Clinicopathological Profile and Outcome of Patients with Septic Shock in PICU

Sepsis significantly contributes to the pediatric population's morbidity, mortality, and global healthcare burden. Fatality rates among pediatric sepsis patients vary between 4%-50%, depending on factors like illness severity, risk elements, and geographical context. Many deaths occur within the initial 48-72 hours of treatment – often resulting from refractory shock and multiple organ dysfunction syndromes.

The aim of a recent prospective observational study––conducted at a pediatric intensive care unit (PICU) in a prominent tertiary care hospital in Western India between 2021-22––was to assess the clinicopathological profiles and outcomes among children who suffered septic shock.

The results revealed that among 570 PICU admissions, 25 met the inclusion criteria for septic shock. The average age of presentation was 24 months. The most common symptoms were fever (72%), vomiting (60%), and breathlessness (60%). Meanwhile, four patients (16%) exhibited culture-positive sepsis, with three being positive on blood culture and one on urine culture. However, 60% of the patients were diagnosed with multiple organ dysfunction syndrome (MODS). Of note, there was a significant association between mortality and patients requiring multiple inotropes, mechanical ventilation, and those progressing to MODS.

Septic shock imposes a high mortality rate among children, owing to its swift progression leading to multi-organ dysfunction and death, particularly among those under five years old. Early recognition and diagnosis of sepsis and standardized protocols are crucial in mitigating mortality risks.

Source: Bose SS, Khemani P, Khemka A, et al. International Journal Of Community Medicine And Public Health. 2021 Jan;8:339-45.