Prognostic markers among Egyptian children with sepsis in the Intensive Care Units, Cairo University Hospitals

Ibrahiem, Sally K; Galal, Yasmine Samir; Youssef, Meray Rene Labib; Sedrak, Amal S.; Khateeb, Engy El; Abdel-Hameed, Nehal D

doi:10.1016/j.aller.2015.07.005

Cited by 13 publications

(14 citation statements)

References 24 publications

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“…In our study, the mortality rate was 40.0% among the studied 40 patients. These figure is notably higher than that reported by some studies [11,12] but it is also lower that morality rates reported by other studies [13][14][15]. Discrepancy between various studies is probably attributed to the different nature and severity of underlying illnesses affecting patients recruited by different studies.…”

Section: Plos Onecontrasting

confidence: 54%

Prognostic value of baseline carotid blood flow in critically ill children with septic shock

et al. 2021

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Background and aim Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment. The present study aimed to test the value of carotid artery ultrasound analysis in prediction of mortality in pediatric patients with septic shock. Methodology/Principal finding Forty children with septic shock were included in the study. Upon admission, patients were subjected to careful history taking and thorough clinical examination. The consciousness level was assessed by the Glasgow Coma Scale (GCS). Laboratory assessment included complete blood count, C-reactive protein, arterial blood gases, serum electrolytes, and liver and kidney function tests. Electrical cardiometry was used to evaluate hemodynamic parameters. Patients were also subjected to transthoracic 2-D echocardiography. CBF was evaluated using GE Vivid S5 ultrasound device through dedicated software. At the end of study, 14 patients (35.0%) died. It was found that survivors had significantly higher CBF when compared non-survivors [median (IQR): 166.0 (150.0–187.3) versus 141.0 (112.8–174.3), p = 0.033]. In addition, it was noted that survivors had longer ICU stay when compared with non-survivors [16.5 (9.8–31.5) versus 6.5 (3.0–19.5) days, p = 0.005]. ROC curve analysis showed that CBF could significantly distinguish survivors from non-survivors [AUC (95% CI): 0.3 (0.11–0.48), p = 0.035] (Fig 2). Univariate logistic regression analysis identified type of shock [OR (95% CI): 28.1 (4.9–162.4), p<0.001], CI [OR (95% CI): 0.6 (0.43–0.84), p = 0.003] and CBF [OR (95% CI): 0.98 (0.96–0.99), p = 0.031]. However, in multivariate analysis, only type of shock significantly predicted mortality. Conclusions CBF assessment may be a useful prognostic marker in children with septic shock.

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Section: Plos Onecontrasting

confidence: 54%

Prognostic value of baseline carotid blood flow in critically ill children with septic shock

et al. 2021

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“…The database search and hand search of reference lists yielded a total of 8535 and 12 articles, respectively (Figure 1). After applying the inclusion/exclusion criteria, 94 studies that included a combined 7561 patients were eligible for analysis. Characteristics of included studies are summarized in Table 1 and eTables 2 and 3 in the Supplement.…”

Section: Resultsmentioning

confidence: 99%

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

et al. 2019

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IMPORTANCE The global patterns and distribution of case-fatality rates (CFRs) in pediatric severe sepsis and septic shock remain poorly described. OBJECTIVE We performed a systematic review and meta-analysis of studies of children with severe sepsis and septic shock to elucidate the patterns of CFRs in developing and developed countries over time. We also described factors associated with CFRs. DATA SOURCES We searched PubMed, Web of Science, Excerpta Medica database, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane Central systematically for randomized clinical trials and prospective observational studies from earliest publication until January 2017, using the keywords "pediatric," "sepsis," "septic shock," and "mortality." STUDY SELECTION Studies involving children with severe sepsis and septic shock that reported CFRs were included. Retrospective studies and studies including only neonates were excluded. DATA EXTRACTION AND SYNTHESIS We conducted our systematic review and meta-analysis in close accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled case-fatality estimates were obtained using random-effects meta-analysis. The associations of study period, study design, sepsis severity, age, and continents in which studies occurred were assessed with meta-regression. MAIN OUTCOMES AND MEASURES Meta-analyses to provide pooled estimates of CFR of pediatric severe sepsis and septic shock over time. RESULTS Ninety-four studies that included 7561 patients were included. Pooled CFRs were higher in developing countries (31.7% [95% CI, 27.3%-36.4%]) than in developed countries (19.3% [95% CI, 16.4%-22.7%]; P < .001). Meta-analysis of CFRs also showed significant heterogeneity across studies. Continents that include mainly developing countries reported higher CFRs (adjusted odds ratios: Africa, 7.89 [95% CI, 6.02-10.32]; P < .001; Asia, 3.81 [95% CI, 3.60-4.03]; P < .001; South America, 2.91 [95% CI, 2.71-3.12]; P < .001) than North America. Septic shock was associated with higher CFRs than severe sepsis (adjusted odds ratios, 1.47 [95% CI, 1.41-1.54]). Younger age was also a risk factor (adjusted odds ratio, 0.95 [95% CI, 0.94-0.96] per year of increase in age). Earlier study eras were associated with higher CFRs (adjusted odds ratios for 1991-2000, 1.24 [95% CI, 1.13-1.37]; P < .001) compared with 2011 to 2016. Time-trend analysis showed higher CFRs over time in developing countries than developed countries. CONCLUSIONS AND RELEVANCE Despite the declining trend of pediatric severe sepsis and septic shock CFRs, the disparity between developing and developed countries persists. Further characterizations of vulnerable populations and collaborations between developed and developing countries are warranted to reduce the burden of pediatric sepsis globally.

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“…Our meta-analysis provides strong support for greater organ dysfunction in nonsurvivors compared with survivors as shown by the pooled estimates for renal dysfunction ( 50 , 64 , 67 , 70 ), multi-organ dysfunction (MODS) ( 23 , 33 , 41 , 50 , 69 , 70 , 93 , 94 ), number of organ dysfunctions ( 28 , 40 , 64 , 83 ), PEdiatric Logistic Organ Dysfunction (PELOD) score ( 23 , 28 , 40 , 44 , 50 , 53 , 55 , 60 , 65 , 72 , 85 ), and PELOD-2 ( 85 , 86 , 95 ). Our meta-analysis also provides strong support for greater illness severity in nonsurvivors compared with survivors as shown by the pooled estimates pediatric Sequential (Sepsis-related) Organ Failure Assessment (pSOFA) ( 50 , 58 , 70 , 95 ) and Sequential (Sepsis-related) Organ Failure Assessment (SOFA) ( 85 , 86 , 95 ), PRISM ( 32 , 43 , 51 , 53 , 55 , 60 – 62 , 64 , 68 , 70 – 72 , 75 , 77 , 81 , 84 , 85 , 88 ), Pediatric Index of Mortality (PIM)-2 ( 79 , 85 ), and PIM-3 ( 23 , 61 , 65 , 85 ) (Supplementary Fig. 7,…”

Section: Resultsmentioning

confidence: 99%

Criteria for Pediatric Sepsis—A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce*

Menon

Schlapbach

Akech

et al. 2021

Critical Care Medicine

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Prognostic markers among Egyptian children with sepsis in the Intensive Care Units, Cairo University Hospitals

Abstract: Monitoring the levels of cellular and humoral immunological parameters together with assessing PELOD and PRISM III scores can significantly affect prognosis and survival of septic children.

Cited by 13 publications

References 24 publications

Prognostic value of baseline carotid blood flow in critically ill children with septic shock

Prognostic value of baseline carotid blood flow in critically ill children with septic shock

Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock

Criteria for Pediatric Sepsis—A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce*

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