Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea
Aim To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not. Methods We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for D...
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| Veröffentlicht in: | Acta Paediatrica 2014-07, Vol.103 (7), p.e306-e311 |
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| container_title | Acta Paediatrica |
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| creator | Sarmin, Monira Ahmed, Tahmeed Bardhan, Pradip K. Chisti, Mohammod J. |
| description | Aim
To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
Methods
We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
Results
Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p |
| doi_str_mv | 10.1111/apa.12640 |
| format | Article |
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To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
Methods
We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
Results
Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).
Conclusion
Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.</description><identifier>ISSN: 0803-5253</identifier><identifier>EISSN: 1651-2227</identifier><identifier>DOI: 10.1111/apa.12640</identifier><identifier>PMID: 24661049</identifier><language>eng</language><publisher>Norway: Blackwell Publishing Ltd</publisher><subject>Bangladesh ; Bangladesh - epidemiology ; Child, Preschool ; Children ; Diarrhea - complications ; Diarrhea - mortality ; Diarrhoea ; Humans ; Retrospective Studies ; Septic shock ; Severe sepsis ; Shock, Septic - etiology ; Shock, Septic - mortality ; Sleep Stages</subject><ispartof>Acta Paediatrica, 2014-07, Vol.103 (7), p.e306-e311</ispartof><rights>2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd</rights><rights>2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2014 Foundation Acta Pædiatrica</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4610-d4e1505737156df3cb65a66a7e296b395a4163d4b9aed2b30d44fc33a0abe4ca3</citedby><cites>FETCH-LOGICAL-c4610-d4e1505737156df3cb65a66a7e296b395a4163d4b9aed2b30d44fc33a0abe4ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapa.12640$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapa.12640$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24661049$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sarmin, Monira</creatorcontrib><creatorcontrib>Ahmed, Tahmeed</creatorcontrib><creatorcontrib>Bardhan, Pradip K.</creatorcontrib><creatorcontrib>Chisti, Mohammod J.</creatorcontrib><title>Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea</title><title>Acta Paediatrica</title><addtitle>Acta Paediatr</addtitle><description>Aim
To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
Methods
We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
Results
Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).
Conclusion
Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.</description><subject>Bangladesh</subject><subject>Bangladesh - epidemiology</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Diarrhea - complications</subject><subject>Diarrhea - mortality</subject><subject>Diarrhoea</subject><subject>Humans</subject><subject>Retrospective Studies</subject><subject>Septic shock</subject><subject>Severe sepsis</subject><subject>Shock, Septic - etiology</subject><subject>Shock, Septic - mortality</subject><subject>Sleep Stages</subject><issn>0803-5253</issn><issn>1651-2227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS0EokvhwBdAlrjAIa3_hxy3FRRQBUgtlJs1sWcVt9kk2A7b_fZ42bYHJOYy0szvPY3mEfKSsyNe6hgmOOLCKPaILLjRvBJC1I_Jgr1jstJCywPyLKVrxoRslHlKDoQyhjPVLMjtxYQuQB9Spt2YppChpynPfktTN24SzR1kmnDKwe0m7obC4KmPZRcGTIlOEX1wma7HWLQhb2kYqOtC7yMOdB48RroKv5FuQu6oDxBjNyI8J09W0Cd8cdcPyfcP7y9PP1bnX88-nS7PK6fKiZVXyDXTtay5Nn4lXWs0GAM1isa0stGguJFetQ2gF61kXqmVkxIYtKgcyEPyZu87xfHXjCnbdUgO-x4GHOdkuZaKNUo3sqCv_0GvxzkO5bodJRpei0YU6u2ecnFMKeLKTjGsIW4tZ3YXhy1x2L9xFPbVnePcrtE_kPf_L8DxHtiEHrf_d7LLb8t7y2qvKInh7YMC4o015UvaXn05sxefRX1y9fPS_pB_AJ-gpMo</recordid><startdate>201407</startdate><enddate>201407</enddate><creator>Sarmin, Monira</creator><creator>Ahmed, Tahmeed</creator><creator>Bardhan, Pradip K.</creator><creator>Chisti, Mohammod J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>201407</creationdate><title>Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea</title><author>Sarmin, Monira ; Ahmed, Tahmeed ; Bardhan, Pradip K. ; Chisti, Mohammod J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4610-d4e1505737156df3cb65a66a7e296b395a4163d4b9aed2b30d44fc33a0abe4ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Bangladesh</topic><topic>Bangladesh - epidemiology</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Diarrhea - complications</topic><topic>Diarrhea - mortality</topic><topic>Diarrhoea</topic><topic>Humans</topic><topic>Retrospective Studies</topic><topic>Septic shock</topic><topic>Severe sepsis</topic><topic>Shock, Septic - etiology</topic><topic>Shock, Septic - mortality</topic><topic>Sleep Stages</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sarmin, Monira</creatorcontrib><creatorcontrib>Ahmed, Tahmeed</creatorcontrib><creatorcontrib>Bardhan, Pradip K.</creatorcontrib><creatorcontrib>Chisti, Mohammod J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta Paediatrica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sarmin, Monira</au><au>Ahmed, Tahmeed</au><au>Bardhan, Pradip K.</au><au>Chisti, Mohammod J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea</atitle><jtitle>Acta Paediatrica</jtitle><addtitle>Acta Paediatr</addtitle><date>2014-07</date><risdate>2014</risdate><volume>103</volume><issue>7</issue><spage>e306</spage><epage>e311</epage><pages>e306-e311</pages><issn>0803-5253</issn><eissn>1651-2227</eissn><abstract>Aim
To evaluate the clinical characteristics and outcome in children hospitalised with diarrhoea, comparing those developed septic shock with those who did not.
Methods
We carried out a retrospective chart review on children aged 0–59 months admitted to the Dhaka Hospital, International Centre for Diarrhoeal Diseases Research, Bangladesh, with diarrhoea between October 2010 and September 2011. They were included if they had severe sepsis defined as tachycardia plus hyperthermia or hypothermia or an abnormal white blood cell count plus poor peripheral perfusion in absence of dehydration. Patients unresponsive to fluid and boluses, who required inotropes, were categorised as having septic shock (n = 88). The controls were those without septic shock (n = 116).
Results
Death was significantly higher among the children with septic shock (67%) than the controls (14%) (p < 0.001). A logistic regression analysis, adjusted for potential confounders, found that children with septic shock were more likely to be drowsy on admission and received blood transfusions and mechanical ventilation (all p < 0.05).
Conclusion
Children hospitalised for diarrhoea with septic shock were more likely to die, be drowsy on admission and receive blood transfusions and mechanical ventilation. A randomised clinical trial on inotropes in children with diarrhoea, severe sepsis and drowsiness may expedite their use and prevent mechanical ventilation and deaths.</abstract><cop>Norway</cop><pub>Blackwell Publishing Ltd</pub><pmid>24661049</pmid><doi>10.1111/apa.12640</doi><tpages>6</tpages></addata></record> |
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| ispartof | Acta Paediatrica, 2014-07, Vol.103 (7), p.e306-e311 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Alma/SFX Local Collection |
| subjects | Bangladesh Bangladesh - epidemiology Child, Preschool Children Diarrhea - complications Diarrhea - mortality Diarrhoea Humans Retrospective Studies Septic shock Severe sepsis Shock, Septic - etiology Shock, Septic - mortality Sleep Stages |
| title | Specialist hospital study shows that septic shock and drowsiness predict mortality in children under five with diarrhoea |
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