A Valuable Tool in Predicting Poor Outcome due to Sepsis in Pediatric Intensive Care Unit: Tp-e/QT Ratio

Area of Science:

• Pediatric Cardiology
• Critical Care Medicine
• Biomedical Engineering

Background:

• Sepsis is a life-threatening condition in children, necessitating accurate prognostic tools.
• Electrocardiography (ECG) offers a non-invasive method to assess cardiac function.
• Identifying reliable ECG markers for predicting outcomes in pediatric sepsis is crucial.

Purpose of the Study:

• To evaluate the predictive value of various 12-lead ECG parameters for poor outcomes in pediatric intensive care unit (PICU) sepsis patients.
• To determine if specific ECG measures, including P wave dispersion (PWd), QT interval, QT dispersion (QTd), and Tp-e interval, can identify sepsis-induced mortality.
• To assess the feasibility of using the Tp-e/QT and Tp-e/QTc ratios as predictors of mortality in this population.

Main Methods:

• A study involving 93 pediatric patients diagnosed with sepsis, severe sepsis, or septic shock.
• Comparison with 103 age- and sex-matched healthy children.
• Acquisition of 12-lead ECG data, including PWd, QT interval, QTd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios.

Main Results:

• Septic patients exhibited significantly higher PWd, QTd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios compared to controls.
• Mortality was observed in 41 patients during the study period.
• Multivariate logistic regression identified the Tp-e/QT ratio as an independent predictor of mortality.

Conclusions:

• Standard ECG measurements demonstrate potential in predicting adverse outcomes for pediatric sepsis patients.
• The Tp-e/QT ratio emerges as a potentially valuable and accessible tool for predicting mortality in critically ill septic children.
• Further research can validate these ECG findings for clinical application in PICU settings.