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Clinical and Laboratory Parameters Associated with Septic Myocardial Dysfunction in Children with Septic Shock

Samriti Gupta1, Jhuma Sankar2, Praveen Narsaria1

  • 1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India.

Indian Journal of Pediatrics
|February 18, 2021
PubMed

Insights

In children with septic shock, prolonged capillary refill time, elevated lactate, low platelets, and increased blood urea may indicate septic myocardial dysfunction (SMD). Early cardiac function assessment is recommended for these pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Cardiology
  • Infectious diseases

Background:

  • Septic shock in children can lead to myocardial dysfunction.
  • Early identification of septic myocardial dysfunction (SMD) is crucial for improving outcomes.
  • Clinical and laboratory parameters at admission may predict SMD.

Purpose of the Study:

  • To identify clinical and laboratory parameters associated with septic myocardial dysfunction (SMD) in children with septic shock.
  • To determine predictors of SMD in pediatric patients.
  • To assess the relationship between admission parameters and cardiac function in pediatric septic shock.

Main Methods:

  • Retrospective chart review of pediatric patients (3 months to 17 years) with fluid-refractory septic shock.
  • Echocardiography performed within 3 hours of admission to diagnose septic myocardial dysfunction (SMD).
  • Univariate and multivariate analyses to identify associated factors.

Main Results:

  • Of 95 children, 46% (44) had septic myocardial dysfunction (SMD).
  • Children with SMD showed longer capillary refill time (CRT), increased lactate, lower platelet count, increased blood urea, and elevated alanine aminotransferase (ALT).
  • Multivariate analysis did not find these parameters to be significant predictors; however, mortality was higher in children with SMD (36% vs. 20%).

Conclusions:

  • Prolonged CRT, elevated lactate, low platelets, increased blood urea, and high liver enzymes may be associated with SMD in pediatric septic shock.
  • These findings suggest a potential need for early cardiac function assessment in children presenting with these parameters.
  • Further research is needed to validate these associations and their impact on mortality.

Keywords:
ChildrenClinical and laboratory parametersEchocardiographySMDSeptic myocardial dysfunctionSeptic shock

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