Pediatric Logistic Organ Dysfunction (PELOD) Score as prognosis of multiple organ failure in sepsis
Abstract
Background Sepsis is an emergency event that often found in
pediatric intensive care unit. If this condition is not early detected
and promptly treated, severe complications including septic shock
and multiple organ failure may result that can end up as death.
Objective To discover alternative measurement as a prognosis of
multiple organ failure in sepsis.
Methods This cross sectional study was conducted in 37 patients
diagnosed as sepsis. The age of the patients were 1 month until 13
years and the patients were hospitalized in child health department
of R. D. Kandou Hospital during June 2009 – September 2009.
Result Bronchopneumonia (18) was the most common
infection source, followed by gastroenteritis (11), encephalitis
(6) and meningitis (2). The bacteria which is found was Proteus
mirabilis (5), Citrobacter difersus (5), Staphylococcus aureus (3),
Escherichia coli (2) and Acinetobacter baumannii (1). There was
no significant difference in gender distribution, nutrition status
and blood culture between both groups. Laboratory findings and
clinical manifestations which included white blood cell (WBC)
> 10.000/μL (34), platelet count > 150.000 (27) and body
temperature 38oC – 39oC (20). There was a correlation between
PELOD score and multiple organ failure (P=0.02). A higher
PELOD score will increase opportunity to get multiple organ
failure. In patient with organ failure more than two, PELOD
score 0-10 (9 patients), score 11-20 (7 patients), score 21-30 (8
patients), and score 31-40 (1 patient).
Conclusion There was a correlation between PELOD score and
multiple organ failure in patient with sepsis. A higher PELOD
score will increase opportunity to get multiple organ failure.
References
2. Sands KE, Bates DW Lanken PN. Epidemiology of sepsis syndrome in 8 academic medical senters. JAMA. 1997; 278:234-40.
3. Saez Lorens X, McCracken G H. Sepsis and septic shock in pediatrics: current concepts of terminology, phatophysiology, and management. J Pediatr. 1995; 123:497-508.
4. Latief A. Pendekatan diagnosis sepsis. In: Lubis M, Evalina R, Irsa L, editors. Makalah lengkap simposium nasional pediatri gawat darurat VI. Medan: Bagian Ilmu Kesehatan Anak FK USU, 2003; p. 28-35.
5. Chairulfatah A. Sepsis dan syok septic. � � � � � � In: Sumarmo S, Soedarmo P, Hadinegoro SR, editors. Buku ajar ilmu kesehatan anak. Jakarta: Balai Penerbit FKU UI, 2002; p. 391-8.
6. Goldstein B, Ginoir B, Randolph A. International pediatric sepsis consensus conference: definition for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005; 6:2-8.
7. Lacroix J, Cotting J. Severity of illness and organ dysfunction scoring in children. Pediatr Crit Care Med. 2005; 6:126-34
8. Metta D, Soebardja D, Soemasetia DH. The use of Pediatric Logistic Organ Dysfunction (PELOD) scoring system to determine the prognosis of patients in pediatric intensive care units. Pediatr Indones. 2006; 46: 1-6.
9. Leclerc F, Leteurtre S, Duhamel A, Grandbastiaen B, Proulx F, Gauvin F, et al. Cumulative influence of organ dysfunction and septic state on mortality of critically ill children. Am J Respir Crit Care Med. 2005; 171:348-53.
10. Pudjiadi S. Ilmu gizi klinis pada anak. 4th ed. Jakarta: FKUI, 2000; p. 95-138.
11. Harijanto PN. Gejala klinik malaria berat. In: Harijanto PN,editors. Malaria: epidemiologi, patogenesis, manifestasi klinis dan penanganan. Jakarta : EGC, 1999; p. 166-84.
12. Noerasid H, Suraatmadja S, Asnil PO. Gastroenteritis (diare) akut. In: Suharyono, Boediarso A, Halimun EM, editors. Gastroenterologi anak praktis. Jakarta: BP FKUI, 1988; p. 51-76.
13. Wantania JM, Naning R, Wahani A. Infeksi respiratori akut. In: Rahajoe NN, Supriyatno B, Setyanto DB, editors. Buku ajar respirologi anak. Jakarta: BP IDAI, 2008; p. 268-77.
14. Saharso D, Hidayati SN. Infeksi susunan saraf pusat. In: Soetomenggolo TS, Ismael S, editors. Buku ajar neurologi anak. Jakarta: BP IDAI, 1999; p. 339-85.
15. Leteurtre S, Martinot A, Duhamel A, Proulx F, Gransbastein B, Cotting J, et al. Validation of Pediatric Logistic Organ Dysfunction (PELOD) score: prospective, observational, multicentre study. Lancet. 2003; 362:192-7.
16. Watson RS, Carcillo JA, Linde-Zwirbe WT. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003; 167:695-701.
17. Proulx F, Fayon M, Farrell CA, Lacroix J, Gauthier M. Epidemiology of sepsis and multiple organ dysfunction syndrome in children. Chest. 1996; 109:1033-7.
18. Duke TD, Butt W, South M. Predictors of mortality and multiple organ failure in children with sepsis. Intensive care M
ed. 1997; 23:684-92.
19. Thukral A, Kohli U, Lodha R. Validation of the PELOD Score for multiple organ dysfunction in children. Indian Pediatr. 2007:683-6.
20. Jacobs RF, Sowell MK, Moss MM. Septic shock in children: bacterial etiologies and tempral relationships. Pediatr Infect Dis J. 1990; 11:196-200.
21. Xavier XL, Vargas S, Guerra F, Coronado L. Application of new sepsis definition for evaluate outcome of pediatric patient with severe systemic infection. Pediatr Infect Dis J. 1995; 14(7):557-60.
22. Marshall JC. Inflammation, coagulopathy, and the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med. 2001; 29 suppl:99-106.
23. Latief A. Support nutrisi pada anak dengan sepsis. In: Lubis M, Evalina R, Irsa, editors. Makalah lengkap simposium nasional pediatri gawat darurat VI. Medan: Bagian Ilmu Kesehatan Anak FK USU, 2003; p. 86-103.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2017-01-29
Published 2010-08-31
