Prognostic value of baseline carotid blood flow in critically ill children with septic shock

Autor: HebatAllah Fadel Algebaly, Hafez M. Bazaraa, Ahmed A. Baz, Fatma Mamdouh
Rok vydání: 2020
Předmět:
Electrical cardiometry
Physiology
Hemodynamics
Cardiovascular Analysis
Biochemistry
Pediatrics
0302 clinical medicine
Blood Flow
Medicine and Health Sciences
Child
Cerebral Blood Flow Assay
Multidisciplinary
medicine.diagnostic_test
Complete blood count
Hematology
Prognosis
C-Reactive Proteins
Shock
Septic
Hospitals
Body Fluids
Intensive Care Units
Carotid Arteries
Blood
Bioassays and Physiological Analysis
Shock (circulatory)
Cardiology
Arterial blood
Medicine
medicine.symptom
Anatomy
Research Article
medicine.medical_specialty
Death Rates
Science
Critical Illness
Research and Analysis Methods
Sepsis
03 medical and health sciences
Signs and Symptoms
Population Metrics
Internal medicine
medicine
Humans
Retrospective Studies
Population Biology
business.industry
Septic shock
Glasgow Coma Scale
Biology and Life Sciences
Proteins
030208 emergency & critical care medicine
medicine.disease
Health Care
030228 respiratory system
ROC Curve
Health Care Facilities
Clinical Medicine
business
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 7, p e0251154 (2021)
ISSN: 1932-6203
Popis: Background and aim Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment. The present study aimed to test the value of carotid artery ultrasound analysis in prediction of mortality in pediatric patients with septic shock. Methodology/Principal finding Forty children with septic shock were included in the study. Upon admission, patients were subjected to careful history taking and thorough clinical examination. The consciousness level was assessed by the Glasgow Coma Scale (GCS). Laboratory assessment included complete blood count, C-reactive protein, arterial blood gases, serum electrolytes, and liver and kidney function tests. Electrical cardiometry was used to evaluate hemodynamic parameters. Patients were also subjected to transthoracic 2-D echocardiography. CBF was evaluated using GE Vivid S5 ultrasound device through dedicated software. At the end of study, 14 patients (35.0%) died. It was found that survivors had significantly higher CBF when compared non-survivors [median (IQR): 166.0 (150.0–187.3) versus 141.0 (112.8–174.3), p = 0.033]. In addition, it was noted that survivors had longer ICU stay when compared with non-survivors [16.5 (9.8–31.5) versus 6.5 (3.0–19.5) days, p = 0.005]. ROC curve analysis showed that CBF could significantly distinguish survivors from non-survivors [AUC (95% CI): 0.3 (0.11–0.48), p = 0.035] (Fig 2). Univariate logistic regression analysis identified type of shock [OR (95% CI): 28.1 (4.9–162.4), p Conclusions CBF assessment may be a useful prognostic marker in children with septic shock.
Databáze: OpenAIRE
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