Page 175 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-028
Systemic Vasculitis as A Complication of Multiple Arterial Thrombosis
in the Pediatric Intensive Care Unit: A Case Report

Maria Theresia, Desy Rusmawatiningtyas, Nurnaningsih
Department of Pediatrics, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada/
Dr. Sardjito Central General Hospital, Yogyakarta, Central Java, Indonesia

Abstract
Background Systemic vasculitis is a group of disorders with multiorgan involvement. It is a relatively
uncommon disorder, with a reported annual incidence of 40 to 54 cases per 1 million people.
Objective To present complications that can occur in pediatric patients with multiple arterial thrombosis
Case A 15-year-old boy who was referred from the Regional Hospital came with fever, swelling, pain in both
cheeks, painful swallowing, lower abdominal pain, fresh red urine, and swelling in the testicles. On physical
examination, he presented pale, active bleeding in the penoscrotal area, necrotic tissue appeared above the
hyperemic edge bulla on the penoscrotal, right and left cruris. The results of computed tomography (CT)
angio aortic examination with contrast were suspicious of bilateral pudendal artery occlusion at the base.
The results of arteriography examination were acute occlusion of the right anterior tibial artery as high as 5
cm from the ankle joint and acute occlusion of the right and left internal pudendal arteries. During treatment,
he had a hemorrhagic shock, Disseminated Intravascular Coagulation (DIC), Acute Kidney Injury, and
psychiatric disorders. The patient was treated with Methylprednisolone 1 mg/kg/day for 2 weeks, empiric
antibiotics, inotropes, antidepressants, massive transfusion, and heparinization. He was hospitalized for
1.5 months and he got lower right limb amputation and partial penectomy. He was discharged after he got
improvement. Conclusion Systemic vasculitis is a complex disease and requires treatment from various
experts. Rapid diagnosis is needed to maintain organ function.
Keywords: systemic vasculitis; thrombosis; complication

P-EPIC-029
The Value of the Neutrophil Lymphocytes Count Ratio in Assessing the Outcomes
of Sepsis Patients Admitted to the Pediatric Intensive Care Unit

Thadea Tandi, Jose Mandei, Marsino Rondo
Department of Child Health, Medical Faculty of Universitas Sam Ratulangi/Prof. DR. R. D. Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Neutrophil-to-lymphocyte ratio (NLR) has been used to predict the prognosis of patients with
sepsis with inconsistent results. The physiological immune response to infection and other stressful events
is characterized by an increase in neutrophil count and a decrease in lymphocyte count. Objective To assess
the relationship between NLR values and the outcome of sepsis in children. Methods This study used a
retrospective cross sectional study method on septic children who were treated in the Pediatric Intensive
Care Unit of Prof. Dr. R. D Kandou Manado. By assessing the outcome of sepsis patients with NLR. Data
were analyzed using IBM SPSS Statistics version 28.0 and logistic regression analysis. Results We found 87
septic children who were treated at the Pediatric Intensive Care Unit, Prof. Dr. R. D Kandou during February
to August 2020. Of these 87 children, 37 died and 50 recovered. Of the 37 children who died, 33 (89%)
children with NLR values >3 were found (OR:26.125;95%CI 7.683 to 88.838; P<0.001). From Pearson's
analysis, significant results were obtained, namely there was a strong positive linear relationship between
NLR and length of stay (r=0.645; P<.001). Conclusion The NLR measured at admission of sepsis patients
was an independent predictor of in-hospital mortality. There is a significant difference between septic patients
who have a high NLR value on mortality and patients with high NLR values require a longer length of stay.
Keywords: sepsis; children; neutrophil-to-lymphocyte ratio; length of stay

KONIKA XVIII Abstract Book 127