European Journal of Molecular & Clinical Medicine

Abstract

Background: Shock is one of the most dramatic, dynamic and life-threatening problems
faced by the physician in critical care setting.The mortality rate of shock in pediatric
patients has declined as a consequence of educational efforts (pediatric advance life
support), which emphasize early recognition and intervention and rapid transfer of
critically ill patients to a PICU via a transport service. To know about the risk factors in
a critically ill child with shock and its association with outcome, will give us an early
clue in identifying and prioritizing management strategies.
Material & Methods: A descriptive study done on 100 children in the age group of one
month to 12 years presenting with shock (or) who later develop shock during PICU stay
at RUHS College of Medical Sciences, Jaipur, Rajasthan, India during one year period.
Children who had received inpatient treatment prior to admission in PICU, post
cardiac arrest shock and traumatic shock / Burns were excluded in our study. During
the PICU stay periodic vital signs and other measures like urine output and oxygen
saturation were recorded. IV fluid therapy, rate and duration of inotrope and other
organ support like ventilatory support were documented.
Results: In present study the frequency of shock was found to be 1.64%.Undernutrition,
decompensated shock, cardiogenic shock, duration of shock more than 6 hours,
leucopenia, hypocalcemia, inotrope requirement, ventilator support & MODS was
present in higher proportion of children who died(36.11%, 69.44%, 27.77%, 72.22%,
22.22%, 38.88%, 94.44%, 97.23% & 69.45 respectively) when compared to those who
had survived (20.32%, 14.06%, 9.37%, 26.56%, 4.68%, 10.93%, 57.82%, 47.25% &
15.62% respectively). Oddsof different variables were measure among the children who
died, when compared tothose who had survived (2.17, 13.78, 3.56, 7.45, 5.89, 5.11, 13.87,
104.2 & 12.78 respectively.
Conclusion: We concluded that under nutrition, decompensated shock, inotrope
requirement, MODS, leucopenia and ventilatory support are independently associated
with poor outcome.