caa a22 4500 475785932 CHVBK 20180406123658.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004310050070 doi (NATIONALLICENCE)springer-10.1007/s004310050070 Life-threatening heart failure in meningococcal septic shock in children: non-invasive measurement of cardiac parameters is of important prognostic value [Elektronische Daten] [W. Hagmolen of ten Have, A. Wiegman, G. J. van den Hoek, W. B. Vreede, H. H. F. Derkx] Heart failure is a life-threatening complication of fulminant meningococcal septic shock (MSS). Depression of left ventricular function, in particular, is thought to be due to circulating meningococcal endotoxin. Myocardial failure leads to ventricular dilation expressed by an increased left-ventricle end-diastolic diameter (LVED). With ultrasonography, LVED can be accurately measured as well as the shortening fraction (SF). In an evaluative study we investigated the accuracy of the SF and compared it to the accuracy of the Glasgow meningococcal septicemia prognostic score (GMSPS) in the prediction of mortality in children with fulminant MSS. In 27 children admitted in a 4-year period with a presumptive clinical diagnosis of fulminant MSS, hypotension persisted for more than 1 h despite volume loading and inotropic therapy. Seven of these children died (26%); all had an SF <0.30 and a GMSPS ≥10 (the sensitivity of both scores was 100%). Positive predictive values of the SF and GMSPS were 41% and 58% respectively. Conclusions SF can be used in addition to other severity scores in clinical decision-making and contribute to the selection of children with the worst prospects for inclusion in experimental treatment studies. Springer-Verlag Berlin Heidelberg, 2000 Key words Ultrasonography nationallicence Heart failure nationallicence Neisseria meningitidis nationallicence Septic shock nationallicence Shortening fraction nationallicence Glasgow meningococcal septicemia prognostic score nationallicence Hagmolen of ten Have W. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut Wiegman A. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut van den Hoek G. J. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut Vreede W. B. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut Derkx H. H. F. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut https://doi.org/10.1007/s004310050070 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004310050070 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hagmolen of ten Have W. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut NATIONALLICENCE 700 1- Wiegman A. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut NATIONALLICENCE 700 1- van den Hoek G. J. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut NATIONALLICENCE 700 1- Vreede W. B. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut NATIONALLICENCE 700 1- Derkx H. H. F. Academic Medical Centre, University of Amsterdam, Emma Kinder Ziekenhuis AMC, Department of Paediatrics, PO Box 22700, 1100 DE Amsterdam, The Netherlands e-mail: h.h.derkx@amc.uva.nl Tel.: +31-20-5663053; Fax: +31-20-6917735, NL aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer