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Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with
Monira Sarmin1, Tahmeed Ahmed, Pradip K Bardhan
1Clinical Service (CS), International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
Insights
Children with septic shock due to diarrhea face higher mortality. They are more likely to be drowsy, require blood transfusions, and mechanical ventilation, highlighting the need for prompt treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Diarrhea is a common childhood illness, but can lead to severe complications.
- Severe sepsis and septic shock are life-threatening conditions in children.
Purpose of the Study:
- To compare clinical characteristics and outcomes of children hospitalized with diarrhea, focusing on those who developed septic shock versus those who did not.
Main Methods:
- Retrospective chart review of children aged 0-59 months admitted with diarrhea.
- Defined severe sepsis and septic shock based on clinical and laboratory criteria.
- Compared outcomes between septic shock patients (n=88) and controls (n=116).
Main Results:
- Mortality was significantly higher in the septic shock group (67%) compared to controls (14%).
- Children with septic shock were more likely to be drowsy on admission.
- Septic shock patients had increased rates of blood transfusions and mechanical ventilation.
Conclusions:
- Septic shock in children hospitalized with diarrhea is associated with increased mortality and need for intensive interventions.
- Early recognition and treatment of severe sepsis and septic shock in pediatric diarrhea are crucial.
- Further research, including randomized trials on inotropes, is warranted to improve outcomes.
Aim:
To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
Methods:
We carried out a retrospective chart review on children aged 0-59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
Results:
Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).
Conclusion:
Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.
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