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Etiology, Pathophysiology and Mortality of Shock in Children in Low (Middle) Income Countries : A Systematic Review. / Assies, Roxanne; Snik, Ilse; Kumwenda, Mercy et al.

In: Journal of tropical pediatrics, Vol. 68, No. 4, 01.08.2022.

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Assies, Roxanne ; Snik, Ilse ; Kumwenda, Mercy et al. / Etiology, Pathophysiology and Mortality of Shock in Children in Low (Middle) Income Countries : A Systematic Review. In: Journal of tropical pediatrics. 2022 ; Vol. 68, No. 4.

BibTeX

@article{ebd987c024f54729aca3d9f1d55c906e,
title = "Etiology, Pathophysiology and Mortality of Shock in Children in Low (Middle) Income Countries: A Systematic Review",
abstract = "Objectives: Shock is a life-threatening condition in children in low- and middle-income countries (LMIC), with several controversies. This systematic review summarizes the etiology, pathophysiology and mortality of shock in children in LMIC. Methods: We searched for studies reporting on children with shock in LMIC in PubMed, Embase and through snowballing (up to 1 October 2019). Studies conducted in LMIC that reported on shock in children (1 month-18 years) were included. We excluded studies only containing data on neonates, cardiac surgery patients or iatrogenic causes. We presented prevalence data, pooled mortality estimates and conducted subgroup analyses per definition, region and disease. Etiology and pathophysiology data were systematically collected. Results: We identified 959 studies and included 59 studies of which six primarily studied shock. Definitions used for shock were classified into five groups. Prevalence of shock ranged from 1.5% in a pediatric hospital population to 44.3% in critically ill children. Pooled mortality estimates ranged between 3.9-33.3% for the five definition groups. Important etiologies included gastroenteritis, sepsis, malaria and severe anemia, which often coincided. The pathophysiology was poorly studied but suggests that in addition to hypovolemia, dissociative and cardiogenic shock are common in LMIC. Conclusions: Shock is associated with high mortality in hospitalized children in LMIC. Despite the importance few studies investigated shock and as a consequence limited data on etiology and pathophysiology of shock is available. A uniform bedside definition may help boost future studies unravelling shock etiology and pathophysiology in LMIC.",
keywords = "Children, Circulatory insufficiency, Low- and middle-income countries, Pediatric, Review, Shock",
author = "Roxanne Assies and Ilse Snik and Mercy Kumwenda and Yamikani Chimalizeni and Josephine Langton and {van Woensel}, {Job B. M.} and Allan Doctor and Calis, {Job C. J.}",
note = "Publisher Copyright: {\textcopyright} 2022 The Author(s). Published by Oxford University Press. All rights reserved.",
year = "2022",
month = aug,
day = "1",
doi = "10.1093/tropej/fmac053",
language = "English",
volume = "68",
journal = "Journal of tropical pediatrics",
issn = "0142-6338",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Etiology, Pathophysiology and Mortality of Shock in Children in Low (Middle) Income Countries

T2 - A Systematic Review

AU - Assies, Roxanne

AU - Snik, Ilse

AU - Kumwenda, Mercy

AU - Chimalizeni, Yamikani

AU - Langton, Josephine

AU - van Woensel, Job B. M.

AU - Doctor, Allan

AU - Calis, Job C. J.

N1 - Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press. All rights reserved.

PY - 2022/8/1

Y1 - 2022/8/1

N2 - Objectives: Shock is a life-threatening condition in children in low- and middle-income countries (LMIC), with several controversies. This systematic review summarizes the etiology, pathophysiology and mortality of shock in children in LMIC. Methods: We searched for studies reporting on children with shock in LMIC in PubMed, Embase and through snowballing (up to 1 October 2019). Studies conducted in LMIC that reported on shock in children (1 month-18 years) were included. We excluded studies only containing data on neonates, cardiac surgery patients or iatrogenic causes. We presented prevalence data, pooled mortality estimates and conducted subgroup analyses per definition, region and disease. Etiology and pathophysiology data were systematically collected. Results: We identified 959 studies and included 59 studies of which six primarily studied shock. Definitions used for shock were classified into five groups. Prevalence of shock ranged from 1.5% in a pediatric hospital population to 44.3% in critically ill children. Pooled mortality estimates ranged between 3.9-33.3% for the five definition groups. Important etiologies included gastroenteritis, sepsis, malaria and severe anemia, which often coincided. The pathophysiology was poorly studied but suggests that in addition to hypovolemia, dissociative and cardiogenic shock are common in LMIC. Conclusions: Shock is associated with high mortality in hospitalized children in LMIC. Despite the importance few studies investigated shock and as a consequence limited data on etiology and pathophysiology of shock is available. A uniform bedside definition may help boost future studies unravelling shock etiology and pathophysiology in LMIC.

AB - Objectives: Shock is a life-threatening condition in children in low- and middle-income countries (LMIC), with several controversies. This systematic review summarizes the etiology, pathophysiology and mortality of shock in children in LMIC. Methods: We searched for studies reporting on children with shock in LMIC in PubMed, Embase and through snowballing (up to 1 October 2019). Studies conducted in LMIC that reported on shock in children (1 month-18 years) were included. We excluded studies only containing data on neonates, cardiac surgery patients or iatrogenic causes. We presented prevalence data, pooled mortality estimates and conducted subgroup analyses per definition, region and disease. Etiology and pathophysiology data were systematically collected. Results: We identified 959 studies and included 59 studies of which six primarily studied shock. Definitions used for shock were classified into five groups. Prevalence of shock ranged from 1.5% in a pediatric hospital population to 44.3% in critically ill children. Pooled mortality estimates ranged between 3.9-33.3% for the five definition groups. Important etiologies included gastroenteritis, sepsis, malaria and severe anemia, which often coincided. The pathophysiology was poorly studied but suggests that in addition to hypovolemia, dissociative and cardiogenic shock are common in LMIC. Conclusions: Shock is associated with high mortality in hospitalized children in LMIC. Despite the importance few studies investigated shock and as a consequence limited data on etiology and pathophysiology of shock is available. A uniform bedside definition may help boost future studies unravelling shock etiology and pathophysiology in LMIC.

KW - Children

KW - Circulatory insufficiency

KW - Low- and middle-income countries

KW - Pediatric

KW - Review

KW - Shock

UR - http://www.scopus.com/inward/record.url?scp=85134360628&partnerID=8YFLogxK

U2 - 10.1093/tropej/fmac053

DO - 10.1093/tropej/fmac053

M3 - Article

C2 - 35796755

VL - 68

JO - Journal of tropical pediatrics

JF - Journal of tropical pediatrics

SN - 0142-6338

IS - 4

ER -

ID: 25190561