{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:10:49Z","timestamp":1790644249349,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,7,6]],"date-time":"2012-07-06T00:00:00Z","timestamp":1341532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Department of Pediatrics Soochow University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pneumonia is the major cause of death under 5 years. With high CAP numbers in China and growing access to PICUs, factors associated with severe CAP need to be determined to optimize care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To prospectively determine PICU CAP admission features and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 4 year prospective study of CAP aged 1 month to &lt;14 years admitted to PICU, Children's Hospital Affiliated to Soochow University, China. All were managed in a standard manner. Clinical, laboratory, and imaging findings were collected systematically. All received antibiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight hundred ten (7%) of 10,836 CAP hospital admissions needed PICU. Seven hundred seven (87%) were enrolled. PICU CAP children were young (76%\u2009\u2264\u200912 months) and 33% had co\u2010morbid conditions; 21% congenital heart disease.21% required mechanical ventilation. The average length of PICU stay was 5 days (range, 3\u201327). The case fatality rate was 5.8%. Viruses were detected in 38%, RSV 24%; bacteria in 23%, <jats:italic>Streptococcus pneumoniae<\/jats:italic> 7%, <jats:italic>Haemophilus influenza b<\/jats:italic> 4%, <jats:italic>Mycoplasma<\/jats:italic> 11%. On single factor analysis, PICU admission respiratory rate &gt;70\/min, grunting\/groaning, head nodding, cyanosis, and anemia were associated with respiratory failure and with fatality. On multivariate analysis only presence of congenital heart disease, Trisomy 21 and immunodeficiency correlated with fatality; not microbe nor PICU findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Young age and underlying congenital heart disease were associated factors for PICU support in CAP in China. Early referral if altered sensorium, high respiratory rate, head nodding, grunting and anemia, and universal access to conjugated vaccines may decrease morbidity and mortality. Pediatr Pulmonol. 2013; 48:390\u2013397. \u00a9 2012 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.22608","type":"journal-article","created":{"date-parts":[[2012,7,6]],"date-time":"2012-07-06T11:59:28Z","timestamp":1341575968000},"page":"390-397","source":"Crossref","is-referenced-by-count":55,"title":["A 4 year prospective study to determine risk factors for severe community acquired pneumonia in children in southern China"],"prefix":"10.1002","volume":"48","author":[{"given":"Qingli","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongqin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjiang","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noni E.","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,6]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.048769"},{"key":"e_1_2_5_3_2","unstructured":"World Health Organization The United Nations Children's Fund (UNICEF). Global action plan for prevention and control of pneumonia. 2009http:\/\/www.who.int\/maternal_child_adolescent\/documents\/fch_cah_nch_09_04\/en\/index.htmlAccessed March 19 2012."},{"key":"e_1_2_5_4_2","unstructured":"International Monetary Fund. World Economic Outlook Database. 5. Report for Selected Countries and Subjects.http:\/\/www.imf.org\/external\/pubs\/ft\/weo\/2012\/01\/weodata\/index.aspxAccessed May 23 2012."},{"key":"e_1_2_5_5_2","first-page":"907","article-title":"Aetiology and outcome of severe community\u2010acquired pneumonia in children admitted to a paediatric intensive care unit","volume":"92","author":"Delport SD","year":"2002","journal-title":"S Afr Med J"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200103000-00013"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.049551"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.074229"},{"key":"e_1_2_5_9_2","volume-title":"Cough and difficulty breathing","author":"World Health Organization","year":"2005"},{"key":"e_1_2_5_10_2","first-page":"977","article-title":"Diagnosis and management of community\u2010acquired pneumonia in childhood\u2014South African Thoracic Society guidelines","volume":"95","author":"Zar HJ","year":"2005","journal-title":"S Afr Med J"},{"key":"e_1_2_5_11_2","first-page":"1529","article-title":"Risk factors for fatal pneumonia: a case control study","volume":"29","author":"Deivanayagam N","year":"1992","journal-title":"Indian Pediatr"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008692"},{"key":"e_1_2_5_13_2","first-page":"213","article-title":"Predictors of mortality in subjects hospitalized with acute lower respiratory tract infections","volume":"34","author":"Sehgal V","year":"1997","journal-title":"Indian Pediatr"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/02724936.1997.11747905"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/44.6.343"},{"key":"e_1_2_5_16_2","first-page":"60","article-title":"Risk factors associated with morbidity and mortality of pneumonia in Thai children under 5 years","volume":"25","author":"Suwanjutha S","year":"1994","journal-title":"Southeast Asian J Trop Med Public Health"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200005000-00007"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/49.6.327"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102431\u20109\u201015"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2007.01872.x"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0027997"},{"key":"e_1_2_5_22_2","unstructured":"Global Health Workforce Alliance WHO (2010) Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: a Systematic Review Country Case Studies and Recommendations for Integration into National Health Systems. WHO 2010.http:\/\/www.who.int\/workforcealliance\/knowledge\/publications\/CHW_FullReport_2010.pdfAccessed March 16 2012."},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyh025"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181ec6245"},{"key":"e_1_2_5_25_2","first-page":"814","article-title":"Mycoplasma pneumoniae and Chlamydophila pneumoniae in children with community\u2010acquired pneumonia in Thailand","volume":"11","author":"Lochindarat S","year":"2007","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804877"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31822f845f"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0018176"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2010.505126"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0b013e3181fe258e"},{"key":"e_1_2_5_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20364"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.22268"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03603.x"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-2659.2011.00206.x"},{"key":"e_1_2_5_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-010-0009-2"},{"key":"e_1_2_5_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03541.x"},{"key":"e_1_2_5_37_2","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/129134"},{"key":"e_1_2_5_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60921-5"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.22608","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.22608","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.22608","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T01:05:14Z","timestamp":1696899914000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.22608"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,7,6]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,4]]}},"alternative-id":["10.1002\/ppul.22608"],"URL":"https:\/\/doi.org\/10.1002\/ppul.22608","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,7,6]]}}}