da Silva Paulo Sérgio Lucas, Fonseca Marcelo Cunio Machado
Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil.
Health Technologies Assessment Center, Federal University of São Paulo, São Paulo, Brazil.
J Pediatr Intensive Care. 2020 Sep;9(3):172-180. doi: 10.1055/s-0040-1705181. Epub 2020 Mar 9.
It is unknown if the requirement for high dose of vasopressor (HDV) represents a poor outcome in pediatric septic shock. This is a retrospective observational analysis with data obtained from a single center. We evaluated the association between the use of HDV and survival in these patients. A total of 62 children (38 survivors and 24 nonsurvivors) were assessed. The dose of vasopressor (hazard ratio 2.06) and oliguria (hazard ratio 3.17) was independently associated with mortality. The peak of vasopressor was the best prognostic predictor. A cutoff of 1.3 μg/kg/min was associated with mortality with a sensitivity of 75% and specificity of 89%. Vasopressor administration higher than 1.3 μg/kg/min was associated with increased mortality in children with septic shock.
高剂量血管升压药（HDV）的使用是否预示着小儿脓毒性休克的不良预后尚不清楚。这是一项基于单中心数据的回顾性观察分析。我们评估了这些患者中HDV的使用与生存率之间的关联。共评估了62名儿童（38名存活者和24名非存活者）。血管升压药剂量（风险比2.06）和少尿（风险比3.17）与死亡率独立相关。血管升压药的峰值是最佳的预后预测指标。血管升压药剂量为1.3μg/kg/min时与死亡率相关，敏感性为75%，特异性为89%。脓毒性休克患儿使用血管升压药的剂量高于1.3μg/kg/min与死亡率增加相关。
