Outcomes of pediatrics cardiac patients in the PICU: an analysis of clinical and echocardiographic risk factors

Background: Cardiovascular diseases in pediatric patients present significant challenges in Pediatric Intensive Care Units (PICUs), with adverse outcomes influenced by factors such as ventricular dysfunction, sepsis and delayed intervention. Echocardiography plays a vital role in assessing cardiac function, identifying risk factors and guiding treatment. This study aims to analyze the clinical and echocardiographic profiles of pediatric cardiac patients admitted to the PICU and identify critical mortality risk factors to improve care and outcomes. Methods: A prospective observational study was conducted over 18 months from November 2022 to April 2024 in a tertiary care hospital in Srinagar. The study included 103 pediatric patients aged 1 month to 18 years with congenital or acquired heart diseases. Data collected included demographics, clinical presentations, echocardiographic findings, laboratory results and outcomes. Statistical analysis was performed using SPSS 25, with p<0.05 considered significant. Results: The cohort comprised 48 males (46.6%) and 55 females (53.4%), predominantly aged 1 month to 5 years. Ventricular Septal Defect (VSD) was the most common cardiac anomaly (18%), followed by Tetralogy of Fallot (4.8%). Respiratory distress (65.5%) and bronchopneumonia (30%) were prevalent comorbidities. Significant mortality risk factors included infant age, cyanosis (50% mortality), congestive heart failure (52.3%), deranged kidney function tests, altered pH and prolonged mechanical ventilation. Conclusions: Early diagnosis and timely interventions targeting high-risk groups are critical to improving survival. Identifying key echocardiographic profiles and clinical risk factors provides insights for optimizing PICU care for pediatric cardiac patients.