MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN TỔN THƯƠNG GAN Ở BỆNH NHI NHIỄM HUYẾT

Abstract

Objectives: To find factors associated with sepsis-associated liver injury (SALI) in children. Methods: A clinical cross-sectional study was conducted on 198 pediatric sepsis patients at the Intensive Care Department, National Hospital of Pediatrics, from May 2022 to the end of April 2023. Results: The rate of SALI in pediatric patients with sepsis is relatively high, accounting for 32% (64/198 sepsis patients ). Clinical forms of SALI include hypoxic hepatitis (24/64, 37%), cholestasis (21/64, 33%), and hepatocellular injury (19/64, 30%). The median (IQR) age of the SALI group was 15.75 (6.9 - 81.9) months. SALI patients were hospitalized with severe symptoms, shown by: a high VIS median (IQR) score of 35 (20 - 67), high rate of kidney failure (46.88%), very high rate of the need for dialysis (56.3%), blood albumin (mean ± SD) is low reduced 29.15 ± 4.93 g/l, SGOT (AST) median (IQR) is very high 272 (182 - 617) U/ L, SGPT (ALT) median (IQR) increased 98 (47.4 - 239) U/L, LDH median (IQR) high 1201.5 (717.75 - 3034) U/L, PLT median (IQR) severely decreased 172.5 ± 161.28 G/L, metabolic acidosis with pH (mean ± SD) 7.26 ± 0.16 and BE (mean ± SD) 12.9 ± 6.33 mmol/l, finally is the high mortality rate (40.7%). Conclusion: Pediatric patients with sepsis have SALI at a relatively high rate, have extremely severe manifestations, and have a higher mortality rate than sepsis patients without SALI. pSOFA is a factor independently associated with SALI in pediatric sepsis patients.