Hospital, ICU characteristics and Facilities. This prospective study was conducted in the 6-bedded PICU of a tertiary care multidisciplinary teaching hospital. This 600-bedded hospital has separate adult medical and surgical, pediatric, neonatal, cardiac and post transplant ICUs.The PICU is equipped with 6 ventilators, central oxygen, air and vacuum supply. Each bed has multiparameter monitor for continuous hemodynamic and respiratory monitoring .Nurse on duty maintain vital sign and intake-output record on hourly basis. Besides standard treatment modalities and ventilation, bedside renal replacement therapy, electroencephalography, echocardiography and flexible bronchoscopy facilities are available. Extracorporeal membrane oxygenation and nitric oxide therapies are not yet available. The PICU is staffed with full time, experienced pediatric intensivists, critical care fellows and residents. The nurse / patient ratio of 1:2 is provided round the clock.