07/09/18

LCICU Akriti Hyperacute ALF Colistin D 1 Fever 100 2 spikes Hgm:9.4/5.9/1279.8/8.3/2149/9/224

DOA 15/F Grade III-IV HE Inj Meropenam D4 Pupil 2 mm SR KFT:21/0.5/136/5.210/0.56/147/3.223.5/0
03/08/18 173463 Raised ICP Inj Teicoplanin D4 .47/151/4.2151/4.6
Inj flucon D4 HR 90/min 00> 20/0.36/137/4 creat 2
MELD HAV BP 120/71 mm Hg LFT:6.1/-/4655/4488/6.8/3.9--.
Mannitol stat ONSD 5.4/5.23.2/3.4 6.5/2.9/980/2088/92/34/7.3/3.1
Injj 3 % saline hold 4.4/2.1/366/1360/78/-/2.7
R/S: alb 2.6
Sedation stopped PSIMV PSV
FIO2: 30
Inj propofol 410ml Rate : 12 INR:2.95 FFP
/hr stop PI 12 (outside)2.072.091.641.49
Inj atra2 ml/hr HBsAg/ HCV non reactive
Inj fenta 2 ml/hr High BP 140/90 (110- HAV reactive
Anti ammonia 115) Sodium/pot--. 151/4.1
measures i/O Ammonia24134820011188
Vitamin k :2853/13352938/12 PCT- 12.30
75 (oral 2000) +1663
IVF 30ML/HR
NG – 130 L/HR Feeding : 200 ML/2 HR

ABG-
7.4/035/129/26/lactat
e 2.3
HDU Md. Rayyan POD 78 Inj. Dorepenam D35 Fever: 1014 and 102 at Hgm:
DOA 13 Y/M Post LDLT Inj. colistin D13 11 pm 6.6/5.7/78.1/3.8/N81%/10000
28/05/18 17608 PFIC-Low GGT Inj Eraxis D36 7.4/3/298.5/6.4/34 12.2/8.1/343--
with PEBD with Inj Teico D15 Stools: 4 times semi .10.7/10.5/18--.8.3/3.9/276.7/1.1/11
uncontrolled Inj Tigecycline D25 solid 1 PRBC+2 RDPC9.4/2.5/15
pruritus 8.7/1.7/519.9/3.9/21, N 81%--
Severe growth IVIG on 26.8.18 and AST/ALT: 29/31 .11.1/4.4/177.2/2.6/12PRBC/ ½ SDPC
failure with ABO i HVPE 4 sessions 10.6/3.4/23
LDLT Tac W/H
TPN 60ml/hr Wysolone 20mg OD BMA- 3% hemophagocytes, M:E-
Drain replacement: 2:1(Provisional)
50% with 5% Albumin Oral: 14385/ (oral
07/09/18

Tip C/S : Klebsiella 1090)/1930 LFT: 1.9/0.8/75/106/303/132/5/3.7

Amikacin Neocate feeds 80ml/hr + 2455 3.0/71/92/244/103/5.3/3.9
in morning + MCT oil Drain-680 1.5/0.5/38/53/157/55/5.2/2.9
Wt. 16.6 2.1/0.5/32/36/119/53/5/2.7
Tac-W/h 2.5/0.5/39/30/106/38/5.2/3.01.4/0.5/29/
Cellcept-W/h 31/77/26/2.4
Wysolone 20mg OD 2.9/2/25/32/207/64/4.8/3

Ferritin-553, Fibrinogen-232, TG-121

Urine c/s – Scanty fungal growth? colonisation
Fibrinogen 88, TG 141
Anti A titre 1:41:2

KFT77/0.03/136/2.659/0.3/135/3.3
44.9/0.3/130/3.449/0.3/132/3.6
->29/0.11/129/3.242.8/0.3/132/4.3
42.8/0.3/131/4.4
Drain- TLC-672, N-5%

