Septic Shock in Children in an Urban Area in Western Germany – Outcome, Risk Factors for Mortality and Infection Epidemiology

Breuling, T.; Tschiedel, Eva; Große-Lordemann, A.; Hünseler, Christoph; Schmidt, Christine; Niemann, F; Dettmer, P.; Freymann, Holger; Noorden, Carl von; Wallot, M.; Heister, P; Heitmann, Friedhelm; Rothoeft, Tobias; Schürmann, U.; Backendorf, A.; Heldmann, Michael; Schubert, Erland W.; Nuñez, Francisco Brevis; Seiffert, Peter; Felderhoff-Müser, Ursula; Dohna-Schwake, Christian

doi:10.1055/s-0034-1398690

Cited by 7 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mortality remains high in the initial 72 hours of onset of sepsis and septic shock partly due to the hyper in ammatory phase (cytokine storm) of the immune response [13]. Presence of low arterial systolic blood pressure and PH, presence of disseminated intravascular coagulation and extent of multi-organ failure have been associated with poor outcomes [14]. A study in India showed a 96 hours mortality of 70% [15].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey

Vekaria-Hirani

Kumar

Musoke

et al. 2019

International Journal of Pediatrics

View full text Add to dashboard Cite

Background. Paediatric septic shock is a subset of sepsis associated with high mortality. Implementing the existing international Surviving Sepsis Campaign Guidelines 2012 (SSCG) have contributed to reduction of mortality in many places but these have not been adopted in our setting. The current study aimed at documenting the practice at a national referral hospital. Methods. A hospital based longitudinal survey carried out among 325 children from September to October 2016. Children aged 0 days (≥37 weeks gestation) to12 years were included. The aim was to determine the prevalence, audit the management and determine the outcome at 72 hours of septic shock among children admitted at the Kenyatta National Hospital (KNH). A standard questionnaire was used for data collection and Surviving Sepsis Guideline 2012 was used as a reference for auditing the management of septic shock. Data was stored in MS-EXCEL and analysed in STATA 12. Results. The prevalence of septic shock was 50 (15.4%), with a median age of 4 months. Septic shock was recognized by the attending clinician in 28 (56%). The level of care to children with septic shock was not to the level recommended by the SSCG 2012. Odds of being diagnosed with septic shock reduced with age (odds ratio 4.38 (1.7–11.0), p=0.002) and no child aged above 60 months age was diagnosed with septic shock. The mortality was 35 (70%) at 72 hours of admission, with a median of 14 hours. Infants had the highest case fatality of 82.6%. It was found that lack of mechanical ventilation, and presence of hypotension at admission were associated with greater mortality (p values of 0.03 and 0.01 respectively). Conclusion. The prevalence rate of septic shock is 15.4% among children admitted at the KNH and is associated with high mortality. The advanced degree of shock contributed to mortality. The level of care at KNH was not to the level of SSCG 2012, and hence the need to include septic shock management guidelines/protocols in our local Kenyan paediatric guideline.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey

Vekaria-Hirani

Kumar

Musoke

et al. 2019

International Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…Furthermore, mortality rates remain notably high within the first 72 hours of sepsis and septic shock onset, primarily due to the hyper-inflammatory phase (cytokine storm) of the immune response [18]. Various factors have been linked to unfavorable outcomes, such as low arterial systolic blood pressure and pH, disseminated intravascular coagulation, and the degree of multi-organ failure [19].…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology and Outcomes of Children Septic Shock in Developing Countries: A Literature Review

Wibowo¹,

Kusumastuti²,

Fitriati³

et al. 2023

IJRP

View full text Add to dashboard Cite

Sepsis, a condition marked by an imbalanced immune response to infection, can lead to organ dysfunction, and potentially life-threatening consequences. Within the spectrum of sepsis, septic shock stands out as a severe manifestation with pronounced circulatory and cellular metabolism abnormalities, contributing to an elevated mortality rate. This literature review aims to provide an enhanced understanding of the epidemiology and outcomes of septic shock in children populations residing in developing countries. By synthesizing and expanding upon existing research in the field, this review seeks to offer a more comprehensive analysis of this critical healthcare issue.

show abstract

“…However, the intrinsic factors that contribute to this variability are not well understood. Previous literature has focused primarily on the association of illness severity scores and mortality with septic shock (22)(23)(24)(25). However, these scores may not be sensitive enough to predict those at risk of a differential outcome following therapies such as corticosteroids leading to the impetus for patient specific biomarkers.…”

Section: At the Bedsidementioning

confidence: 99%

The Association of Corticosteroids and Pediatric Sepsis Biomarker Risk Model (PERSEVERE)-II Biomarker Risk Stratification With Mortality in Pediatric Septic Shock*

Klowak

Bijelić

Barrowman

et al. 2022

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

OBJECTIVES: Mortality risk stratification may identify a subset of children who benefit from or are harmed by corticosteroid administration. The Pediatric Sepsis Biomarker Risk Model (PERSEVERE)-II score is a biomarker-based mortality risk stratification tool for pediatric sepsis. Our objective was to assess the association of corticosteroid administration with 28-day mortality within different levels of baseline mortality risk (PERSEVERE-II) in a cohort of children with septic shock. DESIGN:We performed a secondary analysis using prospectively collected data (January 2015 to December 2018).

show abstract

Septic Shock in Children in an Urban Area in Western Germany – Outcome, Risk Factors for Mortality and Infection Epidemiology

Abstract: Mortality from pediatric septic shock in an urban area in Western Germany is high. Disease severity and treatment in a department with few cases were associated with increased mortality.

Cited by 7 publications

References 13 publications

Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey

Prevalence and Management of Septic Shock among Children Admitted at the Kenyatta National Hospital, Longitudinal Survey

The Epidemiology and Outcomes of Children Septic Shock in Developing Countries: A Literature Review

The Association of Corticosteroids and Pediatric Sepsis Biomarker Risk Model (PERSEVERE)-II Biomarker Risk Stratification With Mortality in Pediatric Septic Shock*

Contact Info

Product

Resources

About