The morbidity and mortality of pediatric oncology patients presenting to the intensive care unit with septic shock

2008 ◽  
Vol 51 (5) ◽  
pp. 584-588 ◽  
Author(s):  
Catherine M. Pound ◽  
Donna L. Johnston ◽  
Rachel Armstrong ◽  
Isabelle Gaboury ◽  
Kusum Menon
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Pediatric Oncology ◽  
Morbidity And Mortality ◽  
Oncology Patients

scholarly journals Pediatric Cancer Outcomes in an Intensive Care Unit in Pakistan

2019 ◽  
pp. 1-5
Author(s):  
Gull Zareen Khan Sial ◽  
Saadiya Javed Khan
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Developing Countries ◽  
Intensive Care ◽  
Pediatric Oncology ◽  
Retrospective Chart Review ◽  
Developed Countries ◽  
Therapeutic Interventions ◽  
Disease Stage ◽  
Oncology Patients

PURPOSE Although cancer is uncommon, it is a significant cause of pediatric morbidity and mortality in the developing world. The need for intensive care in pediatric oncology has increased with more intense chemotherapeutic interventions. It is important to identify patients who will benefit from management in the intensive care unit (ICU), given the resource limitation in developing countries. In this review, we examine our institutional experience with pediatric patients with cancer needing ICU care. METHODS A retrospective chart review from December 2015 to June 2017 was performed with institutional review board approval for all pediatric oncology patients admitted to the ICU. Data collection included age, diagnosis, disease stage, Pediatric Risk of Mortality (PRISM III) score, and therapeutic interventions. RESULTS We reviewed 59 pediatric oncology ICU medical records. There were 36 boys (61%) and 23 girls (39%). The median age was 4 years. Average stay in the ICU was 4.6 days. Three significant reasons for ICU referral were respiratory distress, sepsis, and circulatory collapse. There were 34 ICU survivors (57.6%). Among those who survived the ICU, 20 patients (58.8%) later died of therapy-related complications. Factors related to increased ICU mortality included the need for mechanical ventilation, the need for inotropic support, the number of failing organs, and a high PRISM III score. CONCLUSION The mortality rate for pediatric oncology patients admitted to the ICU in developing countries is higher than in developed countries. Mortality was significantly related to the need for mechanical ventilation. PRISM III scoring can help identify patients who can benefit from ICU treatment, which is expensive in resource-limited low- and middle-income countries such as Pakistan.

scholarly journals Clinical profile and outcome of shock in mechanically ventilated patients in pediatric intensive care unit of tertiary care centre

2018 ◽  
Vol 7 (1) ◽  
pp. 71
Author(s):  
Swati M. Gadappa ◽  
Manas Kumar Behera
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Morbidity And Mortality ◽  
Clinical State ◽  
Critically Ill Children ◽  
Multicentric Study ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Background: The clinical syndrome of shock, a clinical state characterized by inadequate tissue perfusion, is one of the most dramatic, dynamic and life-threatening problems faced by the physician in the critical care setting.Methods: Retrospective observational study of all critically ill children between 1month-12years who were admitted and mechanically ventilated in our 8-bedded PICU between January 2015 to June 2016; and had clinical evidence of shock. PIM3 (Paediatric Index of Mortality 3) was calculated. Authors noted morbidity and mortality pattern in all types of shock including outcome in Paediatric ICU. The data collected were compiled and tabulated.Results: The frequency of shock in authors’ Paediatric intensive care unit was 8.6% (n=780). However, among mechanically ventilated patients it was present in 65.5% patients. Septic shock was the most commonly encountered shock (n=48, 61.5%). Mortality was highest in cardiogenic shock (n=12, 80%) and obstructive shock (n=4, 80%). Survival was best in Hypovolemic shock. Authors found significant correlation between LOS MV and mortality (p=0.018). Type of shock had no correlation with PIM3 score (p=0.374) and mortality (p=0.884). Blood culture yield was positive in 26.9% patients with Klebsiella pneumoniae, Pseudomonas aeruginosa and MRSA being most common organisms isolated.Conclusions: Shock is a major cause of morbidity and mortality in children especially below 5yrs of age. Septic shock was the commonest form of shock in children. Severe pneumonia was the commonest illness causing septic shock. Mortality was associated with longer length of stay on mechanical ventilation. Larger prospective multicentric study in developing countries is desirable.

ROLE OF SERUM CORTISOL AS A MARKER OF MORBIDITY AND MORTALITY IN SEPTIC SHOCK PATIENTS IN THE INTENSIVE CARE UNIT.

