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Abstract PD-025: SEVERE SEPSIS AND SEPTIC SHOCK IN HEMATOLOGICAL PEDIATRIC PATIENTS ADMITTED TO PICU A BICENTRIC RETROSPECTIVE STUDY FROM 2011 TO 2017

Alimi, A.1; Sommet, J.1; Rambaud, J.2; Le Bourgeois, F.1; Leger, P.L.2; Dauger, S.3

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 37
doi: 10.1097/01.pcc.0000537427.82030.62
Poster Discussion Abstracts
Free

1Robert Debré University Hospital- AP-HP, Department of Pediatric Intensive Care Unit, Paris, France

2Armand Trousseau University Hospital- AP-HP, Pediatric Intensive Care Unit, Paris, France

3Hôpital Robert Debré, PICU, PARIS, France

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Aims & Objectives:

Pediatric sepsis remains a burdensome public health problem, especially in patients with immuno-deficiency. Adherence to Survival Sepsis Campaign (SSC) would be associated with lower mortality. However, this correlation had never been evaluated in children with hematologic malignancies.

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Methods

Retrospective bicentric cohort study of children with identified hematologic malignancy or hematopoietic stem cell transplantation and requiring intensive care for severe sepsis between January 2011 and August 2017. Description of resuscitation just before and within six hours after the diagnosis of sepsis. Evaluation of adherence to SSC recommandations, before and after admission to PICU. Accurate analysis of microbiologic etiologies. Assessment of mortality 6 months after the sepsis.

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Results

Of 78 patients screened, 65 patients were included. Before admission in ICU: 38% of them did not receive oxygen, 47% of patients showed low blood pressure for age without continuous infusion of inotropes, and lactic acid was obtained in few patients (14%). Within 6 hours of picu admission, 28% did not receive oxygen and only 24% of patients with continuous infusion of inotropes were ventilated. Lactic acid and central venous oxygen saturation were obtained in only one third of patients. An infectious organism was isolated in 51% of patients. The most common primary site of infection was central venous catheter (70%) and 5 patients (13%) presented a fungic infection. The mortality within 6 months was18.5%.

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Conclusions

Higher adherence to SSC recommandations for children with hematologic malignancies and better sensitization of medical and nurse staff would be potentially associated with much better prognosis

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies