Management of Septic Shock

Lodha, Rakesh; Oleti, Tejo Pratap; Kabra, S. K.

doi:10.1007/s12098-011-0415-z

Cited by 6 publications

(5 citation statements)

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“…Fortunately, in the past few decades, with the development of diagnosis and treatment, the mortality rate of children with septic shock has decreased in developed nations ( 9 ). However, the mortality rates in third world countries are still extremely high as before ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 95%

Analysis of signature genes and association with immune cells infiltration in pediatric septic shock

et al. 2022

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BackgroundEarly diagnosis of septic shock in children is critical for prognosis. This study committed to investigate the signature genes and their connection with immune cells in pediatric septic shock.MethodsWe screened a dataset of children with septic shock from the GEO database and analyzed differentially expressed genes (DEGs). Functional enrichment analysis was performed for these DEGs. Weighted gene co-expression network analysis (WCGNA) was used to screen the key modules. Least absolute shrinkage and selection operator (LASSO) and random forest analysis were finally applied to identify the signature genes. Then gene set enrichment analysis (GSEA) was exerted to explore the signaling pathways related to the hub genes. And the immune cells infiltration was subsequently classified via using CIBERSORT.ResultsA total of 534 DEGs were screened from GSE26440. The data then was clustered into 17 modules via WGCNA, which MEgrey module was significantly related to pediatric septic shock (cor=−0.62, p<0.0001). LASSO and random forest algorithms were applied to select the signature genes, containing UPP1, S100A9, KIF1B, S100A12, SLC26A8. The receiver operating characteristic curve (ROC) of these signature genes was 0.965, 0.977, 0.984, 0.991 and 0.989, respectively, which were verified in the external dataset from GSE13904. GSEA analysis showed these signature genes involve in positively correlated fructose and mannose metabolism and starch and sucrose metabolism signaling pathway. CIBERSORT suggested these signature genes may participate in immune cells infiltration.ConclusionUPP1, S100A9, KIF1B, S100A12, SLC26A8 emerge remarkable diagnostic performance in pediatric septic shock and involved in immune cells infiltration.

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Section: Introductionmentioning

confidence: 95%

Analysis of signature genes and association with immune cells infiltration in pediatric septic shock

et al. 2022

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“…Incidence of severe sepsis was relatively higher in Indian pediatric ICU (40-60%) compared to those admitted in western pediatric intensive care unit (2-4%). 4 Since the present study was conducted in a tertiary level hospital, complicated cases were referred to this PICU which explains more incidence of septic shock in this PICU. Incidence of septic shock appears to have increased from 3.7% to 4.4% between 2004-2012 [5].…”

Section: Resultsmentioning

confidence: 99%

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

Vasundhara¹,

Sahoo²,

Chowdary³

2017

Int J Contemp Pediatr

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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.

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“…Unfortunately, in third world countries the mortality rate is still extremely high (5,6). Moreover, every hour of septic shock without appropriate resuscitation and restoration of blood pressure increases mortality risk by 40% (7).…”

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confidence: 99%

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

Mickiewicz

Vogel²,

Wong³

et al. 2013

Am J Respir Crit Care Med

167

175

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Rationale: Septic shock is a significant cause of morbidity and mortality in the pediatric population. Early recognition of septic shock and appropriate treatment increase survival rate; thus, developing new diagnostic tools may improve patients' outcomes. Objectives: To determine whether a metabolomics approach could be useful in the diagnosis and prognosis of septic shock in pediatric intensive care unit (PICUs). Methods: Serum samples were collected from 60 patients with septic shock, 40 PICU patients with systemic inflammatory response syndrome (not suspected of having an infection), and 40 healthy children. Proton nuclear magnetic resonance spectroscopy spectra were analyzed and quantified using targeted profiling methodology. Measurements and Main Results: Multivariate statistical analysis was applied to detect specific patterns in metabolic profiles and to highlight differences between patient samples. Supervised analysis afforded good predictive models and managed to separate patient populations. Some of the metabolite concentrations identified in serum samples changed markedly, indicating their influence on the separation between patient groups. These metabolites represent a composite biopattern of the pediatric metabolic response to septic shock and might be considered as the basis for a biomarker panel for the diagnosis of septic shock and its mortality in PICU. Conclusions: Our results indicate that nuclear magnetic resonance metabolite profiling might serve as a promising approach for the diagnosis and prediction of mortality in septic shock in a pediatric population and that quantitative metabolomics methods can be applied in the clinical evaluations of pediatric septic shock.Keywords: pediatric septic shock; biomarkers; metabolomics; proton nuclear magnetic resonance spectroscopy; mortalityIn the 1980s the death rate from septic shock in children was around 50% (1, 2), but over the past few decades with better early diagnosis and therapy it has decreased to approximately 10% (3, 4). Unfortunately, in third world countries the mortality rate is still extremely high (5, 6). Moreover, every hour of septic shock without appropriate resuscitation and restoration of blood pressure increases mortality risk by 40% (7). Septic shock is a very dynamic process, and the clinical status of a child can deteriorate quickly (8). The first hours after the diagnosis are called the "golden hours" for a patient's survival; therefore, aggressive and goal-directed treatment should be initiated as quickly as possible (9). It is reported that those children in whom septic shock is recognized early and properly treated have a much higher survival rate than children who were diagnosed later (10-12). Thus, developing diagnostic approaches that might accelerate disease recognition is extremely important to improve patient outcomes and decrease mortality.In this study we investigated whether we could use a metabolomics approach for the diagnosis and prognosis of pediatric septic shock. Metabolomics is defined as "the quantita...

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Management of Septic Shock

Cited by 6 publications

References 43 publications

Analysis of signature genes and association with immune cells infiltration in pediatric septic shock

Analysis of signature genes and association with immune cells infiltration in pediatric septic shock

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

Metabolomics as a Novel Approach for Early Diagnosis of Pediatric Septic Shock and Its Mortality

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