Abstract

Myocardial dysfunction remains an important cause of mortality and morbidity in children requiring intensive care. Cardiac impairment occurs in significant number of children with no pre-existing cardiac illness both congenital and acquired. Often cardiac impairment is overlooked due to lack of sensitive diagnostic tests. Objectives: To study the frequency, probable cause, clinical profile and immediate outcome of children with left ventricular dysfunction and it’s correlation with serum Creatine phosphokinase (CPK MB) level, ejection fraction, ionotropic support and duration of ventilation. Method: It was Retrospective observational study. Case records of children with sepsis, cardiogenic shock, dengue, arrhythmia, Post COVID MIS-C (Multisystem inflammatory syndrome in children) who were evaluated with 2D ECHO in age group of 1 month to 18 years admitted to PICU were screened. Data was entered in pre-structured proforma and analysed statistically Results- Out of 167 patients screened, 35 patients were included in the present study, most common age group was between 1 to 3years 11(31.43%). Majority were male-21(60%). The mean age of presentation was 4.42 years. Most common etiology was Post COVID MISC (45.71%) and Sepsis (40%). Fever (85.7%) was the most common symptom while tachypnoea (77.14%) was the most common sign observed. Survival was more in males (66.6%) as compared to females. Patients with severe dysfunction (22.86%) and on mechanical ventilation (57.14%) had more mortality (p-<0.001). 75% of non-survivor had ejection fraction <30% (P-0.007). There was a signification association between ejection fraction more than >30 and survival (p-0.007). There was a significant Co-relation between length of PICU stay and ejection fraction (p-0.02). Conclusion: Left ventricular dysfunction had varied presentation and outcomes including death. It was imperative to initiate prompt treatment for better outcome. Severe dysfunction was associated with poor outcome(p-0.027). Early recognition and prevention of complications improves quality of life. There was a significant co-relation between severe dysfunction, mechanically ventilated patients and mortality (p-<0.001).

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