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

<h4>Background and aim</h4>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...

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Autores principales:	Fatma Mamdouh, Hafez Bazaraa, Ahmed Baz, HebatAllah Fadel Algebaly
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d3a75aa883e6427dafdb4f9d01d17c96
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spelling	oai:doaj.org-article:d3a75aa883e6427dafdb4f9d01d17c962021-12-02T20:04:52ZPrognostic value of baseline carotid blood flow in critically ill children with septic shock.1932-620310.1371/journal.pone.0251154https://doaj.org/article/d3a75aa883e6427dafdb4f9d01d17c962021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251154https://doaj.org/toc/1932-6203<h4>Background and aim</h4>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.<h4>Methodology/principal finding</h4>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.<h4>Conclusions</h4>CBF assessment may be a useful prognostic marker in children with septic shock.Fatma MamdouhHafez BazaraaAhmed BazHebatAllah Fadel AlgebalyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0251154 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Fatma Mamdouh Hafez Bazaraa Ahmed Baz HebatAllah Fadel Algebaly Prognostic value of baseline carotid blood flow in critically ill children with septic shock.
description	<h4>Background and aim</h4>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.<h4>Methodology/principal finding</h4>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.<h4>Conclusions</h4>CBF assessment may be a useful prognostic marker in children with septic shock.
format	article
author	Fatma Mamdouh Hafez Bazaraa Ahmed Baz HebatAllah Fadel Algebaly
author_facet	Fatma Mamdouh Hafez Bazaraa Ahmed Baz HebatAllah Fadel Algebaly
author_sort	Fatma Mamdouh
title	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_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_sort	prognostic value of baseline carotid blood flow in critically ill children with septic shock.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d3a75aa883e6427dafdb4f9d01d17c96
work_keys_str_mv	AT fatmamamdouh prognosticvalueofbaselinecarotidbloodflowincriticallyillchildrenwithsepticshock AT hafezbazaraa prognosticvalueofbaselinecarotidbloodflowincriticallyillchildrenwithsepticshock AT ahmedbaz prognosticvalueofbaselinecarotidbloodflowincriticallyillchildrenwithsepticshock AT hebatallahfadelalgebaly prognosticvalueofbaselinecarotidbloodflowincriticallyillchildrenwithsepticshock
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Prognostic value of baseline carotid blood flow in critically ill children with septic shock.

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