Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
Pediatr Crit Care Med. 2013 Jun;14(5):448-53. doi: 10.1097/PCC.0b013e31828a7270.
Determine if the shortest sampling interval for laboratory variables used to estimate baseline severity of illness in pediatric critical care is equivalently sensitive across multiple sites without site-specific bias, while accounting for the vast majority of dysfunction compared with the standard 0- to 12-hour Pediatric Risk of Mortality III score.
Prospective random patient selection.
General/medical and cardiac/cardiovascular PICUs in eight hospitals.
Patients younger than 18 years admitted to the PICU.
None.
A total of 376 patients were included. Measurements for Pediatric Risk of Mortality III laboratory variables (pH, PCO2, total CO2, PaO2, glucose, potassium, blood urea nitrogen, creatinine, total WBC count, platelet count, and prothrombin time/partial thromboplastin time) were recorded from 2 hours prior to PICU admission through 12 hours of PICU care except for data in the operating room. Decreasing the observation period from 0 to 12 hours post-PICU admission resulted in progressive decreases in the Pediatric Risk of Mortality III laboratory variables measured. However, allowing the observation period to start 2 hours prior to PICU admission to 4 hours reduced this loss to only 3.4%. Similar trends existed for each of the individual laboratory Pediatric Risk of Mortality III variables. There was a nearly identical distribution of laboratory Pediatric Risk of Mortality III points within the -2- to 4-hour period compared with the standard period. We did not detect any institutional bias using the -2- to 4-hour time period compared with the baseline.
Prognostically important laboratory physiologic data collected within the interval from 2 hours prior to PICU to admission through 4 hours after admission account for the vast majority of dysfunction that these variables would contribute to Pediatric Risk of Mortality III scores. There was no institutional bias associated with this sampling period.
确定用于估计儿科危重病患者基线严重程度的实验室变量的最短采样间隔是否在多个站点没有站点特异性偏差的情况下同样敏感，同时与标准的 0 至 12 小时儿科死亡率 III 评分相比，考虑到绝大多数功能障碍。
前瞻性随机患者选择。
八家医院的普通/内科和心脏/心血管 PICUs。
入住 PICU 的年龄小于 18 岁的患者。
无。
共纳入 376 名患者。从 PICU 入院前 2 小时至 PICU 护理 12 小时记录儿科死亡率 III 实验室变量（pH、PCO2、总 CO2、PaO2、血糖、钾、血尿素氮、肌酐、总白细胞计数、血小板计数和凝血酶原时间/部分凝血活酶时间），但手术室的数据除外。将观察期从 PICU 入院后 0 至 12 小时缩短导致测量的儿科死亡率 III 实验室变量逐渐降低。然而，允许观察期从 PICU 入院前 2 小时开始至 4 小时，仅将这种损失减少到 3.4%。每个单独的实验室儿科死亡率 III 变量都存在类似的趋势。在-2 至 4 小时期间，实验室儿科死亡率 III 点的分布与标准期间几乎相同。与基线相比，我们在-2 至 4 小时时间段内没有检测到任何机构偏差。
在从 PICU 入院前 2 小时至入院后 4 小时期间收集的具有预后重要性的实验室生理数据，占这些变量对儿科死亡率 III 评分的绝大多数功能障碍。与该采样期相关没有机构偏差。
