The protocol was discussed in multiple sessions with the resident doctors and nurses posted in PICU and Emergency units on the first day of every month throughout the duration of the study. The investigator visited the Emergency and PICU at least twice a day and as and when needed to ensure strict implementation of protocol. Phone number of the investigator was made available in both the units. Posters of protocol design were displayed on the notice boards of the Emergency and PICU. Weekly checks on protocol adherence were carried out by the co-investigators.
Clinical data (respiratory rate, pulse, capillary refill, blood pressure, hydration status, fluid intake, urine output) were continuously recorded, and the values were entered in a pre-designed monitoring sheet. Blood glucose (capillary or venous) was checked every hour and blood gas every 4 h. Urea, creatinine, and electrolytes were measured every 4–8 hourly. We used the enzymatic method of creatinine estimation to prevent interference with non-creatinine products.
For KDIGO staging, if pre-admission creatinine values were available, either the single value or the least value (in case of multiple values) during the previous 3 months was taken as baseline value. If baseline creatinine was unavailable, then a GFR of 127 ml/min and 103 ml/min were assumed for children above 1 year and below 1 year respectively to calculate creatinine using Schwartz formula (Additional file1 : Appendix).
The need for RRT was assessed daily. In addition to renal failure-related data points, the duration of mechanical ventilation (MV), length of ICU and hospital stays from time of study enrolment, and in-hospital mortality were recorded.
Clinical data (respiratory rate, pulse, capillary refill, blood pressure, hydration status, fluid intake, urine output) were continuously recorded, and the values were entered in a pre-designed monitoring sheet. Blood glucose (capillary or venous) was checked every hour and blood gas every 4 h. Urea, creatinine, and electrolytes were measured every 4–8 hourly. We used the enzymatic method of creatinine estimation to prevent interference with non-creatinine products.
For KDIGO staging, if pre-admission creatinine values were available, either the single value or the least value (in case of multiple values) during the previous 3 months was taken as baseline value. If baseline creatinine was unavailable, then a GFR of 127 ml/min and 103 ml/min were assumed for children above 1 year and below 1 year respectively to calculate creatinine using Schwartz formula (Additional file
The need for RRT was assessed daily. In addition to renal failure-related data points, the duration of mechanical ventilation (MV), length of ICU and hospital stays from time of study enrolment, and in-hospital mortality were recorded.
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