Ca/Mg: 8.9/1.978.1/1.68 7.9/1.71

INR: 1.42.12.42.681.681.75
1.31.71.642.011.451.59
2D Echo: No vegetations
Blood culture(9/8) CVP tip and Peripheral
Staph. Hemolyticus
Blood culture(8/8) Arterial tip-Klebsiella
pneumoniae s/t Amikacin
Blood C/S: Candida Auris
Sensitive to Caspofungin/ Micafungin
LTICU Ansh LDLT-BA-Post Septran Tracheostomy CBC-7.9/12.1/2697.4/13.9/293
DOA- 1y5m/M Kasai- Tab Forcan REMOVED 7.5/11.1/3087.5/11.2/297
19/6/18 138857 unsuccessful room air 8.3/12/N39%/2887.9/11.8/244
POD 54 7.9/11.8/2448.6/7.2/264
Date of LT PHTN(bleeder) Clexane HR-118 8.9/10.8/3268.5/8.7/310
12/7/18 Ecospirin RR-40
Blood culture- Amlodipine BP-104/50 LFT 0.5/0.2/46/45/384/220/3.4
07/09/18

Re- klebsiella SPO2-98% 0.8/0.3/38/47/349/169/3.4

Exploratio ET- Immunosuppression- 0.5/0.1/39/51/309/79/6.3/3.4
n Stenotrophomnas W-2.5 mg No fever 0.5/0.1/29/29/241/50/6.2/3.5
13/7/18 Drain-E.coli Tac 0.5mg – 0.5 0.5/0.1/31/24/236/46/6.3/3.60.4/0.1/39/
14/7/18 Et- Elizebeth MMF W/H Graft Fn Fine: 36/215/33/3.2
Partial- Kingae Tracheal Oral feed Wys: 2.5 mg
17/7/18 aspirate- stopped Tac:W/H INR 1.141.151.201.131.18—
Bagota PSEUDOMONAS Inj Cefta D11 >1.11.17
closure Inj Colistin D8 Wt-6.8Kg
GRWR 3.2 I/O- 635/400 KFT 27/0.3/136/4.228/0.07/146/3 1
Bagota Graft wt-260gm 23/0.3/132/3.823/0.3/132/3.8
closed on 3 times stools passed 29/0.3/135/4.32.9/0.3/133/4.219.2/0.3/
22/7/18 Sputum c/s 135/4.3
PSEUDOMONAS
Ca/ Mg: 9.4/1.789.4/1.68--
.9.2/1.859/1.789/1.83

Blood culture- klebshiella, Stenotrophomnoas

Drain-E C coli
ET- Elizabeth Kingae meningoseptica
Tac level-5.8(24/7/18)2.32.46.44.2
Ticu Jagruti POD 10 Doripenam D9 Raised ICP: CBC: 9.4/5.9/477.1/17/62 
DO LT 3yr/F DDLT TeicoD9 Hr: 106 8.3/8.4/548.0/13.8/53
25/8/18 101353 WIT: 8 hrs Colistin D6 Bp: 104/64/84 8.3/4.97.3/3.8/209.2/3.1/30
CIT 30mins TigeD6 Pupil 3 mm/2 mm SR
Intraop blood loss Amika D6 LFT: 1/0.6/2930/957/74/22/3/1.1
2.5 L Eraxis D9 Graft Dysfn: 2.6/1.4/5781/1390/201/53/3.1/2.3
AST/ALT: 4.9/2.9/5337/1806/253/58/3.7/2.8
Tac 0.5mg BD Bili 1.74.96.5 6.5/4.1/1079/1130/207/47/4.3/3.2
MPS 50mg20 mg INR 3.834.62.4 7.0/4.4/377/838/190/49/4.5/3.2
Amlodipine 2.5 mg BD Doppler normal 5.8/3.7/90/133/138/29/3.26.8/4.2/106/14
Tac 0.5hold 9/146/27/3.5
Inj Labetalol 3 ml BD MPS 50mg20 mg
Inj 3 % saline 7 ml/hr INR: 3.83.34.44.62.52.82.4-
Inj Propofol 7 ml /hr R/S: >1.81.33
Inj Thiopentone 5 Crepts
07/09/18

ml/hr ?fluid overload KFT

INJ ATRA 1.5 L/HR ABG:7.4/91/33/4.1 66/0.2/145/4.436/0.3/145/4.4
49/0.23/145/4.766/0.07/142/4.727.8/0.
I/O 04/150.8/4.6
2198/5431875/887-- Ca/Mg-10/2
.2485/1950 PO4-2.5
Iv 1535
Oral 950
U/O 1220 ml

Drain : 740 ML
Right:290
Left 15 ml
PCD- 430 ml
P1 Harshit ALF - Inj cefotaxime D5 No HE INR, urine copper CBC-10.8/6.8/271
1 10y/M Indeterminate Inj NAC Hemodynamically LFT-27.1/19.2/1257/881/175/30/2.8
DOA- 173545 Inj vit K stable 23.614.7/761/661/144/26/4.8/2.7
3/9/18 Supplements INR 2.392 KFT-10.7/0.06/139.8/4.6
Ca/Mg/P-9/1.83/4.2
Pupil- 3mm INR-2.552.362.402.392
Ammonia-36
I/O 1083/1000 IgG-9.67
Wt26.45 kg26.8 Ceruloplasmin-18 LDH-1060
AG51 cm DCT-ve, Retic count-0.97

02 Garvita Severe Acute Meropenem D10 Fever 101 F (self CBC- 9..5/28.8(86%)/359
DOA- 15 yrs/ Fe pancreatitis with Inj colistin D4 resolving) 8.5/25.38.1/24.58.8/20.4N90/357(20/8)
26/08/18 172743 cholelithiasis UDCA 7.5/20.4N84/369(30/8)
APACHE II (9) Iv fluid Hemodynamically 7.3/17.1/N81(1/9)9.2/16.2/425
Inj Albumin 25% stable
stopped(28/8) KFT- 23.5/0.57/135/3.2
NJ feeds 120 ml/
stopped: hourly LFT- 0.9/0.2/33/12/109/35/5.6/2.5
Inj Metrogyl 0.6/0.2/29/11/89/20/5.5/2.5
Inj Taxim) I/O-
Inj Ofloxacin 1800/16901950/175 PT/INR 2.31.74
07/09/18

0 2550/2200 Reti 1.63/ Dct –ve

Anti Hbs titre 14miu/l
Wt- 58.2 Calcium- 6.2/ Amylase- 81
57.157.04 Urine R/M :NAD
LDH :1123/PCT:0.220.166.2
CHL/TG/HDL/LDL:48/64/10.8/23.6
ESR- 50
Pancreas. fluid G stain nil(30/8)
Blood c/s no growth(29/8)
USG s/o large collection 10x9 cm near
pancreatic tail with calcified component and
settled debris. peripancreatic necrotic region
noted

05 Muzzamil ACLF Inj. Colistin Fever: 100.2/102F Collect AI markers CBC- 7.2/5.3/111, PCT-9.18
DOA 5 yr/ male Acute: HAV IgM + D4 (6am) 6.1/5.4/ P49/1528.5/5.6/143
03/09/18 173578 + ? AIH (IgG 19.2, Inj Meropenam D4 No over HE, Abd. pain, TJLB
Inj flucon D4 INR- 2.12->2.22.7
ASMA+, DCT 2+ Loose stools, Dysuria
Inj Teico D5
Chronic: HBV KFT- 23.8/0.3/130/4.0131/4.7
Inj NAC Wt- 18.4
AARC ACLF- 9 Inj Vit k kg18.23=.17.8 LFT- 22/12.8/233/102/111/31/5.3/1.5
PELD 26 Tab Entacavir 20/10.8/186/90/103/25/5.2/1.9
CLIF SOFA 8 Tab Aldactone Ammonia- 114109
Inj. Albumin DCT-2+ Retic-0.5
Ascitic Tap- TLC-29, N-25%
Anti Hbc IgM + Anti HBe + HBeAg +

