Systemic capillary leak syndrome due to systemic inflammatory response syndrome in infants: a report on 31 patients

• Authors: Chun-Yan Yang , Ping Xu , Yu-Jun Yang , Bao-Yun Li , Shi-Zhi Sun , Qiao-Zhi Yang , Le-Xin Wang
• Languages of publication: EN

Abstracts

EN

The aim of this study was to describe the clinical features, management strategies and outcomes of 31 infants with systemic capillary leak syndrome (SCLS) secondary to sepsis or systemic inflammatory response syndrome. There were 23 boys and 8 girls, with an average age 9.6 ± 2.1 days (range, 3.1 to 20 days). The primary disease was pneumonia in 11 patients and sepsis in other 20. Within 72 hrs of admission, all had progressive skin and mucosal edema, septic shock, respiratory distress, oliguria and severe hypoalbuminemia (10–20g/L). Other complications were pulmonary edema or hemorrhage, disseminated intravascular coagulopathy, heart failure, renal or liver dysfunction. All patients were treated with mechanical ventilation with a mean mechanical ventilation time of 19.7± 3.5 days. Intravenous hydroxyethyl starch was also applied at an early stage for 4–12 days, together with broad spectrum antibiotics, plasma and albumin infusion. Twenty one patients (67.0%) were discharged from the neonatal intensive care unit after a median stay of 29 days, and 7 died (37.0%) in the hospital. During a 6.3-month follow-up, 4 patients had hydrocephalus and another 4 had muscle spasm or rigidity in the lower-limbs. We conclude that SCLS is a serious complication of neonatal sepsis with a high rate of in-hospital mortality and post-discharge disability.

Keywords

EN

Infants; Sepsis; Systemic inflammatory response syndrome; Capillary leak syndrome; Mortality

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2014
• Volume: 9
• Issue: 3
• Pages: 477-480

Dates

published

1 - 6 - 2014

online

8 - 7 - 2014

Contributors

author

Chun-Yan Yang

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Ping Xu

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Yu-Jun Yang

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Bao-Yun Li

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Shi-Zhi Sun

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Qiao-Zhi Yang

• Department of Paediatrics, Liaocheng People’s Hospital and Liaocheng Clinical School of Taishan Medical University, Shandong, 252000, P. R. China

author

Le-Xin Wang

References

• [1] Xie Z, Ghosh CC, Patel R, Iwaki S, Gaskins D, Nelson C, Jones N, Greipp PR, Parikh SM, Druey KM. Vascular endothelial hyperpermeability induces the clinical symptoms of Clarkson disease (the systemic capillary leak syndrome). Blood 2012; 119(18):4321–4332 http://dx.doi.org/10.1182/blood-2011-08-375816[Crossref][WoS]
• [2] Druey KM. Greipp PR. Narrative review: the systemic capillary leak syndrome. Ann Intern Med 2010; 153(2):90–98 http://dx.doi.org/10.7326/0003-4819-153-2-201007200-00005[Crossref]
• [3] Dhir V, Arya V, Malav IC, Suryanarayanan BS, Gupta R, Dey AB. Idiopathic systemic capillary leak syndrome (SCLS): case report and systematic review of cases reported in the last 16 years. Intern Med 2007; 46(12):899–904 http://dx.doi.org/10.2169/internalmedicine.46.6129[WoS][Crossref]
• [4] Goldstein B, Giroir B, Randolph A. International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6(1):2–8 http://dx.doi.org/10.1097/01.PCC.0000149131.72248.E6[Crossref]
• [5] Dong MF. Ma ZS. Wang JT. Chai SD. Tang PZ. Wang LX. Effect of preoperational mechanical ventilation on short-term postoperative outcomes in patients with severe tetralogy of Fallot. Heart Lung Circ 2012; 21(11):679–683 http://dx.doi.org/10.1016/j.hlc.2012.06.021[Crossref]
• [6] Bone RC, Balk RA, Cerra FB. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992; 101:1644–1655 [Crossref]
• [7] Haque KN. Definitions of bloodstream infection in the newborn. Pediatr Crit Care Med 2005; 6(3):45–49 http://dx.doi.org/10.1097/01.PCC.0000161946.73305.0A[Crossref]
• [8] Van der Heijden M, Verheij J, Van Nieuw Amerongen GP, Groeneveld AB. Crystalloid or colloid fluid loading and pulmonary permeability, edema, and injury in septic and nonseptic critically ill patients with hypovolemia. Crit Care Med. 2009, 37(4):1275–1281 http://dx.doi.org/10.1097/CCM.0b013e31819cedfd[WoS][Crossref]
• [9] Brierley J, Carcillo JA, Choong K, et al. Clinical practice parameters for hemodynamics support of pediatric and neonatal septic shock:2007 update from the American College of Critical Care Medicine. Crit Care Med 2009; 37(2):666–688 http://dx.doi.org/10.1097/CCM.0b013e31819323c6[Crossref]
• [10] Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008; 36(1):296–327 http://dx.doi.org/10.1097/01.CCM.0000298158.12101.41[Crossref]
• [11] Jungheinrich C, Scharpf R, Wargenau M, Bepperling F, Baron JF. The pharmacokinetics and tolerability of an intravenous infusion of the new hydroxyethyl starch 130/0.4 (6%, 500 mL) in mildtosevere renal impairment. Anesth Analg 2002; 95(3):544–551
• [12] Feng X, Ren B, Xie W, Huang Z, Liu J, Guan R, Duan M, Xu J. Influence of hydroxyethyl starch 130/0.4 in pulmonary neutrophil recruitment and acute lung injury during polymicrobial sepsis in rats. Acta Anaesthesiol Scand 2006; 50(9):1081–1088 http://dx.doi.org/10.1111/j.1399-6576.2006.01113.x
• [13] Wang TS, Deng JC. Molecular and cellular aspects of sepsis-induced immunosuppression. J Mol Med (Berl) 2008; 86(5):495–506 http://dx.doi.org/10.1007/s00109-007-0300-4[Crossref]
• [14] Hirasawa H, Oda S, Nakamura M. Blood glucose control in patients with severe sepsis and septic shock. World J Gastroenterol 2009; 15:4132–4137 http://dx.doi.org/10.3748/wjg.15.4132[Crossref]
• [15] Zarychanski R, Abou-Setta AM, Turgeon AF, Houston BL, McIntyre L, Marshall JC, Fergusson DA. Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis. JAMA. 2013;309:678–688 http://dx.doi.org/10.1001/jama.2013.430[WoS][Crossref]
• [16] Kyle UG, Coss Bu JA, Kennedy CE, Jefferson LS. Organ dysfunction is associated with hyperglycemia in critically ill children. Intensive Care Med 2010; 36:312–320 http://dx.doi.org/10.1007/s00134-009-1703-1[Crossref]

Identifiers

DOI

10.2478/s11536-013-0292-0