Paediatric patients with septic shock admitted to the Paediatric Intensive Care Unit of the National Cancer Institute
Keywords:
Septic shock, Cancer Institutions, Neoplasms, Critical care, PaediatricsAbstract
Introduction: Sepsis is one of the leading causes of death in children, and for patients with cancer the risk is even greater. A recent study by our group shows that the main cause of admission to the Paediatric Intensive Care Unit (PICU) of the National Cancer Institute (INC) is septic shock. It is important to better describe this population to look for potential early and effective interventions.
Objective: To describe the clinical course of paediatric patients with cancer and with a diagnosis of septic shock who were admitted to the PICU of the INC between October 2011 and December 2013.
Materials and methods: Descriptive study of all cancer patients under 18 years of age who were admitted to the PICU with a diagnosis of septic shock. A record was made of demographic data, admission diagnoses, any microorganisms isolated, as well as clinical and treatment outcomes. The observed mortality was compared to the expected mortality using the PIM3 score (Paediatric Index of Mortality 3)
Results: The study included a total of 109 patients, with a mean age of 7 years old. The median length of stay in the unit was 7 days (IRQ 10.1). Febrile neutropenia with shock (27%) was the most frequent infectious diagnosis. The large majority (79%) of the patients had haematological malignancies. Gram-negative bacteria were the most common microorganism isolated. The observed mortality was 24.7%, while the expected mortality was 14.3%.
Conclusion: Although the patients in this group have similar characteristics to those reported in other series, the observed mortality was greater than the expected mortality. This finding should be explored by additional studies to establish if it is a question of low calibration of the PIM3 score or of particular differences in the diagnosis and management of these patients.
Author Biographies
Alexandra Jiménez Chaves, Universidad Nacional de Colombia
Cuidado Intensivo Pediátrico, Facultad Medicina, Universidad Nacional de Colombia, Bogotá D. C., Colombia
Javier Godoy, Instituto Nacional de Cancerología
Unidad de Cuidado Intensivo Pediátrico, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
Pablo Vásquez Hoyos, Universidad Nacional de Colombia
Cuidado Intensivo Pediátrico, Facultad Medicina, Universidad Nacional de Colombia, Bogotá D. C., Colombia
Luis Carlos Maya, Universidad Nacional de Colombia
Cuidado Intensivo Pediátrico, Facultad Medicina, Universidad Nacional de Colombia, Bogotá D. C., Colombia
Amaranto Suárez, Instituto Nacional de Cancerología
Oncología Pediátrica, Instituto Nacional de Cancerología, Bogotá D. C., Colombia
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