THE STUDY OF DIAGNOSTIC CRITERIA FOR CARDIAC DYSFUNCTION WHEN SEPSIS IN CHILDREN
Abstract
Introduction. The sepsis-assoсiated cardiac dysfunction (SACD) remains a poorly understood syndrome in children. The hemodynamic criteria of septic shock adopted by the international consensus of the Society of Critical Care Medicine on January 21, 2024, based on the use of the Phoenix Sepsis scale, were used as the “gold standard”. The aim of the study — to study the diagnostic criteria of SACD for children. Materials and methods. 22 children aged from 1 month to 17 years with suspected sepsis were examined. 2 groups of patients were formed, 1 group with SACD — 5 patients and the second group without SACD — 17 patients. Results. As a result of a comprehensive study, it was revealed that the diagnostic criteria can be clinical and one laboratory criterion. Clinical criteria include: resistant sinus tachycardia 180–200 beats per minute or resistant bradycardia (relative risk (RR) 27; 95% confidence interval (CI) 1.68—431, z — 2.331, the number needed to treat (Harm) (NNT(Harm)) 1.385, 95% CI (Harm) 2.071 — 1.04). The laboratory criterion is the level of N-terminal prohormone of brain natriuretic peptide (NT-PROBNP) in the blood of 2094 pg/ml (sensitivity — 100%, specificity — 100%, area under curve ROC (AUCROC) — 1.0). The statistical power turned out to be higher than 0.8 — the threshold criterion. Conclusion. The study indicates that the identified criteria are sufficiently accurate for the diagnosis of this syndrome.
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