Clinical outcome of severe sepsis and septic shock in critically ill children

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Global health

Background:

• Limited data exists on severe sepsis and septic shock outcomes in children with tropical infections, especially in low-income settings.
• Tropical infections pose a significant health burden, contributing to pediatric morbidity and mortality.

Purpose of the Study:

• To investigate the clinical outcomes of severe sepsis and septic shock in children with tropical infections.
• To identify clinical and laboratory parameters associated with mortality in this pediatric population.

Main Methods:

• Prospective consecutive cohort study of children (1 month to 16 years) admitted to pediatric intensive care.
• Data collected included demographics, symptoms, co-morbidities, organ dysfunction, and laboratory parameters.
• Analysis focused on discriminating factors between survivors and non-survivors.

Main Results:

• Respiratory and central nervous system derangements, along with cardiovascular dysfunction, were common presentations.
• Hematological involvement was nearly universal; involvement of ≥3 organ systems increased mortality risk.
• Dengue was the most frequent tropical infection; non-survivors were younger, had faster illness progression, and required earlier ventilation. Procalcitonin levels were the only independent predictor of mortality.

Conclusions:

• Tropical infections causing severe sepsis and septic shock are a major cause of pediatric mortality.
• No specific clinical parameters reliably differentiate between survivors and non-survivors.
• Procalcitonin levels are a key indicator for mortality risk in children with severe sepsis and septic shock due to tropical infections.