Page 171 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-020
Upper Airway Obstruction due to Infantile Hemangioma: A Case Report

Erli Meichory Viorika, Mayetti, Indra Ihsan, Amirah Zatil Izzah
Department of Child Health, Faculty of Medicine Universitas Andala/Dr. M. Djamil General Hospital,
Padang, West Java, Indonesia
Abstract
Background Hemangioma is a benign tumor potentially cause emergency condition, such as airway
obstruction, depending on their location. Hemangioma generally respond well to therapy with propranolol,
corticosteroids, or combination of both. Objective To report an emergency case of upper airway obstruction
caused by infantile hemangioma on the laryngeal. Case A well-nourished 3-months-old baby girl came to
our ward with cyanosis, inspiratory stridor and had a hemangioma at almost all over the left head, occipital
temporoparietal area that extended to the left neck area with a size of 13 cm x 10 cm. Work of breathing
was increased with subcostal, suprasternal retractions and desaturated to 85%. Intubation was immediately
performed and the subglottis was found to be bluish-red, swollen, narrowed subglottic space and swollen
larynx with impression of suspected laryngeal subglottic hemangioma mass. There were no abnormal findings
on chest radiograph. CT scan of the neck could not be performed because the patient was not transportable.
The patient was on a ventilator, treated with propranolol 2 mg/kg of body weight/day in combination with
oral prednisone 2 mg/kg of body weight/day. Symptoms improved and the patient was extubated after 12
days on mechanical ventilation. The patient was discharged on the 20th day of hospitalization. CT Carotid
Angiography performed 1 month after the patient was discharged, showed a hypervascular lesion in the left
parotid-submandibular area with external carotid artery supply. Conclusion Patients with airway obstruction
due to laryngeal hemangioma have excellent improvement with combination therapy with propranolol and
prednisone.
Keywords: hemangioma; propranolol; prednisone; upper airway obstruction

P-EPIC-021
Incidence of Anemia in Pediatric Intensive Care Unit

Prabandari Kusumaningtyas, Wulandewi Marhaeni, Choirul Anam
Department of Child Health, Faculty of Medicine Universitas Lambung Mangkurat/Ulin General Hospital,
Banjarmasin, South Borneo, Indonesia

Abstract
Background Anemia is a common complication of pediatric critical illness. Etiology of anemia is various
and multifactorial, but most of it caused by inflammation and/or blood losses (iatrogenic or disease-related).
Criteria of anemia based on World Health Organization (WHO) recommendations was influenced by gender
and age. The impact of anemia in critically ill children is unclear but hemoglobin is an important factor for
oxygen-carrying capacity. Low hemoglobin can result in insufficient oxygen delivery to vital organs and
tissues especially in the context of an acute illness Objective To determine the incidence of anemia in PICU.
Methods This is retrospective descriptive study, conducted in the PICU Ulin General Hospital for seven
months (January - July 2021). Sixty-three critically ill children of age 6 months - 18 years admitted to PICU
with complete patient information were included in this study. Results A total of 63 cases were found in the
present study, 34 (53.9%) patients had anemia [22 (64.7%) males and 12 (35.3%) females]. Out of these 34
patients, 13 patients 38.2%) had mild, 15 patients (44.1%) had moderate and 6 patients (17.7%) had severe
anemia. Mortality in patients with anemia was higher (53% vs. 47%). But the relation between anemia and
mortality is difficult to characterize because many factors affecting causes of death. Conclusions Anemia
is a frequent occurrence critical illness, over 50% of children that are admitted to PICU are anemic and
follow-up is required to understand consequences of anemia.
Keywords: anemia; PICU; mortality

KONIKA XVIII Abstract Book 123