Page 160 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-001
Comparison of Fluid Overload, Use of Inotropes, Mortality Rate of Patients
with Dengue Shock Syndrome Before and After using Ultrasonic Cardiac Output
Monitor in PICU Prof. DR. R.D. Kandou Hospital Manado

Anita Yolaningtyas, Jose M. Mandei
Department of Child Health, Faculty of Medicine Universitas Sam Ratulangi/Prof. DR. R.D. Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Hemodynamic measurement with Ultrasonic Cardiac Output Monitor (USCOM) could
be useful to measure cardiac performance and hemodynamic status quantitatively. Intervention using
USCOM will be approached to decrease fluid overload, reduce the inotropic used, and mortality
Objective Comparing the rate of fluid overload, use of inotropes, mortality rates before and after using USCOM.
Methods A retrospective study before and after using USCOM from June 2020- June 2021. Data was taken
since the pediatric patients arrived at the hospital and was diagnosed with DSS and treated in PICU RSUP
R.D. Kandou Hospital Manado. Results Before using USCOM, from June 2020- November 2020, there
were 42 subjects, and after using USCOM, December 2020 - June 2021 were 40 subjects. Based on Chi
Square tests, patients with fluid overload <10% obtained 78% before, 83% after that. Patients with fluid
overload >10% were 22% before, and reduced to 17%, not significantly different with P > 0.05(OR 0.778).
The use of inotropic was 95% before, and reduced to 5%, it has a significant difference with P< 0.0001
(OR 42.9). Mortality rate decreased from 75% to 25%, but not significant with P>0.05 (OR 0.33).
Conclusion The incidence of fluid overload and the mortality rate did not decrease statistically significant
after using USCOM except the reduction of inotropic used.
Keywords: pediatric intensive care unit; ultrasonic cardiac output monitor; dengue shock syndrome;
fluid overload; inotropes; mortality

P-EPIC-002
Mortality’s Predictor between pSOFA and PELOD-2 Score
among Critically Ill Children

Rizal Marubob Silalahi, Badai Buana Nasution, Bugis Mardina Lubis
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara, Adam Malik General Hospital,
Medan, North Sumatera, Indonesia
Abstract
Background A sequential organ failure assessment (SOFA) score has developed into a pediatric sequential
organ failure assessment (pSOFA) score. However, this scoring has not been widely applied to pediatric
patients, as the pediatric logistic organ dysfunction-2 (PELOD-2) score is still the most widely used scoring
system to determine the severity of organ dysfunction and provides a descriptive of patient’s outcome in
PICU. Objective To compare the mortality’s predictor ability between pSOFA and PELOD 2 among critically
ill children. Methods A retrospective study was conducted in PICU Adam Malik General Hospital by a total
sampling of patients admitted between May 2019 until May 2020. Results 184 patients were admitted to
PICU. 142 consecutive admissions fulfilling the inclusion criteria were enrolled in the study. Analysis using
the ROC curve obtained AUC of PELOD-2 score was 98.7% (95%CI 97.2 to 100%, P<0.001) and pSOFA
score was 97.4% (95%CI 94.5 to 100%, P<0.001) in predicting mortality. Patient who has PELOD 2 score
≥8.5, will have higher mortality risk compared PELOD-2 score <8.5 (RR 36.563 (95%CI 9.296 to 143.812),
P<0.001) which 8.5 cut-off had sensitivity 96.8%, specificity 95%, PPV 93.8%, NPV 97.4% and accuracy
95.8%. While pSOFA score ≥3.5, will have higher mortality risk compared pSOFA score <3.5 (RR 37.619
(95%CI 9.5665 to 147.950), P<0.001) which 3.5 cut-off had sensitivity 96.8%, specificity 96.2%, PPV 95.2%,
NPV 97.5% and accuracy 96.5% respectively for predicting mortality.Conclusion pSOFA score has a better
performance in predicting critically ill children’s mortality compared to PELOD-2 score. A pSOFA score
≥3.5 increases the risk of mortality by 37.619-fold.
Keywords: mortality’s predictor; PELOD 2; pSOFA; mortality; children

112 KONIKA XVIII Abstract Book