Sepsis, severe sepsis and septic shock in paediatric multiple organ dysfunction syndrome.
OBJECTIVE
To determine the association between severity of sepsis with outcome and severity of illness in children with multiple organ dysfunction syndrome (MODS).


METHODS
Four hundred and ninety-five consecutive paediatric intensive care unit (PICU) admissions were analysed. multiple organ dysfunction syndrome was defined as simultaneous dysfunction of >/= 2 organ system and sepsis by the American College of Chest Physicians and Society of Critical Care Medicine Consensus Conference definition.


RESULTS
Eighty-four patients developed MODS. The incidence of sepsis, severe sepsis and septic shock in these patients was 10.7%, 23.8% and 17.9%, respectively. Worsening categories of sepsis were associated with: (1) a higher mean admission Paediatric Risk of Mortality (PRISM II): 36.6 +/- 25.9, 56.8 +/- 32.1 and 73.6 +/- 28.5%, respectively (P = 0. 005), (2) a larger number of organ dysfunctions: mean MODS index of 37%, 46% and 58%, respectively (P = 0.007), and (3) a higher mortality: 22.2%, 65% and 80%, respectively (P = 0.03).


CONCLUSIONS
Presence of sepsis, severe sepsis and septic shock was associated with an increasing severity of illness, increased number of organ dysfunctions and a distinct risk of mortality among critically ill children.
Goh
A
A
Paediatric Intensive Care Unit, University Malaya Medical Center, KualaLumpur, Malaysia. adrian@medicine.med.um.edu.my
Lum
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L
D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D012772:Shock, Septic / Q000150:complications / Q000175:diagnosis* / Q000401:mortality