Daljit Singh*, Puneet Aulakh Pooni**, Atul Chopra***, R.C. Bhatia ****
Dayanand Medical College & Hospital, Ludhiana, Punjab, India *, Dayanand Medical College & Hospital, Ludhiana, Punjab, India **, Dayanand Medical College & Hospital, Ludhiana, Punjab, India ***, Dayanand Medical College & Hospital, Ludhiana, Punjab, India ****
This prospective study was conducted to determine the outcome of shock in children admitted to a multi-speciality tertiary care teaching hospital.
Subjects & Methods
All children, 1 month - 15 years of age with clinical evidence of shock admitted in pediatric emergency / ICU over 18 months were included. Shock was classified into etiological groups and categorized as compensated or decompensated.
Among 98 cases of shock (4.3% of admissions), mean age was 2.8 ± 3.4 years with M:F ratio of 1.6:1. Hypovolemic, septic, cardiogenic and distributive shock was seen in 45.9%, 32.7%, 17.3% and 2.1% cases respectively. Overall survival was 73.6%. Survival rate was highest in hypovolemic (97.7%) followed by septic (53.3%) and cardiogenic shock (43.7%). Survival was not influenced by the age or sex. Nearly 98% patients presenting in compensated shock survived, whereas 2/3rd (67%) children in decompensated shock died (p> 0.05). Presence of respiratory failure, combined metabolic and respiratory acidosis increased mortality significantly. Malnutrition, anemia, renal failure or electrolyte abnormality did not increase mortality.
Hypovolemia constitutes the commonest cause of shock. Factors influencing outcome of shock were type and stage of shock, combined acidosis, and presence of respiratory failure.
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