Related Experiment Video
Updated: Aug 19, 2026
Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression
Published on: June 15, 2019
[Severe sepsis and septic shock in children with cancer]
Christiane Finardi Pancera1, Cecília M L da Costa, Massami Hayashi
1Hospital do Câncer, São Paulo, SP.
Insights
Early intensive treatment for pediatric cancer patients with severe sepsis and septic shock may reduce mortality. Noninvasive ventilation is a potential alternative to reduce the need for invasive mechanical ventilation in these critical cases.
Area of Science:
- Pediatric Oncology
- Critical Care Medicine
- Infectious Diseases
Background:
- Children and adolescents with cancer admitted to the Pediatric Intensive Care Unit (PICU) often develop severe sepsis and septic shock.
- Understanding the clinical characteristics and predicting factors for mortality is crucial for this vulnerable population.
Purpose of the Study:
- To describe the clinical features of pediatric cancer patients with severe sepsis/septic shock admitted to the PICU.
- To identify predictors of mortality and the need for mechanical ventilation.
Main Methods:
- Prospective evaluation of 33 children diagnosed with severe sepsis and septic shock.
- Data collected on demographics, cancer type, infectious agents, and interventions received (respiratory, inotropic, dialysis).
Main Results:
- The study analyzed 33 admissions (ages 1-23 years); 20 had leukemia/lymphoma, 13 had solid tumors.
- Gram-negative organisms were common (67%), with infections in 73% of patients.
- Mortality rates were high for patients requiring respiratory support (69%) or dialysis (100%), with an overall mortality of 27%.
Conclusions:
- Early intensive treatment is suggested to improve survival rates in pediatric cancer patients with severe sepsis/septic shock.
- Noninvasive ventilation may be a viable option to decrease endotracheal intubation and invasive mechanical ventilation needs.
Background:
This report describes the clinical characteristics of children and adolescents bearers of oncological disease who were admitted to PICU with severe sepsis and septic shock. The predicting factors for mortality and for need of pulmonary mechanical ventilation were also determined.
Methods:
Thirty-three children diagnosed with severe sepsis and septic shock were evaluated prospectively at the PICU of Hospital do Câncer between June and December of 2001.
Results:
Thirty-three admissions were analyzed during this period; ages ranged from 1 to 23 years; 16 (48%) were boys and 17 (52%) were girls. Twenty patients had leukemia/lymphoma and 13 patients had solid tumors. Twenty-eight patients had a diagnosis of infectious diseases. In 73% of the patients, infection germs were isolated and gram negative organisms were responsible for 67% of the samples. Respiratory support was necessary for 18 patients (54%), inotropic support for 22 (67%) and dialysis for four patients. The mortality rate was of 41% for patients who needed inotropic support, of 69% for those requiring respiratory support and of 100% for those with an indication for dialysis. The overall mortality rate was of 27%.
Conclusions:
This research suggests that early intensive treatment for children with cancer exhibiting severe sepsis and/or septic shock could be an important factor to influence the mortality rate of these patients. Moreover, that noninvasive ventilation could be an option to reduce endotracheal intubation and invasive ventilation.
