Assessment of clinical parameters and immediate outcome of children with shock in a tertiary care hospital ASRAM, Eluru, Andhra Pradesh, India

Abstract

Background: Shock is a state of impaired tissue perfusion resulting in an imbalance between oxygen demand and supply. This widespread reduction in effective tissue perfusion causes insufficient or improper delivery and distribution of oxygen and nutrients, the end result of which is an altered cellular and sub cellular function leading to anaerobic metabolism and accumulation of lactic acid, and consequently cellular damage, multiple organ dysfunction and finally cardiovascular collapse.Methods: The present study was conducted in the department of Pediatrics at Alluri Sitarama Raju Academy of Medical Sciences hospital, Eluru, between December 2014 and June 2016. It is a prospective study. Children aged 1 month to 12 years with a clinical diagnosis of shock were included after written consent from parents.Results: Out of 75 children admitted with shock, 69.33% had septic shock, 25.33% had hypovolemic shock, 2.66% had distributive shock, 2.66% cardiogenic shock. Most common age group admitted with shock was 1 month-1 year 38.666%. Among 75 children with shock, 74.66% children survived and 25.33% children died. Mortality rate in cardiogenic shock was 100%, in septic shock 28.84%, in hypovolemic shock 10.52%.Conclusions: Septic shock was the most common type of shock. Most common cause for septic shock was pneumonia. Septic shock has got highest mortality in the present study.Need for inotropes and mechanical ventilaton indicates poor prognosis in shock.

A prospective observational study on assessment of types of shock in children and requirement of inotropes in treatment of shock in tertiary care hospital

“…9 The most common type of Shock in our study was Septic shock which occupies 72.2% of total cases followed by Hypovolemic shock, 25.8%, cardiogenic shock accounts for 1.2% and Dengue shock constituted 0.6%. in previous studies the most common type of shock is Septic shock 69.33% followed by Hypovolemic shock 25.33%, distributive and cardiogenic shock of 2.66% [9] and in a study by Singh et al, the most common type of shock was hypovolemic shock followed by septic shock, cardiogenic shock and distributive shock. 10 Though hypovolemic shock is recognized as the most common cause of shock in children, it was not the most common cause of shock in this study.…”

“…In previous studies, the mortality rate of Cardiogenic shock was 100%. 9 Dengue shock was present in a single patient and this patient was dead. Mortality rate of Hypovolemic shock was 7.61%; in previous studies the mortality rate of Hypovolemic shock was constituted 3.4%.…”

“…10 The most common cause of Septic shock in this study is underline bacterial infection and in previous studies, the causes of Septic shock were pneumonia followed by sepsis. 9 In this study treatment of Hypovolemic shock includes aggressive fluids and appropriate antibiotics which follow guidelines.…”

A Study on Aetiology and Outcome of Shock in Children

“…In a study by Singh et al, 3 hypovolemic shock was the leading cause, accounting for 45% of cases followed by septic shock in 34%. However, in a study by Vasundhara et al, 4 septic shock was seen in 69% of case s of shock. Comparable results were seen in other studies.…”

Predictors of outcome in pediatric septic shock: Experience from a tertiary care teaching hospital

“…Vasundhara et al assessed clinical parameters and immediate outcome of children with shock in a tertiary care hospital in Andhra Pradesh [9]. Among 75 children with shock, 74.66% children survived, and 25.33% children died.…”