HAV IgM Reactive, IgG 19.2, ASMA +, ASLA/LKM

Neg

Ceruloplasmin 18

Outside- LFT- 17.3/15.4

HAV IgM, HBsAg, ANTI HBc TOTAL, HBeAg, HBc
IgM reactive
07/09/18

07 Nyra Biliary Atresia- Inj Colistin D6 Fever: 101.2F (6pm) USG Abdomen CBC: 8.2/12.4/351
DOA 4 mo/F Post KPE (DOL 77, Inj Tige D6 LFT: 4.2/2.4/155/69/664/295/6.3/2.4
5/9/18 167679 17/7/18) UDCA WT. 4.08 KFT: 12/0.04/129/4.8
Supplements PCT 14.28
Recurrent AG
Cholangitis I/O
09 JANVI, Biliary atresia ATT (Mod.) HREL- D9 Fever- CBC- 9.5/22.9(63%N)/935-8.9/44.6/937
DOA 3 MONTH/ F with post KPE Inj Magnex D2 102.2/101.2/100/101 Collect Na report 10/41.4/N62/2047.9/48.5/195
17/07/18 166113 Inj Teicoplanin D2 (4am) 7.5/61.5/32510.8/52.2/376 (72%P)
Cholangitis Inj Clarithro D2 TLC: 24.630.6 8.4/45,N 61%/437PRBC
PELD 078 (Blood C/S: Amikacin D21 10.3/30.0/4079.8/24.6/268(28/8)
Acinetobacter) Inj. Colistin D3 Persistent tachycardia 8.9/30.6/470
DOS HPS (mod.) Cefixime D5 and tachypnea
29/06/18 TAB Fluconazole D13 Cough+ Wheeze+ PCT- 6.212.300.463.477.7
Inj Hydrocort D3 HR 160/ min
RR 70-80/min LFT- 7.3/4.5/221/224/405/6.9/4.0-
SYP UCDA 5.5/3.3/105/222/464/2.52.9 4.6
Supplements Na-118127 7.2/4.6/66/47/162/320/6.6/2.3Bili
Bili 4.67.28.88.0 8.89.28.07.38.5(28/8)
Stopped 7.38.5 8.4/5.1/80/63/92/410/8.1/3.2
Inj. Eraxis D23STOPPED
Inj Metrogyl D5 Wt5.0195.070(^50) Albumin- 2.91.5
Inj. Tigecycline D19+15 4.7654.8254.98 2.32.31.92.93.2(28/8)
INJ MEROPENAM D16 55.015
WYSOLONE stopped Ammonia 82,
Inj Netilmycin I/O KFT- 21/0.10 34.24/0.3/127.3/4.7128/4.3
Inj colistin D21 717+10BF/485710 118/3.9 131/3
Inj Doripenam D16 /525ml USG- No IHBRD, no abscess s/o possible
Syp Septran D14 cholangitis
Inj. Lasix 0.2ml AG-
BDOD 383837CM37 Blood C/S: Acinetobacter : Sensitive to Colistin
ALDACTONE 25mg ½ CMS4038434 Repeat Blood C/S- no growth(9/08)
1cm Urine R/M - normal
07/09/18

CSF:TLC 34, N20%, Sugar 67/ protein 50

c/s sterile
2D ECHO : old vegetations over Tricuspid valve
PFO
CT s/o- definite pneumonic patchy
consolidation in post segment of right upper
lobe
Urine C/S No Bacterial Growth

Ph-2 VIiraaj Liver SOL Supplements Chemo completed Discharge today CBC:11/9.8/771
DOA 9 M/M Hepatoblastoma Ferronia XT LFT:1/0.2/137/35/136/71/7.3/4.5
31/08/18 173136 Pretext II No Fever Kft:49/0.2/131/5.1
Chest clear INR 0.89
O/A fair AFP: 190718
I/O :1797/1070
Wt
03 Tohibi BA, successful PE Inj. Colistin D20 Fever- 99.4/100.3 CBC- 8.4/12.6/N48%/1567.7/15.7/90000
DOA 1 yr/F PHTN non bleeder Inj. Tazact D21 (4am) 7.1/8600/N%69/122 7.2/14.4/125
19.08.18 148451 Cholangitis Inj. Tigecycline D19 6.7/14.2/N61/111PRBC
Some Septran D5 Hb 6PRBC given DONE8.8/26.4(29/8)7.9/13/150
dehydration Inj.Flucon D2 6.9/11, N-55/2316/6.3/186
PELD- 41612 Tab ciplar Wt-10.2211.04
11.418.8959.015 KFT- 53/ /136/3.921/0.31/130.1/4.1
9.160(^145)9.3 135/3.9138/4.7(29/8)
T. Aldactone 12.5 mg 9.479.5759.445kg
STOPPED 9.502 LFT- 7.2/4.7/101/101/376/122/4.1/1.6
8.9/5.7/60/62/322/109/2.1
I/O- 4 BF+3 ½ 6.7/3.6/48/45/281/129/4.7/2.4/2.3
BOWL/11908BF+BO 8.69.8/5.7/74/49/356/115/6.4/3.913
WL+50/7407 time /3.7(alb)14.1//3.316.8
custard+8BF/980 Albumin-
3.216.8/9.6/279/111/317/104/5.8/2.7
AG-5445cm46
CM465049 INR-1.691.66-->1.81.42
07/09/18

USG- No cholangilitic abcess, no ascities

PCT- 11.910.58

USG abdomen :Minimal ascites.