2006 ◽  
Vol 34 ◽  
pp. A104
Author(s):  
Bhavneesh Sharma ◽  
Ashish Sangal ◽  
Manisha Sharma ◽  
Sharad Chandrika ◽  
Mujibur Majumder ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Serum Cortisol ◽  
Morbidity And Mortality

Activation of the Intrinsic Pathway of Coagulation in Children with Meningococcal Septic Shock

1995 ◽  
Vol 74 (06) ◽  
pp. 1436-1441 ◽  
Author(s):  
Walter A Wuillemin ◽  
Karin Fijnvandraat ◽  
Bert H F Derkx ◽  
Marjolein Peters ◽  
Willem Vreede ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Contact System ◽  
Morbidity And Mortality ◽  
Factor Xii ◽  
C1 Inhibitor ◽  
Intrinsic Pathway ◽  
Factor Xi ◽  
Meningococcal Septic Shock

SummaryMeningococcal septic shock (MSS) is complicated by activation of coagulation, fibrinolytic, and complement systems. We studied the contact system of the intrinsic pathway of coagulation in thirteen children with MSS. Activation was assessed upon admittance to the intensive care unit and 48 h thereafter, based on the measurement of factor XII- (FXII), prekallikrein- and factor XI (FXI) antigen levels, as well as on the detection of FXIa-FXIa inhibitor, FXIIa-C1-inhibitor, and kallikrein-C1-inhibitor complexes, respectively. Levels of FXII, prekallikrein and FXI were reduced to about 50% in all patients on admission, and were significantly higher 48 h later. FXIIa-C1-inhibitor complexes were elevated in 7 patients, and kallikrein-C1-inhibitor complexes in 2 patients. FXIa-α1-antitrypsin complexes were elevated in all patients, FXIa-C1-inhibitor complexes in nine, and FXIa-anti-thrombin III complexes in one patient. We conclude that patients with MSS have activation of the contact system, which may contribute to activation of coagulation, and thus to morbidity and mortality.

Effect of hydrocortisone versus methylprednisolone on clinical outcomes in oncology patients with septic shock

2020 ◽  
pp. 107815522091078
Author(s):  
Emily McDonnell ◽  
Reagan Collins ◽  
Mike Hernandez ◽  
Anne Rain T. Brown
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Primary Outcome ◽  
Intensive Care Unit Mortality ◽  
Adjunctive Treatment ◽  
Oncology Patients ◽  
Lengths Of Stay ◽  
Shock Reversal ◽  
The Impact

Background Corticosteroids are used as adjunctive treatment of critical illness-related corticosteroid insufficiency in patients with septic shock. This study aims to compare the impact of hydrocortisone versus methylprednisolone on duration of septic shock in critically ill oncology patients. Methods Single-center, retrospective cohort study of adult patients receiving hydrocortisone ≥200 mg/day or methylprednisolone ≥40 mg/day with septic shock. The primary outcome was time to shock reversal defined as time to systolic blood pressure ≥90 mmHg without vasopressors for ≥24 h. Results Eighty-eight patients were included, 49 patients received hydrocortisone and 39 patients received methylprednisolone. Solid tumor malignancy was more common in the hydrocortisone group, while hematological malignancy was more common in the methylprednisolone group (p = 0.009). Time to shock reversal was similar between hydrocortisone and methylprednisolone groups (72.4 versus 70.4 h; p = 0.825). Intensive care unit mortality occurred in 51.02% versus 53.85% of patients in hydrocortisone versus methylprednisolone, respectively (p = 0.792). Patients who received methylprednisolone had higher rates of mechanical ventilation (89.74% versus 55.1%, p < 0.001) and longer intensive care unit and hospital lengths of stay (4.2 versus 11.4 days and 14.3 versus 25.7 days; p < 0.001) compared to hydrocortisone. No differences were seen in incidence of steroid-related adverse effects between groups. Conclusions In oncology patients with septic shock, the use of hydrocortisone versus methylprednisolone does not appear to affect time to shock reversal.

scholarly journals Healthcare-Associated Infections among Patients in a Large Burn Intensive Care Unit: Incidence and Pathogens, 2008–2012

2014 ◽  
Vol 35 (10) ◽  
pp. 1304-1306 ◽  
Author(s):  
David J. Weber ◽  
David van Duin ◽  
Lauren M. DiBiase ◽  
Charles Scott Hultman ◽  
Samuel W. Jones ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
The United States ◽  
Burn Injuries ◽  
Morbidity And Mortality ◽  
Common Source ◽  
Healthcare Associated Infections ◽  
Burn Patients ◽  
Healthcare Associated

Burn injuries are a common source of morbidity and mortality in the United States, with an estimated 450,000 burn injuries requiring medical treatment, 40,000 requiring hospitalization, and 3,400 deaths from burns annually in the United States. Patients with severe burns are at high risk for local and systemic infections. Furthermore, burn patients are immunosuppressed, as thermal injury results in less phagocytic activity and lymphokine production by macrophages. In recent years, multidrug-resistant (MDR) pathogens have become major contributors to morbidity and mortality in burn patients.Since only limited data are available on the incidence of both device- and nondevice-associated healthcare-associated infections (HAIs) in burn patients, we undertook this retrospective cohort analysis of patients admitted to our burn intensive care unit (ICU) from 2008 to 2012.

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