0A-S3-1

SEPTIC SHOCK IN CHILDREN - A FIVE -YEAR REVIEW

Chen XN, Geng R, Qian SY, Wu JC

Beijing Children’s Hospital, Beijing, China

Objective: To investigate the epidemiology, clinical features and to seek the classification of septic shock in PICU.

Methods: Three hundred and sixty five children with shock were identified and retrospectively analyzed from January 1996 to December 2000 in PICU and medical department of Beijing Children’s Hospital.

Result: The morbidity and mortality of the 221 cases in PICU shock were 17.4% and 42.2% respectively. There were 93 severe Shegellosis shock with mortality of 3.9%, and 51 Meningococcemia shock with mortality of 66.6%. In 221 PICU septic shock, 75% resulted from cascade of initial inciting event, host defence abnormality and iatrogenic factors. All these shock cases were divided into two clinical patterns: acute onset simple patterns (pattern I) and subacute onset complex pattern (pattern II, according to whether there was presence of chronic diseases, other organ dysfunction at onset. There were 126 pattern II shock cases, mortality 73.5%; 95 pattern I shock cases, mortality 29.1%. The difference in mortality between two patterns was significant. (X² = 12.58, p <0.001).

Conclusion: There are significant differences in clinical feature and outcome between acute onset simple shock and subacute onset complex shock. Establishing diagnosis and treatment strategy for the two patterns of shock may be of benefit to early recognition and treating efficacy. Mortality and morbidity of the shock could be compared with each other only until it was categorized into the two patterns of shocking state.