No cholangitic abscess.
Portal vein = 3.7 mm, Hepatic artery RI = 0.8
04 Sachi rana , Decompensated D- Pen 250 OD No fever Donor evaluation LFT 1.9/0.8/209/386/76/5.8/2.4
DOA 1 yr, F CLD, PTHN, Aldactone 25 mg Stable Ammonia 117
05-08- 161062 On empirical ATT Levoflox Hgm 6.3/6.6/ P38/ 63
2018 Liver SOL ? Ciplar Wt 9.25 AFP3228
cirrhotic nodule Combutol INR: 2.022.11.77
AFP 10-32 Zinconia
Cyclical antibiotics-
cefexime
DOA Priyank Shah EHPVO Ciplar Planned for Rex shunt UGIE, CBC: 11.6/12.9/91
6/7/18 11 mo/F On UGIE- Last if feasible CECT LFT: 1.3/0.3/109/75/500/38/70/4/3
168199 UGIE 6/8/18 2D Echo KFT: 12/0.15/139/3.9
Large HR EVx, WT. 5.5 INR 1.5
GOV2 EST done
DOA Anushka Acute Hepatitis Inj Taxim Fever 101.2/100.2 Widal, MP, Urine CBC: 14/15/ P53%/291
6/7/18 Sharma with serositis UDCA Focus? Chest R/M, Dengue LFT: 6.4/4.4/1073/1486/129/94/4.4/2.2
6yr/F Supplements Mild- Moderate KFT: 17.1/0.2/126/3.4
173757 ascites PCT 3.45
B/L mild pleural INR 1.08
effusion
No cytopenias, rash,
Dysuria, respiratory
complaints
Ph-2 Krishna AILD (AIH+SC) Supplements No fresh issues Liver biopsy CBC:6.7/9.1/160 prbc
DOA 7 Y/M Albumin (Vascular lab) Inr 1.44
01/08/18 173371 Aldactone 75 mg No loose stools LFT: 0.5/0.2/36/17/269/132/5.2/1.5
Wt KFT: 19/0.16/147/4.3
14.1 14.3 USG:Hepatomegaly with IHBRD
I/o 1300/1600 MRCP
Bilobar IHBRD with irregularity of bile ducts wi
th pruning and beading associated with similar
07/09/18

changes in CBD and cystic duct. F/s/o early ? p

rimary sclerosing cholangitis involving large an
d small ducts

04 Baby Biliary atresia Inj Meropenem D10 No fever USG screen Hgm 8.1/13.8/2759.1/17.2/287
DOA 16- Reedhwani Inj Fluconazole D6 Hemodynamic stable 8.5/9700/N24//1998.1/9800/239
08-2018 day of life 54 Post KPE Inj Amikacin D7 HR 120/min PRBC11.4/12400/N33/271
Inj Eraxis D5 13.5/25900/N44/48113.5/25900/N34/172
RR 34/min
DOL 70 Aldactone 25mg ½ tab 10.5/13/197
DOB 5%Albumin half 10.5/14.5/262 (p-47)
23-06-2018 CHOLANGITIS replacement. Wt -3.95kg
DOS 3.865(^45)4.170 PCT 0.80(1/9)
23/08/18  4.370
IVF STOPPED LFT 18.9/9.9/708/347/827/73/5.9/3.7
POD 11 Inj Tazact D7 stopped I/O 516/29017 BF 15.8/8.7/594/272/715/84/3.69.3/5.5/3.8/21
/740 3/177/4.5/3.13.33.3
Total S.Bil 11.799.2
AG 36Cm35cm 9.8/6/721/309/284/365/5.1/3.3
35CM333434
KFT17/0.07/133/5.3134/4.7133/6.3
Drain 28 ml 108ml-- 5.2(K)131/5.1 133/5.2
.100--100 ML80ml INR 1.36(16/8)
100 Lactate 4.6/ TG 218/ Chol 213
ml10025nil LDH 959/Retic 2.76
Liver biopsy- BA, BSEP-non deficient
USG- min to moderate ascites