Research Article - Current Pediatric Research (2025) Volume 29, Issue 3

Analysis of Acute heart failure Etiology and Outcome in a Cohort admitted to a Non-Surgical Pediatric Intensive Care Unit of a Developing country.

Background: In infants, the most common cause of heart failure is congenital heart disease. In children with a structurally normal heart, myocarditis and primary cardiomyopathies come first. Infants diagnosed with CHD awaiting surgery (either correction or palliation may be at a high risk of poor outcome. Post-viral myocarditis, arrhythmia, or right ventricular dysfunction in idiopathic or acquired pulmonary hypertension are among the root causes of acquired cardiac disease admitted to the ICU. This study aimed to understand the etiology and outcomes of critically ill children presenting with cardiac problems in a tertiary care hospital. Methods: A cohort study was conducted on 120 cardiac patients who received care in the Pediatric Intensive Care Unit (PICU) from August 2021 to November 2022 among 800 total admissions. Results: Total cardiac cases were 120. Heart failure and cardiogenic shock constituted 20% of the total admissions, and acute heart failure on top of Congenital Heart Disease (CHD) was the most prevalent admission diagnosis, accounting for (40%) of patients. Followed by cardiogenic shock due to myocarditis, dilated cardiomyopathy (30%), atrial arrhythmia (11%), and coronary dilation (4%), respectively. Non-survivors had a younger age, poor nutritional status, lower oxygen saturation, higher need for ventilation compared to survivors. The independent factors affecting mortality were younger age and required higher VIS, with p-values of 0.019 , and .004, respectively. Conclusion: Acute heart failure on top of Congenital heart disease and cardiogenic shock in cardiomyopathy patients constitutes an important category in non-surgical PICU. The independent factors affecting mortality were age, nutritional status, and inotropic agents. Close Monitoring of cardiac patients and prevention of infection, early surgeries, and better nutrition may lower this incidence and decrease the rate of admission to the PICU.

Author(s):

Ola Soliman, Radwa Iraqy, Hebat Allah Fadel Algebaly*, Fatma Mamdouh Hussein, ElShima Salah, Aya Osama Mohamed

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