{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:14:41Z","timestamp":1790612081674,"version":"4.1.0"},"reference-count":27,"publisher":"Necmettin Erbakan University Press","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Pediatr Intensive Care"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute myocarditis in children is associated with high morbidity and mortality, with limited data on intravenous immunoglobulin (IVIG) treatment and outcome. Our goal was to describe clinical, treatment profile, and predictors of outcome in children with acute fulminant myocarditis (AFM) receiving intensive care. Case records of 120 children with clinical diagnosis of acute myocarditis from January 2008 to December 2018 were analyzed retrospectively. AFM was seen in 89 (74.2%) children of which nearly two-thirds (54 [60.7%]) were hypotensive at admission. The median (interquartile range [IQR]) ejection fraction on echocardiography was 25 (18.5\u201336%). Eighty-two children (68.3%) received IVIG. Intensive care needs were mechanical ventilation (n\u2009=\u200971; 59.2%) and inotrope support (n\u2009=\u200989; 74.2%); median inotrope score being 30 (IQR: 20\u201355). Twenty-one children died (17.5%). Fever (p\u2009=\u20090.004), arrhythmia (p\u2009=\u20090.03), shock (p\u2009=\u20090.015), higher inotrope score (p\u2009=\u20090.0001), need for ventilation (p\u2009=\u20090.025), acidosis (p\u2009=\u20090.013), AKI (p\u2009=\u20090.0001), transaminitis (p\u2009=\u20090.0001), and multiorgan dysfunction (p\u2009=\u20090.0001) were associated with mortality. The mortality was significantly less in IVIG treated group (12.1 vs. 28.9%; p\u2009=\u20090.02). On multiple logistic regression, MODS (p\u2009=\u20090.002) was independent predictor of mortality while IVIG treatment (p\u2009=\u20090.004) was favorably associated with survival. AFM complicated by multiorgan dysfunction carried a poor prognosis. IVIG was associated with survival benefit.<\/jats:p>","DOI":"10.1055\/s-0040-1722339","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T19:02:11Z","timestamp":1611601331000},"page":"215-220","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Profile and Predictors of Outcome in Children with Acute Fulminant Myocarditis Receiving Intensive Care: A Single Center Experience"],"prefix":"10.53391","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6149-1355","authenticated-orcid":false,"given":"Muralidharan","family":"Jayashree","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Patil","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govindappa","family":"Benakatti","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care, NMC Royal Hospital, Abu Dhabi, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj K.","family":"Rohit","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunit","family":"Singhi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Medanta, the Medicity, Gurugram, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Baranwal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthi","family":"Nallasamy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh Kumar","family":"Angurana","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"31409","published-online":{"date-parts":[[2021,1,25]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.12998\/wjcc.v7.i5.548","article-title":"Clinical presentation and early predictors for poor outcomes in pediatric myocarditis: a retrospective study","volume":"7","author":"M Rodriguez-Gonzalez","year":"2019","journal-title":"World J Clin Cases"},{"issue":"19","key":"ref2","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJM200011093431908","article-title":"Myocarditis","volume":"343","author":"A M Feldman","year":"2000","journal-title":"N Engl J Med"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/00005792-199907000-00005","article-title":"The spectrum of dilated cardiomyopathy. The Johns Hopkins experience with 1,278 patients","volume":"78","author":"G M Felker","year":"1999","journal-title":"Medicine (Baltimore)"},{"issue":"S 02","key":"ref4","first-page":"S648","article-title":"Myocardial diseases in Thai children","volume":"85","author":"J Soongswang","year":"2002","journal-title":"J Med Assoc Thai"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1161\/CIRCULATIONAHA.105.589663","article-title":"Diagnosis of myocarditis: death of Dallas criteria","volume":"113","author":"K L Baughman","year":"2006","journal-title":"Circulation"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1161\/CIRCOUTCOMES.112.965749","article-title":"Demographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006 to 2011","volume":"5","author":"S J Ghelani","year":"2012","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s00246-017-1638-1","article-title":"Characteristics of clinically diagnosed pediatric myocarditis in a contemporary multi-center cohort","volume":"38","author":"R J Butts","year":"2017","journal-title":"Pediatr Cardiol"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01.PCC.0000149131.72248.E6","article-title":"International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics","volume":"6","author":"B Goldstein","year":"2005","journal-title":"Pediatr Crit Care Med"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1136\/emermed-2013-202926","article-title":"Diagnosing paediatric myocarditis: what really matters","volume":"32","author":"S L