Mortality rates in pediatric septic shock

Background Septic shock remain a major cause of morbidity and mortality in children admitted to intensive care unit. Recent investigations from developed countries have reported mortality rates of 20-30%. Few studies had reported mortality rate for pediatric septic shock in intensive care setting from developing countries with limited resources. Objective To determine the current mortality rate for pediatric patients with septic shock in developing country. Methods A retrospective study was conducted in Pediatric Intensive Care Unit (PICU) in DR. Sardjito General Hospital. Medical record and chart were reviewed and recorded for diagnosis of septic shock, from November 1st, 2011 to June 30th, 2014. Results A database of all PICU admissions and cases with diagnoses of septic shock were reviewed. The final data consisted of 136 patients diagnosed with septic shock. Septic shock was defined as a clinical suspicious of sepsis, manifested by hyperthermia or hypothermia, and accompanied by hypoperfusion The overall mortality rate for the study cohort was 88.2%. The median age of patients was 16 months, with 52.2% male. Median initial PRISM III and PELOD scores were 10 and 22, respectively. The median length of PICU stay was 4 days. A total of 48.5% of the subjects were in need of crystalloid and colloid fluid in a median amount of 40 mL/ kg. The median time required to complete the initial resuscitation was 60 minutes. Mechanical ventilator support in the first 24 hours was required in 79.4% of the cases. Fluid overload of >10% (FO>10%) was found in 58.8% of the subjects. Conclusion The mortality rate in pediatric septic shock in our unit is very high. There is a higher incidence of fluid overload in non-survival group.