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Prognostic value of baseline carotid blood flow in critically ill children with septic shock

BACKGROUND AND AIM: Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment. The present study aimed to test the value of carotid artery ultrasound analysis in predic...

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Autores principales: Mamdouh, Fatma, Bazaraa, Hafez, Baz, Ahmed, Algebaly, HebatAllah Fadel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302249/
https://www.ncbi.nlm.nih.gov/pubmed/34298550
http://dx.doi.org/10.1371/journal.pone.0251154
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author Mamdouh, Fatma
Bazaraa, Hafez
Baz, Ahmed
Algebaly, HebatAllah Fadel
author_facet Mamdouh, Fatma
Bazaraa, Hafez
Baz, Ahmed
Algebaly, HebatAllah Fadel
author_sort Mamdouh, Fatma
collection PubMed
description BACKGROUND AND AIM: Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment. The present study aimed to test the value of carotid artery ultrasound analysis in prediction of mortality in pediatric patients with septic shock. METHODOLOGY/PRINCIPAL FINDING: Forty children with septic shock were included in the study. Upon admission, patients were subjected to careful history taking and thorough clinical examination. The consciousness level was assessed by the Glasgow Coma Scale (GCS). Laboratory assessment included complete blood count, C-reactive protein, arterial blood gases, serum electrolytes, and liver and kidney function tests. Electrical cardiometry was used to evaluate hemodynamic parameters. Patients were also subjected to transthoracic 2-D echocardiography. CBF was evaluated using GE Vivid S5 ultrasound device through dedicated software. At the end of study, 14 patients (35.0%) died. It was found that survivors had significantly higher CBF when compared non-survivors [median (IQR): 166.0 (150.0–187.3) versus 141.0 (112.8–174.3), p = 0.033]. In addition, it was noted that survivors had longer ICU stay when compared with non-survivors [16.5 (9.8–31.5) versus 6.5 (3.0–19.5) days, p = 0.005]. ROC curve analysis showed that CBF could significantly distinguish survivors from non-survivors [AUC (95% CI): 0.3 (0.11–0.48), p = 0.035] (Fig 2). Univariate logistic regression analysis identified type of shock [OR (95% CI): 28.1 (4.9–162.4), p<0.001], CI [OR (95% CI): 0.6 (0.43–0.84), p = 0.003] and CBF [OR (95% CI): 0.98 (0.96–0.99), p = 0.031]. However, in multivariate analysis, only type of shock significantly predicted mortality. CONCLUSIONS: CBF assessment may be a useful prognostic marker in children with septic shock.
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spelling pubmed-83022492021-07-31 Prognostic value of baseline carotid blood flow in critically ill children with septic shock Mamdouh, Fatma Bazaraa, Hafez Baz, Ahmed Algebaly, HebatAllah Fadel PLoS One Research Article BACKGROUND AND AIM: Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment. The present study aimed to test the value of carotid artery ultrasound analysis in prediction of mortality in pediatric patients with septic shock. METHODOLOGY/PRINCIPAL FINDING: Forty children with septic shock were included in the study. Upon admission, patients were subjected to careful history taking and thorough clinical examination. The consciousness level was assessed by the Glasgow Coma Scale (GCS). Laboratory assessment included complete blood count, C-reactive protein, arterial blood gases, serum electrolytes, and liver and kidney function tests. Electrical cardiometry was used to evaluate hemodynamic parameters. Patients were also subjected to transthoracic 2-D echocardiography. CBF was evaluated using GE Vivid S5 ultrasound device through dedicated software. At the end of study, 14 patients (35.0%) died. It was found that survivors had significantly higher CBF when compared non-survivors [median (IQR): 166.0 (150.0–187.3) versus 141.0 (112.8–174.3), p = 0.033]. In addition, it was noted that survivors had longer ICU stay when compared with non-survivors [16.5 (9.8–31.5) versus 6.5 (3.0–19.5) days, p = 0.005]. ROC curve analysis showed that CBF could significantly distinguish survivors from non-survivors [AUC (95% CI): 0.3 (0.11–0.48), p = 0.035] (Fig 2). Univariate logistic regression analysis identified type of shock [OR (95% CI): 28.1 (4.9–162.4), p<0.001], CI [OR (95% CI): 0.6 (0.43–0.84), p = 0.003] and CBF [OR (95% CI): 0.98 (0.96–0.99), p = 0.031]. However, in multivariate analysis, only type of shock significantly predicted mortality. CONCLUSIONS: CBF assessment may be a useful prognostic marker in children with septic shock. Public Library of Science 2021-07-23 /pmc/articles/PMC8302249/ /pubmed/34298550 http://dx.doi.org/10.1371/journal.pone.0251154 Text en © 2021 Mamdouh et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Mamdouh, Fatma
Bazaraa, Hafez
Baz, Ahmed
Algebaly, HebatAllah Fadel
Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title_full Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title_fullStr Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title_full_unstemmed Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title_short Prognostic value of baseline carotid blood flow in critically ill children with septic shock
title_sort prognostic value of baseline carotid blood flow in critically ill children with septic shock
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302249/
https://www.ncbi.nlm.nih.gov/pubmed/34298550
http://dx.doi.org/10.1371/journal.pone.0251154
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