• Aditi Jain, Jhuma Sankar, Anubhuti Anubhuti, Dinesh Kumar Yadav, and M Jeeva Sankar.
• Department of Pediatrics, PGIMER and Dr RML Hospital, New Delhi, Delhi 110001, India.
• J. Trop. Pediatr. 2018 Dec 1; 64 (6): 501-509.

ObjectiveTo estimate the prevalence and effects of sepsis-induced myocardial dysfunction (SIMD) in children with septic shock.MethodologyEnrolled children with septic shock (n = 31) and sepsis (n = 30) underwent echocardiography and cardiac troponin-I (cTnI) estimation within first 3 h. SIMD was defined as presence of systolic/diastolic dysfunction by echocardiography.ResultsThe prevalence of SIMD was 71% in 'septic shock' and 23% in 'sepsis'. Diastolic dysfunction (45.2%) was more prevalent than systolic dysfunction (32.3%). Children with SIMD had higher requirement of inotropes [81 vs. 44%; adjusted odds ratio: 1.41 (1.04-1.92)] in first 48 h. cTnI had low sensitivity (62.5%) and specificity (55.1%) for detecting SIMD. On follow-up at 3 months, there was no residual dysfunction in the majority (71.3%).ConclusionSIMD, especially diastolic dysfunction, is common in septic shock and may increase inotrope requirement. It is reversible in majority. Sepsis patients may have asymptomatic underlying SIMD. cTnI does not correlate with the degree of SIMD.

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