Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis
Objective: The aim of this study was to verify the association of echocardiogram, ferritin, C‐reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis. Methods: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients ag...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | Portuguese |
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Brazilian Society of Pediatrics
2017-05-01
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| Series: | Jornal de Pediatria (Versão em Português) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2255553617300058 |
| _version_ | 1811193085524180992 |
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| author | Cristian T. Tonial Pedro Celiny R. Garcia Louise Cardoso Schweitzer Caroline A.D. Costa Francisco Bruno Humberto H. Fiori Paulo R. Einloft Ricardo Branco Garcia Jefferson Pedro Piva |
| author_facet | Cristian T. Tonial Pedro Celiny R. Garcia Louise Cardoso Schweitzer Caroline A.D. Costa Francisco Bruno Humberto H. Fiori Paulo R. Einloft Ricardo Branco Garcia Jefferson Pedro Piva |
| author_sort | Cristian T. Tonial |
| collection | DOAJ |
| description | Objective: The aim of this study was to verify the association of echocardiogram, ferritin, C‐reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis.
Methods: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients aged between 28 days and 18 years. Inclusion criteria were diagnosis of sepsis, need for mechanical ventilation for more than 48 h, and vasoactive drugs. Serum levels of C‐reactive protein, ferritin, and leukocyte count were collected on the first day (D0), 24 h (D1), and 72 h (D3) after recruitment. Patients underwent transthoracic echocardiography to determine the ejection fraction of the left ventricle on D1 and D3. The outcomes measured were length of hospital stay and in the pediatric intensive care unit, mechanical ventilation duration, free hours of VM, duration of use of inotropic agents, maximum inotropic score, and mortality.
Results: Twenty patients completed the study. Patients with elevated ferritin levels on D0 had also fewer ventilator‐free hours (p = 0.046) and higher maximum inotropic score (p = 0.009). Patients with cardiac dysfunction by echocardiogram on D1 had longer hospital stay (p = 0.047), pediatric intensive care unit stay (p = 0.020), duration of mechanical ventilation (p = 0.011), maximum inotropic score (p = 0.001), and fewer ventilator‐free hours (p = 0.020).
Conclusion: Cardiac dysfunction by echocardiography and serum ferritin value was significantly associated with unfavorable outcomes in pediatric patients with sepsis. |
| first_indexed | 2024-04-12T00:02:36Z |
| format | Article |
| id | doaj.art-21c3c35ac6f74503a644c2254775be14 |
| institution | Directory Open Access Journal |
| issn | 2255-5536 |
| language | Portuguese |
| last_indexed | 2024-04-12T00:02:36Z |
| publishDate | 2017-05-01 |
| publisher | Brazilian Society of Pediatrics |
| record_format | Article |
| series | Jornal de Pediatria (Versão em Português) |
| spelling | doaj.art-21c3c35ac6f74503a644c2254775be142022-12-22T03:56:11ZporBrazilian Society of PediatricsJornal de Pediatria (Versão em Português)2255-55362017-05-0193330130710.1016/j.jpedp.2017.02.002Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsisCristian T. Tonial0Pedro Celiny R. Garcia1Louise Cardoso Schweitzer2Caroline A.D. Costa3Francisco Bruno4Humberto H. Fiori5Paulo R. Einloft6Ricardo Branco Garcia7Jefferson Pedro Piva8Pontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Hospital São Lucas, Unidade de Terapia Intensiva, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Hospital São Lucas, Unidade de Terapia Intensiva, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Hospital São Lucas, Serviço de Cardiologia Pediátrica, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Programa de Pós‐Graduação em Pediatria e Saúde da Criança, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Hospital São Lucas, Unidade de Terapia Intensiva, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Programa de Pós‐Graduação em Pediatria e Saúde da Criança, Porto Alegre, RS, BrasilPontifícia Universidade Católica do Rio Grande do Sul (PUC‐RS), Hospital São Lucas, Unidade de Terapia Intensiva, Porto Alegre, RS, BrasilCambridge University Hospitals NHS Trust, Pediatric Intensive Care Unit, Cambridge, InglaterraHospital de Clínicas de Porto Alegre (HCPA), Unidade de Terapia Intensiva Pediátrica, Porto Alegre, RS, BrasilObjective: The aim of this study was to verify the association of echocardiogram, ferritin, C‐reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis. Methods: A prospective cohort study was carried out from March to December 2014, with pediatric critical care patients aged between 28 days and 18 years. Inclusion criteria were diagnosis of sepsis, need for mechanical ventilation for more than 48 h, and vasoactive drugs. Serum levels of C‐reactive protein, ferritin, and leukocyte count were collected on the first day (D0), 24 h (D1), and 72 h (D3) after recruitment. Patients underwent transthoracic echocardiography to determine the ejection fraction of the left ventricle on D1 and D3. The outcomes measured were length of hospital stay and in the pediatric intensive care unit, mechanical ventilation duration, free hours of VM, duration of use of inotropic agents, maximum inotropic score, and mortality. Results: Twenty patients completed the study. Patients with elevated ferritin levels on D0 had also fewer ventilator‐free hours (p = 0.046) and higher maximum inotropic score (p = 0.009). Patients with cardiac dysfunction by echocardiogram on D1 had longer hospital stay (p = 0.047), pediatric intensive care unit stay (p = 0.020), duration of mechanical ventilation (p = 0.011), maximum inotropic score (p = 0.001), and fewer ventilator‐free hours (p = 0.020). Conclusion: Cardiac dysfunction by echocardiography and serum ferritin value was significantly associated with unfavorable outcomes in pediatric patients with sepsis.http://www.sciencedirect.com/science/article/pii/S2255553617300058SepsisSeptic shockEchocardiogramOutcomePediatric intensive care unit |
| spellingShingle | Cristian T. Tonial Pedro Celiny R. Garcia Louise Cardoso Schweitzer Caroline A.D. Costa Francisco Bruno Humberto H. Fiori Paulo R. Einloft Ricardo Branco Garcia Jefferson Pedro Piva Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis Jornal de Pediatria (Versão em Português) Sepsis Septic shock Echocardiogram Outcome Pediatric intensive care unit |
| title | Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| title_full | Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| title_fullStr | Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| title_full_unstemmed | Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| title_short | Cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| title_sort | cardiac dysfunction and ferritin as early markers of severity in pediatric sepsis |
| topic | Sepsis Septic shock Echocardiogram Outcome Pediatric intensive care unit |
| url | http://www.sciencedirect.com/science/article/pii/S2255553617300058 |
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