Mortality rates in pediatric septic shock
Abstract: Septic shock remains
a major cause of morbidity and mortality in children admitted to the intensive
care unit. Recent investigations from developed countries have reported
mortality rates of 20-30%. Few studies have reported mortality rates from
pediatric septic shock in intensive care settings in developing countries with
limited resources.
Objective To determine the current
mortality rates for pediatric patients with septic shock in a developing
country.
Methods A retrospective study was conducted in the Pediatric Intensive
Care Unit (PICU) at DR. Sardjito General Hospital. Medical records and charts
were reviewed and recorded for diagnoses of septic shock, from November 1st,
2011 to June 30th, 2014.
Results A database of all PICU
admissions was assembled, and cases with diagnoses of septic shock were reviewed.
The final data consisted of 136 patients diagnosed with septic shock. Septic
shock was defined as a clinical suspicion of sepsis, manifested by hyperthermia
or hypothermia, and accompanied by hypoperfusion The overall mortality rate for the study cohort
was 88.2%. The median age of patients
was 16 months, with 52.2% males. Median initial PRISM III and PELOD scores were
10 and 22, respectively. The median length of PICU stay was 4 days. A total of
48.5% of the subjects were in need of crystalloid and colloid fluid at a median
amount of 40 mL/kg. The median time required to complete the initial
resuscitation was 60 minutes. Mechanical ventilator support in the first 24
hours was required in 79.4% of the cases. Fluid overload of > 10%
(FO>10%) was found in 58.8% of the subjects.
Conclusion The mortality rate in pediatric septic shock in our hospital
is very high. There is a higher incidence of fluid overload in the non-survival
group .
Keywords: septic shock,
mortality rate, children, developing country
Author: Desy Rusmawatiningtyas,
Nurnaningsih
Journal Code: jpkedokterangg160225
