EPIDEMIOLOGY OF PEDIATRIC SEVERE SEPSIS AND SEPTIC SHOCK IN THREE ASIAN COUNTRIES.
- Rujipat Samransamruajkit, Thailand
- Rujipat Samransamruajkit, Thailand
Abstract
Background
Pediatric severe sepsis remains a major public health problem. However, the prevalence, clinical characteristics, and management of pediatric severe sepsis in Asia is rarely described.
Objectives
To identify the prevalence, risk factors, treatment and outcomes of children with sepsis in PICU
Methods
This is a multicenter retrospective study of children with severe sepsis who were admitted in pediatric intensive care unit (PICU) from January – December, 2017. We included children with severe sepsis or septic shock based on the American College of Critical Care Medicine’s definition.
Results
:Five PICUs in Pediatric Acute & Critical Care Medicine Asian Network participated in this study (Thailand, Singapore, Malaysia). 188 children were included in this study. Mean age was 4.8 ± 5.0 years. 64 (42%) had underlying disease. Pneumonia [39, 34%] was the most common source of infection. 136 (93.8%) patients were resuscitated within the first hour and 108 (72.6%) received fluid bolus after diagnosis of shock. Normal saline (72, 67.9%) was the most common first fluid used for resuscitation, followed by ringer lactate/Acetar (14, 13%) and 5% albumin (4, 3.7%). 106(72.6%) patients received first vasopressor at first hour of resuscitation and dopamine was the most common vasopressor (57, 53.7%) used. Antibiotics were given within 1 hr in 147 (98%) patients. Corticosteroids was given in 45 (40.2%) patients. Duration of PICU stay was 12.6 ± 29.7 days. Overall 28-day mortality was at 30/127 (23.6%).
Conclusion
Children admitted with severe sepsis and septic shock in Asian PICU had high mortality