Improving Evidence Based Care of Community Acquired Pneumonia in Children

Determination of pain experienced by children during intravenous bolus treatments and its causes

OBJECTIVE

The present study aimed to determine the pain experienced by children during intravenous bolus treatment and to identify what causes it.

METHOD

In the first stage of the study, the first 40 observations were performed by two researchers. The study was continued by a single observer after the Kappa test was performed. In this study, 101 drug treatments were administered by intravenous bolus in patients aged between 1 month and 6 years. The pain experienced during treatment was assessed using pain scales according to the age group the patient was in.

RESULTS

Pain was observed in 63.4% (n = 64) of the treatments. There was a significant relationship between the type of medication administered and pain experienced during drug administration. There was also a significant correlation between the age of the children and their pain experiences. Given the location of the catheter, there was no significant difference among the children who experienced pain during intravenous treatment.

CONCLUSION

Intravenous drug therapy may cause pain in children. To minimize such pain, it is recommended to determine the drugs that cause pain during intravenous treatment and to develop application protocols to minimize pain caused by these drugs.

Serum Leptin in Hospitalized Community-Acquired Pneumonia Children under the Age of Five Years

Background

Community-acquired pneumonia (CAP) accounts for 19% of the world’s total deaths among all age groups yearly, with highest rates in children less than 5 years. This study is designed to evaluate the serum leptin level in hospitalized children under the age of 5 years with CAP.

Results

This prospective cross-sectional study included CAP children under the age of 5 years. Forty-one patients admitted to pediatric intensive care unit (PICU) and 41 patients admitted to general ward were enrolled. Patients with any other cause that may elevate serum leptin were excluded. Serum leptin was measured on the day of admission. The PICU patients had a significantly higher median serum leptin than that of the ward patients (p < 0.001). C-reactive protein (CRP) level was significantly higher in patients with elevated serum leptin than in patients with normal serum leptin (p = 0.001). There was a significant association between high serum leptin and positive sputum cultures (p < 0.001), particularly cultures growing more than one organism (p < 0.001). There was a positive, weak correlation between serum leptin and length of stay (r = 0.30, p = 0.007). Serum leptin showed good discrimination between PICU admissions and inpatient ward admissions (AUC = 0.777, p < 0.001); at a cut-off value of > 29.6 pg/ml, serum leptin had a sensitivity of 70.7% and a specificity of 87.8%

Conclusion

We may conclude that CAP patients with a serum leptin level above 29.6 pg/ml should be considered for PICU admission.