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Risk Factors for Mortality in Refractory Pediatric Septic Shock Supported with Extracorporeal Life Support

Jennifer K Workman1, David K Bailly1, Ron W Reeder1

  • 1From the Department of Pediatrics, Division of Critical Care, University of Utah, Salt Lake City, Utah.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 2, 2020
PubMed

Insights

Identifying risk factors for mortality in pediatric septic shock is crucial. Extracorporeal life support (ECLS) patients with cardiac failure, new neurological events, or infections face higher mortality risks.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiovascular Research
  • Infectious Diseases

Background:

  • Refractory pediatric septic shock poses a significant mortality risk.
  • Extracorporeal life support (ECLS) is used for severe cases, but mortality predictors remain unclear.

Purpose of the Study:

  • To identify risk factors for mortality in children (<19 years) with refractory septic shock undergoing ECLS.
  • To inform clinical decision-making for this high-risk pediatric population.

Main Methods:

  • Univariable and multivariable analyses were conducted on data from 514 children treated with ECLS between 2012 and 2014.
  • Seventy children with septic shock were identified using the 2005 International Consensus Criteria.

Main Results:

  • Mortality rates were 54.3% for septic shock patients and 43.7% for others.
  • Risk factors for mortality in septic shock included cardiac failure/ECPR indication, new neurological events, new infections, inability to normalize pH within 48 hours, and higher platelet transfusion volumes.

Conclusions:

  • Cardiac failure/ECPR, neurological events, new infections, pH normalization failure, and platelet transfusion needs are significant risk factors for mortality in pediatric septic shock patients on ECLS.
  • These findings aid in managing children with refractory septic shock.

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