Predicting mortality from septic shock among pediatric population in emergency room

Karthick Jayapal


Background: Sepsis is defined as systemic inflammatory response syndrome in the presence of a suspected or known invasive infection and septic shock is defined as sepsis and cardiovascular organ dysfunction which persists even after initial fluid resuscitation. It is important to identify the risk of progression of sepsis to septic shock and death in the pediatric age group in order to prevent mortality.

Methods: This cohort study was carried out among 142 children aged between one month and 18 years who were diagnosed with sepsis in the emergency room (ER). All the hemodynamic and laboratory parameters were evaluated. The participants were followed up for a period till recovery/death. Particulars related to the management of the cases in terms of fluid resuscitation, inotropes and antibiotics were also documented.

Results: Majority of the participants were aged between 1-10 years and were males. There was a statistically significant difference in the temperature, total leukocyte count and other biochemical parameters between survivors and non survivors (p<0.05). Initiation of antibiotics within one hour was significantly higher among the survivors compared to the non survivors (p<0.05).

Conclusion: There is a need for immediate and early detection of abnormalities in the clinical and laboratory parameters in order to prevent mortality due to septic shock in the pediatric emergency room. 


Hemodynamic parameters, Inotropes, Resuscitation, Sepsis, Septic shock

Full Text:



Martin K, Weiss SL. Initial resuscitation and management of pediatric septic shock. Minerva Pediatr. 2015;67(2):141-58.

Prevention CfDCa. National Vital Statistics System. National Center for Health Statistics, Centers for Disease Control and Prevention. 2010. Available at:

Sethuraman U, Bhaya N. Pediatric shock. Therapy. 2008;5(4):405-23.

Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015;191(10):1147-57.

Mathias B, Mira J, Larson SD. Pediatric sepsis. Curr Opin Pediatr. 2016;28(3):380-87.

Kaur G, Vinayak N, Mittal K, Kaushik JS, Aamir M. Clinical outcome and predictors of mortality in children with sepsis, severe sepsis and septic shock from Rohtak, Haryana: A prospective observational study. Indian J Crit Care Med. 2014;18(7):437-41.

Lee EP, Hsia SH, Lin JJ, Chan OW, Lee J, Lin CY et al. Hemodynamic analysis of pediatric septic shock and cardiogenic shock using transpulmonary thermodilution. Biomed Res Int. 2017;2017:3613475.

Chatrath V, Khetarpal R, Ahuja J. Fluid management in patients with trauma: Restrictive versus liberal approach. J Anaesthesiol Clin Pharmacol. 2015;31(3):308-16

Fan SL, Miller NS, Lee J, Remick DJ. Diagnosing sepsis- the role of laboratory medicine. Clin Chim Acta. 2016;460:203-10.

Westphal GA, Pereira AB, Fachin SM, Sperotto G, Goncalves M, Albino L et al. An electronic warning system helps reduce the time to diagnosis of sepsis. Rev Bras Ter Intensiva. 2018;30(4):414-22.