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Epidemiology and Peculiarities of Pediatric Multiple Organ Dysfunction Syndrome in New Delhi, India

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Abstract

Objective

Most pediatric studies on multiple organ dysfunction syndrome derive from developed countries. There is little information regarding the etiologies and outcomes of multiple organ dysfunction syndrome in critically ill children from developing countries. The objective of this study was to examine the differences in epidemiology of multiple organ dysfunction syndrome and the relationship of the Organ Failure Index (OFI) to outcomes from multiple organ dysfunction syndrome in critically ill children from a developing country.

Design

Prospective observational study.

Setting

A 10-bed tertiary pediatric intensive care unit.

Patients

A total of 1722 children (1 month to 16 years of age) admitted to a pediatric intensive care unit during the study period from January 1998 to June 2003.

Interventions

None.

Measurements and main results

Of all the patients admitted to the pediatric intensive care unit, 184 patients (10.6%) had persistent multiple organ dysfunction syndrome. During the study period 136 deaths (7.9%) occurred in the ICU. Multiple organ dysfunction syndrome was associated with nearly half of these deaths, 67/136 (49.2%). Overall survival of all patients with persistent multiple organ dysfunction syndrome was 64% (117/184). In addition to sepsis, falciparum malaria, fulminant hepatic failure, dengue shock syndrome, severe poisonings, post cardiopulmonary bypass, and post cardiac arrest were significant antecedents of multiple organ dysfunction syndrome . Patients with OFI scores of 2, 3, 4–5, and > 5 exhibited mortalities of 9%, 29%, 58%, and 100% respectively.

Conclusions

In addition to “traditional” sepsis, common etiologies of multiple organ dysfunction syndrome included falciparum malaria, fulminant hepatic failure, and dengue shock syndrome. In developing countries like India, multiple organ dysfunction syndrome carries a significant risk of mortality which is directly related to the OFI.

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Author information

Authors and Affiliations

  1. Pediatric Critical Care Services, Institute of Pediatrics, Max Health Care Hospitals Saket, New Delhi, India

    Praveen Khilnani

  2. Department of Pediatrics, IP Apollo Hospital, New Delhi, India

    Devajit Sarma

  3. Pediatric Critical Care Medicine, University of Washington, Room W-9813, Seattle Children’s Hospital, Sandpoint Way NE, 4800, Seattle, WA 98105-0371, USA

    Jerry Zimmerman

  4. B42 Panchsheel Enclave, New Delhi, India

    Praveen Khilnani

Authors
  1. Praveen Khilnani
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  2. Devajit Sarma
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  3. Jerry Zimmerman
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Correspondence to Praveen Khilnani.

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Khilnani, P., Sarma, D. & Zimmerman, J. Epidemiology and Peculiarities of Pediatric Multiple Organ Dysfunction Syndrome in New Delhi, India. Intensive Care Med 32, 1856–1862 (2006). https://doi.org/10.1007/s00134-006-0373-5

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