Prevention of healthcare-associated infections in paediatric intensive care unit.

INTRODUCTION: Healthcare-associated infections put a tremendous burden on health services around. In the last few decades, there has been a tremendous advancement in foetal and maternal care, and it has led to premature babies born as early as 25 weeks of gestation being nursed and cared for in neonatal and paediatric intensive care units. However, these children can pick up a number of uncommon and rare hospital-acquired infections including central nervous system (CNS) infections. METHODS: The authors have given their own insight as to the prevention of healthcare-associated infections in paediatric intensive care settings and reviewed the current literature on the topic. CONCLUSIONS: Healthcare-associated infections are largely preventable provided adequate prevention and protective measures are put in place and prevention guidelines are stritctly followed.

Association between protein intake and muscle wasting in critically ill children: A prospective cohort study.

BACKGROUND: Survival from pediatric critical illness in high-income countries is high, and the focus now must be on optimizing the recovery of survivors. Muscle mass wasting during critical illness is problematic, so identifying factors that may reduce this is important. Therefore, the aim of this study was to examine the relationship between quadricep muscle mass wasting (assessed by ultrasound), with protein and energy intake during and after pediatric critical illness. METHODS: A prospective cohort study in a mixed cardiac and general pediatric intensive care unit in England, United Kingdom. Serial ultrasound measurements were undertaken at day 1, 3, 5, 7, and 10. RESULTS: Thirty-four children (median age 6.65 [0.47-57.5] months) were included, and all showed a reduction in quadricep muscle thickness during critical care admission, with a mean muscle wasting of 7.75%. The 11 children followed-up had all recovered their baseline muscle thickness by 3 months after intensive care discharge. This muscle mass wasting was not related to protein (P = 0.53, ρ = 0.019) (95% CI: -0.011 to 0.049) or energy intake (P = 0.138, ρ = 0.375 95% CI: -0.144 to 0.732) by 72 h after admission, nor with severity of illness, highest C-reactive protein, or exposure to intravenous steroids. Children exposed to neuromuscular blocking drugs exhibited 7.2% (95% CI: -0.13% to 14.54%) worse muscle mass wasting, but this was not statistically significant (P = 0.063). CONCLUSION: Our study did not find any association between protein or energy intake at 72 h and quadricep muscle mass wasting.