CONCLUSIONS: Septic shock patients are coming from
families who are already deficient in B-vitamins. Children are
likely to become further deficient during critical illness probably
due to increased consumption. Lack of difference between
survivors and non-survivors may be due to significant pre-
existing B-vitamin deficiencies to affect outcome any further.
Such universal deficiencies provide an opportunity to evaluate
role of B-vitamins in metabolic resuscitation of pediatric septic
shock in the studied setting.
P0605 / #959
USE OF EXTRACORPOREAL MEMBRANE
OXYGENATION SUPPORT DURING
STAPHYLOCOCCUS AUREUS REFRACTORY
SEPTIC SHOCK: A CASE REPORT FOR
MECHANICAL SUPPORT
J. Rodriguez Coronado1, J. Saldivar Martinez1, R. Gomez
Gutierrez1, G. Quezada Valenzuela1, M. Contreras Cepeda1, E.
Villarreal Castellanos2, E. Villarreal2
Christus Muguerza Alta Especialidad, Terapia Intensiva Pediatrica,
1 4 babies with risk factors were not put on NeoEWS.
Monterrey, Mexico, 2Tecnologico de Monterrey, Escuela de Medicina y
Ciencias de la Salud, Monterrey, Pediatría, San Pedro Garza García, Mexico
AIMS & OBJECTIVES: Septic shock due to Staphylococcus
aureus is a rare and life-threatening condition that may require
acute intervention for management. This study aims to assess the
clinical features of a case of septic shock due to Staphylococcus
aureus and evaluate the use of extracorporeal membrane
oxygenation (ECMO) to support patients with this condition.
METHODS: We present a case of a 2-year-old female
patient with umbilical hernia repaired 1 month prior.
Patient is admitted to a general hospital due to fever,
anorexia, asthenia, and adynamia of 72 hours of evolution
following a surgical drainage due to a umbilical seroma.
Subsequently, the patient presented a rapid-onset shock
characterized with erythematous macules in the thorax.
RESULTS: Management was initiated following current guidelines
of septic shock and mechanical ventilation, however, patient did
not respond to vasoactive treatment. The intensive care unit team
then emergently decided to cannulate for veno-arterial ECMO.
Patient was then transferred to a private hospital (Hospital Christus
Muguerza Alta Especialidad®) for intensive care follow-up. A positive
wound and blood culture identified Staphylococcus aureus and
broad-spectrum intravenous antibiotics were initiated. After achieving
hemodynamic stabilization vasoactive agents were titrated. Patient
was decannulated and ECMO support was stopped 4 days after
initiation. Patient was discharged 45 days after hospital admission.
CONCLUSIONS: This case underlines the utility of ECMO
as a possible therapy to stabilize pediatric patients with
refractory septic shock
P0606 / #967
NEONATAL EARLY ONSET SEPSIS
GUIDELINE: AN AUDIT OF PRACTICE
S. El Badri, S. Hackett, B. Paturi
Our Lady of Lourdes Hospital, Paediatrics, Louth, Ireland
Pediatric Critical Care Medicine www.pccmjournal.org
Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Unauthorized reproduction of this article is prohibited
AIMS & OBJECTIVES: A new guideline was developed for
the screening, prevention and management of neonatal early
onset sepsis, which was implemented on the 5th November
2018. The aim of this audit was to assess the compliance
of obstetrics, neonatal and midwifery with use of the new
Neonatal Early Onset algorithm.
METHODS: Retrospective chart review of all babies born in
January 2019
Inclusion criteria:- Babies admitted directly to postnatal ward.
Exclusion criteria:- Babies admitted directly to NICU from delivery.
Data collected: Gestational age, Maternal Septic risk factors,
Mode of delivery, Maternal IAP administration, A record of
Neonatal Early Warning Score (NeoEWS) in presence of risk
factors, Appropriate administration of neonatal IV antibiotics.
RESULTS: 36 babies had risk factors for infection.
27 mothers of 36 babies should have received IAP.
IAP given was given to 19 mothers.
There were 8 mothers who did not receive IAP despite the
presence of indication.
16 Babies were commenced on IV antibiotics. There were no
positive blood cultures.
There was 1 baby that required LP for maternal GBS in
blood culture.
There were 14 charts with inadequate information.
CONCLUSIONS: There was generally a good compliance
with the guideline.
17% of babies admitted directly to postnatal had septic risk
factors.
50% of the risk factors were PROM.
8 mothers out of 27 did not receive IAP despite presence of
indication.
2 babies out of 49 were not on NEWS despite presence of
septic risk factors.
2 babies received IV Antibiotics despite adequate maternal IAP.
P0607 / #987
PLASMA LACTOFERRIN LEVELS IN NEWBORN
INFANTS WITH NEONATAL EARLY-ONSET
SEPSIS
J.J. Martínez
Hospital Pediátrico de Sinaloa “Dr. Rigoberto Aguilar Pico”, Pediatric
Critical Care Unit, Culiacán, Sinaloa, Mexico
AIMS & OBJECTIVES: Determine plasma Lf levels in
newborns with neonatal early-onset sepsis (EOS)
METHODS: From January to December 2019 in a neonatal
intensive care unit of a University Hospital we conducted a
prospective, cross-sectional and analytical study. Thirty-four
newborns with EOS and 55 newborns without EOS with
≤10 hours postnatal age was included in the study. The
diagnosis of EOS was made with clinical parameters and
sepsis markers. Plasma concentrations of Lf were measured
by ELISA test. For statistical analysis non-parametric
statistics were used, and the diagnostic performance was
evaluated with area under ROC curve (AUC).