Low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic congenital heart disease
Journal Title: Paediatrica Indonesiana - Year 2018, Vol 58, Issue 5
Abstract
Background Brain abscess is a severe infection of brain parenchyma, which occurs in 25-46% of cases of uncorrected cyanotic congenital heart disease. Low arterial oxygen saturation is the main risk factor for brain abscess in children with cyanotic congenital heart disease, however, the arterial oxygen saturation test is invasive and not routinely done in our setting. Objective To evaluate low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic congenital heart disease. Methods We conducted a matched, case-control study at Sardjito Hospital, Yogyakarta for children aged less than 18 years with cyanotic congenital heart disease, from 2010-2016. Case subjects were children with brain abscess complications. The control group had only cyanotic congenital heart disease, and were matched for age and sex to the case group. During hospitalization due to the brain abscess complication in the case group, data regarding peripheral oxygen saturation, polycythemia, pneumonia, sepsis, dental caries and restricted pulmonary blood flow were collected and compared between both groups. Results During the study period, 18 children with cyanotic congenital heart disease had brain abscesses. This group was compared to the control group of 36 children. Bivariate analysis revealed that the lowest level of peripheral oxygen saturation (OR 0.92; 95%CI 0.85 to 0.98; P=0.02) and dental caries (OR 3.3; 95%CI 1.01 to 11.18; P=0.04) were significant risk factors for brain abscess. However, in the multivariate analysis, the only statistically significant risk factor associated with brain abscess was the lowest level of peripheral oxygen saturation (OR 0.92; 95%CI 0.86 to 0.99; P=0.04). Conclusion Low peripheral oxygen saturation is a significant risk factor for brain abscess development in children with cyanotic congenital heart disease. A decrease of 1% peripheral oxygen saturation may increase the risk of brain abscess by 8%.
Authors and Affiliations
Nadia Firdausy, Indah Murni, Agung Triono, Noormanto Noormanto, Sasmito Nugroho
Ferric sodium edetate therapy in children with iron deficiency anemia
Background Iron deficiency anemia (IDA) is frequentlyfound in school-aged children. The main treatments for IDAare overcoming the causal factors and iron supplementation.Noncompliance in taking iron tablets and the possi...
Effect of glucocorticoid therapy on adrenal function in children with acute lymphoblastic leukemia
BackgroundGlucocorticoids play an important role in thetreatment ofacute lymphoblastic leukemia (ALL), but can causeside effects such as suppression of the hypothalamic-pituitaryadrenal (HPA) axis. Suppression of the HPA...
Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care
Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in...
Mantoux test results and BCG vaccination status in TB-exposed children
Background Tuberculosis (TB) infection is highly prevalent in Indonesia. The source of transmission of TB to a child is usually via an adult with sputum smear-positive pulmonary tuberculosis. The Mantoux test is a diagno...
Prognostic factors for success in the Kangaroo Mother Care method for low birth weight babies
Background Low birth weight (LBW) is closely related to neonatal morbidity and mortality. Management of LBW infants in developing countries remains limited, due to the low availability of incubators. The Kangaroo Mother...