Retrospective Evaluation of the Cases Presenting to the Pediatric Intensive Care Unit with Cardiogenic Shock in Terms of Etiology, Treatment and Long-Term Prognosis

Abstract

ABS TRACT Objective: Cardiogenic shock is acute circulation failure emerg- ing with a linkage to disrupted myocardial contraction. The aim of this study is to identify the underlying etiology, assess the treatment methods, and the long- term prognoses of survivors among the patients admitted to intensive care with cardiogenic shock for the first time and without a previous heart disease history. Material and Methods: This study included patients admitted to the intensive care unit in our hospital for the first time with cardiogenic shock from March 2016 to March 2020. The age interval was 1 month to 18 years. The demographic, clinical, laboratory, and radiological findings for patients were recorded. All pa- tients were evaluated with echocardiography at admission and 12 months after discharge. Results: Of the 24 patients included in this study, 50% were girls (n=12). Nineteen (79.1%) of the 24 patients had acute myocarditis as the underlying cause. Three (12.5%) patients had hypocalcaemia linked to vitamin D de- ficiency, 1 (4.2%) patient had anomalous left coronary artery from the pulmonary artery syndrome, and 1 (4.2%) patient had cardiac tamponade linked to purulent pericarditis. In echocardiographic examinations performed at a 12-month interval, left ventricle ejection fraction increased from 32.45±9.26% to 49.18±15.53%, and left ventricle end-diastolic diameter Z score decreased from 5.65 (4.4) to 2.02 (4.76). Conclusion: With appropriate fluids, diuretic treatment, inotrope man- agement, and extracorporeal support, the prognosis for these patients has clearly improved in recent years.