1. Prognostic value of baseline carotid blood flow in critically ill children with septic shock
- Author
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HebatAllah Fadel Algebaly, Hafez M. Bazaraa, Ahmed A. Baz, and Fatma Mamdouh
- Subjects
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 - Abstract
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.
- Published
- 2020