Clinical profile, cardiac involvement and outcome of children admitted with sepsis in pediatric intensive care unit at GB Pant children hospital Srinagar

Abstract

Background: Sepsis is a systemic illness caused by an infectious agent invading the body, which induces the release of inflammatory mediators, resulting in systemic inflammatory response syndrome (SIRS). The aim of our study was to recognize clinical profile, cardiac involvement, laboratory work up, etiology, treatment, and immediate outcome of patients admitted with sepsis. Methods: This prospective observational study was conducted in pediatric intensive care unit over period of two years. After informed consent from parents, all those patients meeting inclusion criteria were subjected to complete history, general and systemic physical examination. Routine baseline investigations included CBC, LFT, KFT, ABG, chest X-ray, serum calcium and phosphorous were done in all patients. The other investigations like echocardiography, COVID-19 RAT and RTPCR, CSF, blood and urine culture, USG, CT, MRI and various inflammatory markers like serum ferritin, CRP and ESR whenever required were done. Results: In this study 35 patients aged 1 year to 18 years with a diagnosis of sepsis were included. Out of them 20 were males and 15 were females with a male female ratio of 1.3:1 and mean age of 6.2 years. The most common etiology for sepsis was severe pneumonia seen in 17 (48.5%) cases while 8 (22.9%) had osteomyelitis, 3 (8.6%) had urinary tract infection, 2 (5.7%) had meningoencephalitis, 2 (5.7%) had severe diabetic ketoacidosis with culture proven sepsis, 2 (5.7%) had gastrointestinal infection and 1 (2.86%) had iliopsoas abscess with liver abscess. On echocardiography 9 (25.7%) patients had left ventricular (LV) dysfunction with left ventricular ejection fraction (LVEF) less than 55% and 3 (8.6%) patients had pericardial effusion. Out of them 20 (57%) patients were discharged after 8.9 days mean duration of hospital stay and 15 (43%) patients got expired after 3.1 days mean duration of hospital stay. Conclusions: Severe sepsis with septic shock is the leading cause of mortality if not picked early and treated aggressively.