Prevalence and Outcome of Sepsis-induced Myocardial Dysfunction in Children with 'Sepsis' 'With' and 'Without Shock'—A Prospective Observational Study. (3rd January 2018)

• Record Type: Journal Article
• Authors: Jain, Aditi; Sankar, Jhuma; anubhuti, Anubhuti; Yadav, Dinesh Kumar; Sankar, M Jeeva
• Is Part Of: Journal of tropical pediatrics. Volume 64:Number 6(2018:Dec.)
• Page Start: 501
• Page End: 509
• Publication Date: 2018-01-03
• Subjects: cardiac troponin-I (cTnI) -- sepsis-induced myocardial dysfunction (SIMD) -- septic shock -- systolic dysfunction -- diastolic dysfunction -- ejection fraction -- E' -- E/A -- MPI -- myocardial performance index; Pediatrics -- Periodicals; Tropical medicine -- Periodicals; Pediatrics -- Periodicals; Tropical Medicine -- Periodicals; Environmental Health -- Periodicals; Infant; Child; 618.929883
• DOI: 10.1093/tropej/fmx105
• Languages: English
• ISSNs: 0142-6338

Abstract

Abstract: Objective: To estimate the prevalence and effects of sepsis-induced myocardial dysfunction (SIMD) in children with septic shock. Methodology: Enrolled children with septic shock ( n = 31) and sepsis ( n = 30) underwent echocardiography and cardiac troponin-I (cTnI) estimation within first 3 h. SIMD was defined as presence of systolic/diastolic dysfunction by echocardiography. Results: The prevalence of SIMD was 71% in 'septic shock' and 23% in 'sepsis'. Diastolic dysfunction (45.2%) was more prevalent than systolic dysfunction (32.3%). Children with SIMD had higher requirement of inotropes [81 vs. 44%; adjusted odds ratio: 1.41 (1.04–1.92)] in first 48 h. cTnI had low sensitivity (62.5%) and specificity (55.1%) for detecting SIMD. On follow-up at 3 months, there was no residual dysfunction in the majority (71.3%). Conclusion: SIMD, especially diastolic dysfunction, is common in septic shock and may increase inotrope requirement. It is reversible in majority. Sepsis patients may have asymptomatic underlying SIMD. cTnI does not correlate with the degree of SIMD.