ASSOCIATION BETWEEN CONVULSIONS AND ARTERIAL BLOOD GASES IN INFANTS WITH SEVERE BRONCHIOLITIS AT THE TIME OF THEIR ADMISSION INTO A TERTIARY CARE HOSPITAL

DR BALAKA SURESH KUMAR; DR GORRIPATI KALYAN CHAKRAVARTHY

Volume : VIII, Issue : II, February - 2019

ASSOCIATION BETWEEN CONVULSIONS AND ARTERIAL BLOOD GASES IN INFANTS WITH SEVERE BRONCHIOLITIS AT THE TIME OF THEIR ADMISSION INTO A TERTIARY CARE HOSPITAL

Dr Balaka Suresh Kumar, Dr Gorripati Kalyan Chakravarthy

Abstract :

The single most important cause of infant morbidity is acute onchiolitis; nearly 1 out of 5 infants suffer with clinical onchiolitis and among these 2-3% require hospital admission1. The American Academy of Pediatrics (AAP) defines onchiolitis as �acute inflammation, edema and necrosis of epithelial cells lining small airways, increased mucus production, and onchospasm�2. AAP definition has little clinical significance, another useful definition, which was used in many clinical studies, is: the first episode of wheezing in a child younger than 12 to 24 months who has physical findings of a viral respiratory infection and has no other explanation for the wheezing, such as pneumonia or atopy.3 Bronchiolitis is caused by viruses, most common virus implicated was RSV and others are Para influenza, rhinovirus and adenovirus. Emerging pathogens are Human Metapneumovirus & Boca virus4. In current study we made an attempt to find any association between changes in the Po2, Pco2 & pH with convulsions in infants with acute severe onchiolitis and studies on this are lacking. Aims and objectives: To know the association between convulsions and arterial blood gases in infants with severe onchiolitis. To ascertain significance between convulsions and blood gases in infants with severe onchiolitis. MATERIAL AND METHODS: Study was carried out in a tertiary care hospital on infants who were admitted with signs and symptoms of severe onchiolitis for the period September 2018 to November 2018. At the time of admission, detailed history was taken, thorough clinical examination was done and samples for CBP and ABG were sent in all infants admitted with clinical diagnosis of severe onchiolitis and the results were analyzed with SSPS software. Results: A total of 28 infants were studied in current study; 11/28 were presented with history suggestive of convulsions and mean duration of illness in infants with convulsions was prolonged (66%cases) comparative to other infants. In the present study, infants with convulsions most of them will fall under age group 6 to 10 months, 63.6 % of infants with convulsions have had spo2 in the range 71-90% remaining were 27.3%, 9.1% of infants had spo2 values <70, >90 respectively. Infants with convulsions 54.50% were having po2values less than 61mmhg and 9.1% of infants had po2 more than 85mmhg and remaining 36.4% had po2 range between 61-85mmhg.45.5% of infants with convulsions had pco2 value41to 80mmhg, rest of the infants had pco2 >80mmhg .in this study mean pH was 7.27,and 45.0% of infants with convulsions having pH range between 7.21to 7.24, almost all infants (18.2%) having pH less than 7 had convulsions, remaining 36.4% of infants with convulsions had pH in between 7.01 to 7.20. Conclusion: It was found that the association between po2 and convulsions is significant with p-0.048 and the association between pco2 and convulsions is spastically significant with p value 0.007, there is no association between spo2 and convulsions(p-0.268) in present study, and significant association was found between pH and convulsions p-0.02.