Cardiac Dysfunction and Serum Ferritin Level as Early Prognostic Markers in Children with Sepsis.

Abstract Objective: This study aimed to evaluate the association of Cardiac dysfunction assessed by Echocardiogram study, ferritin, c-reactive protein, and leukocyte count with unfavorable outcomes in pediatric sepsis within the pediatric intensive care unit.Methods: A prospective cohort study was carried out from September 2019 to April 2020, with 40 patients admitted to a pediatric intensive care unit(PICU) at Minia University Children and Maternal hospital, aged between 28 days and 15 years. Inclusion criteria where patients diagnosed with sepsis, need for mechanical ventilation for quite 48h, and vasoactive drugs. Serum levels of C-reactive protein, ferritin, and leukocyte count were collected within 24 h of admission (D1), and 72 h (D3) after admission to PICU. Patients underwent echocardiography study to figure out the ejection fraction of the ventricle on D1 and D3. The outcomes measured through length of stay at hospital and at the pediatric intensive care unit, mechanical ventilation(MV) duration, free hours of VM, duration of use of inotropic agents, maximum inotropic score, and mortality.Results: Patients with elevated ferritin levels on D1 had less ventilator-free time and higher maximum inotropic score. Patients with cardiac dysfunction by echocardiogram on D1 had longer hospital stay pediatric intensive care unit, stay longer duration of mechanical ventilation higher maximum inotropic score, and fewer ventilator-free hoursConclusion: Cardiac dysfunction by echocardiography study and serum ferritin value was significantly related to unfavorable outcomes in pediatric patients requiring admission to PICU with sepsis.