Key result
Cardiac dysfunction and elevated serum ferritin levels on admission were associated with an increased risk of mortality in children with sepsis.
Why the study?
Sepsis causes morbidity, mortality, and myocardial dysfunction in children in the PICU, motivating evaluation of echocardiographic cardiac dysfunction, ferritin, and CRP as prognostic markers.
Are cardiac dysfunction and serum ferritin levels associated with unfavorable outcomes in children with sepsis?
Cross-Sectional (n=80)
No
Are cardiac dysfunction and serum ferritin levels associated with unfavorable outcomes in children with sepsis?
In children with sepsis admitted to the PICU, low left ventricular ejection fraction and high serum ferritin levels serve as early prognostic markers associated with unfavorable outcomes.
Answers are grounded in this paper and cite their sources.
May inform prognosis in pediatric sepsis; hypothesis-generating and requires prospective validation before clinical use.
Background: Sepsis still causes morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Sepsis induces myocardial dysfunction and causes a reversible decline in ejection fraction (EF) of ventricles. Many biomarkers have been described for diagnosing sepsis, including serum ferritin and C-reactive protein (CRP). Objectives: This study was conducted to assess the relationship of cardiac dysfunction evaluated using echocardiogram, ferritin, and CRP with negative outcomes of sepsis in the PICU. Methods: A cross-sectional study was conducted on 80 patients aged between one month and six years who fulfilled the following criteria: (1) confirmed diagnosis of sepsis according to the American College of Critical Care Medicine; (2) receiving ventilation for 48 h and/or vasoactive medicines. The CRP and ferritin levels were recorded on the first day (D1) and third day (D3) of hospitalization in the PICU. Participants underwent an echocardiography study to investigate the ejection fraction on D1 and D3. All outcomes were evaluated. Results: Our results showed a highly statistically significant difference between D1 and D3 in ejection fraction (P = 0.001). The serum ferritin level and CRP enhanced significantly from D1 to D3 (P < 0.001). Low left ventricular ejection fraction, and high serum ferritin were associated with unfavorable outcomes (P values < 0.001 and 0.021, respectively), but there was no significant difference in the outcomes regarding CRP. Conclusions: Cardiac dysfunction and high serum ferritin were associated with unfavorable outcomes in children with sepsis admitted to the PICU.
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Ismail et al. (2021) conducted a cross-sectional in Sepsis (n=80). Cardiac dysfunction and elevated serum ferritin vs. Normal cardiac function and lower serum ferritin was evaluated on Mortality (AOR 63.22, 95% CI 1.35-2963, p=0.035). Cardiac dysfunction and elevated serum ferritin levels on admission were associated with an increased risk of mortality in children with sepsis.
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