Sepsis-Induced Myocardial Dysfunction in Pediatric Septic Shock: Prevalence, Predictors, and Outcome-A Prospective...

Area of Science:

• Pediatric Critical Care Medicine
• Cardiology
• Infectious Diseases

Background:

• Sepsis-induced myocardial dysfunction (SMD) is understudied in pediatric septic shock.
• Limited data exists on its prevalence, predictors, and prognostic markers.

Purpose of the Study:

• To estimate the prevalence of SMD in pediatric septic shock using point-of-care functional echocardiography (POCFE).
• To investigate the association of SMD with illness severity, organ dysfunction, and patient outcomes.
• To identify predictors and prognostic markers for SMD.

Main Methods:

• Prospective, observational study in a tertiary pediatric intensive care unit (PICU) in South India.
• Enrolled children with septic shock, performing POCFE within 6 hours of PICU admission.
• Categorized patients based on POCFE findings for SMD diagnosis.

Main Results:

• Prevalence of SMD was 32% (32/100 children).
• Mortality was significantly higher in the SMD group (54.5%) compared to the non-SMD group (7.5%).
• SMD correlated with increased organ dysfunction, worse outcomes, and was an independent predictor of mortality. Lactate levels at 6 hours (threshold 2.4 mmol/L) predicted SMD with 73% sensitivity and 80% specificity.

Conclusions:

• SMD is a significant and not uncommon complication in pediatric septic shock.
• SMD is associated with increased mortality, organ dysfunction, and poorer patient outcomes.
• Lactate trends can serve as a valuable prognostic marker for SMD in pediatric septic shock.