Chong","year":"2015","journal-title":"Emerg Med J"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1007\/s00246-009-9589-9","article-title":"Pediatric patients hospitalized with myocarditis: a multi-institutional analysis","volume":"31","author":"D Klugman","year":"2010","journal-title":"Pediatr Cardiol"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1542\/peds.2007-1073","article-title":"Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation","volume":"120","author":"S B Freedman","year":"2007","journal-title":"Pediatrics"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1097\/01.PCC.0000244336.60719.8C","article-title":"Acute viral myocarditis: diagnosis","volume":"7","author":"P A Checchia","year":"2006","journal-title":"Pediatr Crit Care Med"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jpeds.2008.10.018","article-title":"Clinical myocarditis masquerading as acute coronary syndrome","volume":"154","author":"J Kern","year":"2009","journal-title":"J Pediatr"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00246-002-0402-2","article-title":"The clinical course of acquired complete heart block in children with acute myocarditis","volume":"24","author":"A S Batra","year":"2003","journal-title":"Pediatr Cardiol"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1253\/circj.CJ-10-0918","article-title":"The follow-up evaluation of electrocardiogram and arrhythmias in children with fulminant myocarditis","volume":"75","author":"R Ichikawa","year":"2011","journal-title":"Circ J"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1016\/j.amjcard.2014.07.074","article-title":"Usefulness of arrhythmias as predictors of death and resource utilization in children with myocarditis","volume":"114","author":"B R Anderson","year":"2014","journal-title":"Am J Cardiol"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"552","DOI":"10.24953\/turkjped.2019.04.012","article-title":"Reversible cardiomyopathy-tachycardiomyopathy in children","volume":"61","author":"A Arslan","year":"2019","journal-title":"Turk J Pediatr"},{"issue":"07","key":"ref19","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.hrthm.2014.04.023","article-title":"Predictors of myocardial recovery in pediatric tachycardia-induced cardiomyopathy","volume":"11","author":"J P Moore","year":"2014","journal-title":"Heart Rhythm"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1542\/pir.2018-0044","article-title":"Acute myocarditis and pericarditis in children","volume":"40","author":"H Tunuguntla","year":"2019","journal-title":"Pediatr Rev"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"e0214087","DOI":"10.1371\/journal.pone.0214087","article-title":"Analysis of clinical parameters and echocardiography as predictors of fatal pediatric myocarditis","volume":"14","author":"Y J Chang","year":"2019","journal-title":"PLoS One"},{"issue":"06","key":"ref22","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1542\/peds.2007-1073","article-title":"Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation","volume":"120","author":"S B Freedman","year":"2007","journal-title":"Pediatrics"},{"issue":"03","key":"ref23","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.pedneo.2011.03.005","article-title":"Clinical presentation of pediatric myocarditis in Taiwan","volume":"52","author":"H J Hsiao","year":"2011","journal-title":"Pediatr Neonatol"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1007\/s00246-018-1867-y","article-title":"Identifying non-invasive tools to distinguish acute myocarditis from dilated cardiomyopathy in children","volume":"39","author":"D Suthar","year":"2018","journal-title":"Pediatr Cardiol"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00246-004-0677-6","article-title":"Cardiac troponin T: a marker in the diagnosis of acute myocarditis in children","volume":"26","author":"J Soongswang","year":"2005","journal-title":"Pediatr Cardiol"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1161\/01.CIR.89.1.252","article-title":"Gamma-globulin treatment of acute myocarditis in the pediatric population","volume":"89","author":"N A Drucker","year":"1994","journal-title":"Circulation"},{"issue":"10","key":"ref27","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1136\/hrt.2003.026641","article-title":"Long term follow up of children with myocarditis treated by immunosuppression and of children with dilated cardiomyopathy","volume":"90","author":"M G Gagliardi","year":"2004","journal-title":"Heart"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1536\/ihj.18-299","article-title":"Intravenous immunoglobulin therapy for acute myocarditis in children and adults","volume":"60","author":"X Huang","year":"2019","journal-title":"Int Heart J"}],"container-title":["Journal of Pediatric Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0040-1722339.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T19:50:08Z","timestamp":1758138608000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0040-1722339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,25]]},"references-count":27,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2022,8,2]]},"published-print":{"date-parts":[[2022,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1722339","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2146-4618","2146-4626"],"issn-type":[{"value":"2146-4618","type":"print"},{"value":"2146-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,25]]}}}