafor Ugochukwu et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
An audit of intensive care unit admission in a pediatric cardio-thoracic population in Enugu, Nigeria
Okafor Ugochukwu1,&, Azike Jerome2
1University of Nigeria Teaching Hospital, Enugu, Nigeria, 2 Imo State University Teaching Hospital, Orlu, Imo State, Nigeria
&Corresponding author
Dr. Okafor Ugochukwu, Department of Anaesthesia, University of Nigeria Teaching Hospital, Enugu, phone: 009 2348057980316, Enugu state, Nigeria
Introduction
The study aimed to perform an audit of intensive care unit admissions in the paediatric cardio-thoracic population in Enugu, Nigeria and examine the challenges and outcome in this high risk group. Ways of improvement based on this study are suggested.
Methods
The hospital records of consecutive postoperative pediatric cardiothoracic admissions to the multidisciplinary and cardiothoracic intensive care units of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria to determine their Intensive Care Unit management and outcome over a 2 year span - June 2002 to June 2004 were retrospectively reviewed. Data collected included patient demographics, diagnosis, duration of stay in the intensive care unit, therapeutic interventions and outcome.
Results
There were a total of thirty consecutive postoperative paediatric admissions to the intensive care unit over the 2 year study period. The average age of the patients was 5.1 years with a range of 2 weeks to 13 years. Twelve patients had cardiac surgery with cardiopulmonary bypass (CPB), three patients had colon transplant, four patients had pericardiotomy/pericardicectomy, and five patients had diagnostic/therapeutic bronchoscopy. The remaining patients had the following surgeries, thoracotomy for repair of diaphragmatic hernia/decortications, delayed primary repair of esophageal atresia and gastrostomy. Two patients had excision of a cervical teratoma and cystic hygroma. The average duration of stay in the intensive care unit was 6.2 days. Ten patients (33%) received pressor agents for organ support. Five patients (17%) had mechanical ventilation, while twenty-five patients (83%) received oxygen therapy via intranasal cannula or endotracheal tube. Seven patients (23%) received blood transfusion in the ICU. There was a 66% survival rate with ten deaths.
Conclusion
Paediatric cardio-thoracic services in Nigeria suffer from the problems of inadequate funding and manpower flight to better paying jobs. Government should invest in their people by introducing insurance schemes for cardiac patients. Training programmes for members of cardio-thoracic units in countries with advanced health care systems and hands on experience should be encouraged. Otherwise for a majority of children with heart disease, it will be a slow painful wait for the inevitable.
