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Hendrika Knoester, MD; Jeanine J. Sol, MD; Pascal Ramsodit, MD; Irene M. Kuipers, MD, PhD; Sally-Ann B. Clur, MBBCh, MSc, FCP(SA)Paed; Albert P. Bos, MD, PhD

Arch Pediatr Adolesc Med. 2008;162(12):1164-1168.

Objective  To evaluate the long-term effects of septic shock on cardiac function in children treated with inotropic and/or vasoconstrictive agents for 24 hours or longer.

Design  Cohort study.

Setting  Tertiary pediatric intensive care unit and outpatient follow-up clinic.

Participants  One hundred eight of 144 eligible children who were admitted to our tertiary pediatric intensive care unit with septic shock from 1995 through 2005 and were alive in 2006 were invited to participate and visit our outpatient follow-up clinic. Fifty-two healthy controls were included.

Main Exposure  Septic shock survival.

Outcome Measures  History, physical examination, electrocardiogram during rest and exercise, 24-hour electrocardiography registration, and left and right ventricular function.

Results  No children had abnormalities when histories were taken or during physical examination that were attributable to cardiac dysfunction. Six children (6%) had cardiac abnormalities: polymorphic premature ventricular contractions during exercise and 24-hour electrocardiography registration (2 patients), decreased left ventricular function (2 patients), decreased left ventricular function and polymorphic premature ventricular contractions (1 patient), and decreased right ventricular function (1 patient).

Conclusions  In this small and diverse group of pediatric septic shock survivors, we found an excellent recovery of cardiac performance in most patients. In a limited number of patients, we found rhythm disturbances and decreased ventricular function. We believe that, against the background of aging, long-term cardiac follow-up of these patients is important.

Author Affiliations: Pediatric Intensive Care Unit (Drs Knoester, Sol, Ramsodit, and Bos) and Pediatric Cardiology Department (Drs Kuipers and Clur), Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands. Dr Ramsodit is now with the Twenteborg Hospital, Almelo, the Netherlands.