Research work · 2025
A Study of Clinical Profile and Outcome of Shock in Children in Paediatric Intensive Care Unit in a Tertiary Care Hospital
International Journal of Pharmaceutical Quality Assurance
Abstract
Background: Pediatric shock is a common and life-threatening emergency in intensive care units, with sepsis being a leading cause. Early recognition, risk stratification, and prompt management are crucial to improving outcomes. This study aimed to evaluate the clinical profile, laboratory parameters, and outcomes of children presenting with shock in a tertiary care pediatric intensive care unit (PICU) in India, with particular focus on the predictive utility of the PRISM III score. Methods: A prospective observational study was conducted on 125 children admitted with shock. Demographic details, vital signs, laboratory parameters, etiology of shock, complications, need for inotropic support, and outcomes were recorded. PRISM III scores were calculated at admission to assess severity. Data were analyzed to identify factors associated with mortality. Results: The majority of children were aged 1–5 years (44%) and male (63.2%), with most residing in urban areas (62.4%). Clinically, increased temperature (73.6%), tachycardia (70.4%), and tachypnea (74.4%) were common, with 55.2% hypotensive and 37.6% exhibiting oliguria. Septic shock was the predominant etiology (60%), followed by hypovolemic (15%), cardiogenic (15%), vasoplegic (14%), and obstructive shock (2%). Laboratory abnormalities included hyponatremia (16.8%), elevated CRP (60.8%), ferritin (43.2%), and deranged renal function (14.4%). Overall survival was 68%, with a mortality rate of 32%, higher among children with septic shock (70%). The mean ± SD PRISM III score was significantly higher among nonsurvivors (28.15 ± 5.34) compared with survivors (11.48 ± 2.01), indicating its utility in severity assessment. Conclusion: Pediatric sepsis in India is associated with high mortality, particularly in patients with multiorgan dysfunction, deranged laboratory parameters, and higher PRISM III scores. The PRISM III score is a useful tool for risk stratification and predicting length of hospital stay among survivors. Larger multicenter studies using updated sepsis definitions are warranted to better understand the burden and outcomes of pediatric sepsis in developing countries.