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

Keywords

Related Articles

Blood pressure-to-height ratio for diagnosing hypertension in adolescents

Background Diagnosing hypertension in children and adolescents is not always straightforward. The blood pressure-to-height ratio (BPHR) has been reported as a screening tool for diagnosing hypertension.Objective To evalu...

Pediatric index of mortality 2 scores in pediatric intensive care unit patients

Background Comprehensive care for critically ill children in the pediatric intensive care unit (PICU) is done with the aim of achieving good outcomes. Severe disease in children is characterized by disruption of homeosta...

Host factors related to pneumonia in children under 5 years of age

Background Pneumonia has been one of the serious problems for children under five in Indonesia. Imbalanced interactions among host factors, agents, and environments influence incidence of pneumonia. Objective To determin...

Quality of life in children with cancer and their normal siblings

Background Cancer treatment in children influences the quality of life of patients and their families. The Pediatric Quality of Life (PedsQL) inventory is a questionnaire to assess quality of life of the healthy and ill...

Validation of the Pediatric Early Warning Score to determine patient deterioration from illness

Background Patients who enter the emergency room (ERER) present with a variety of conditions, ranging from mild to critical. As such, it may be hard to determine which patients are in need of intensive care unit treatmen...

Download PDF file
  • EP ID EP508839
  • DOI 10.14238/pi58.5.2018.252-6
  • Views 90
  • Downloads 0

How To Cite

Nadia Firdausy, Indah Murni, Agung Triono, Noormanto Noormanto, Sasmito Nugroho (2018). Low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic congenital heart disease. Paediatrica Indonesiana, 58(5), 252-6. https://www.europub.co.uk/articles/-A-508839