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Published on: August 19, 2020
Tei Index and its Relation to Outcome of Critically Ill Children on Continuous Renal Replacement Therapy
Fatina I Fadel1, Ahmed M Badr1, Marwa M Abdelkareem1
1Department of Pediatrics, Center of Pediatric Nephrology and Transplantation (CPNT), Cairo University, Cairo, Egypt.
Insights
The Tei index can predict poor outcomes in critically ill children undergoing continuous renal replacement therapy (CRRT). This echocardiographic parameter correlates with mortality risk scores and vasoactive inotropic scores.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Renal Replacement Therapy
Background:
- Critically ill children often require continuous renal replacement therapy (CRRT).
- Assessing prognosis in these patients is crucial for management.
- Echocardiographic parameters may offer valuable prognostic information.
Purpose of the Study:
- To evaluate echocardiographic parameters, specifically the Tei index, as predictors of outcome in pediatric patients undergoing CRRT.
- To compare the predictive value of the Tei index with established scores like PRISM III and VIS.
Main Methods:
- A cohort study involving critically ill children receiving CRRT in a Pediatric Intensive Care Unit (PICU).
- Functional echocardiography was performed to assess cardiac function.
- The Tei index, Vasoactive Inotropic Score (VIS), and Pediatric Risk of Mortality (PRISM) III score were calculated.
Main Results:
- The study included 35 pediatric patients (age 6 months to 14 years).
- The Tei index, VIS, and PRISM III were significant predictors of mortality.
- Higher Tei index, VIS, and PRISM III scores were observed in non-survivors compared to survivors.
Conclusions:
- The Tei index is a potential predictor of poor outcomes in children receiving CRRT.
- The Tei index demonstrates correlation with established prognostic markers such as PRISM III and VIS.
Objectives:
To evaluate echocardiographic parameters, especially the Tei index as a predictor of outcome in critically ill children on continuous renal replacement therapy (CRRT).
Methods:
This cohort study included all critically ill patients admitted at the Pediatric intensive care unit (PICU) and underwent CRRT. Functional echocardiography and Pediatric Risk of Mortality Index (PRISM) III were used to evaluate the participants. Both the Tei index and the Vasoactive inotropic score (VIS) were estimated.
Results:
The study included 35 patients with an age range of 6 mo to 14 y. The Tei indexes, VIS, and PRISM III were reported as predictors of mortality with a sensitivity of 88%, 83%, and 94% and a specificity of 73%, 79%, and 89% respectively. In survivors, the mean Tei index score, median VIS, and mean PRISM values were 0.44 ± 0.1, 3.8 (0-40), and 12.06 ± 3.35, respectively. However, in non-survivors, the mean Tei index, median VIS, and mean PRISM score were 0.59 ± 0.16, 0.60 (0-342.5), and 22.94 ± 8.93, respectively.
Conclusions:
The Tei index could be used as a predictor for poor outcomes in children receiving CRRT. It is correlated to the PRISM score and VIS.
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