Pediatr Emerg Care. 2022 Jan 1;38(1):e371-e377. doi: 10.1097/PEC.0000000000002295.
Mortality in pediatric septic shock remains unacceptably high. Delays in vasopressor administration have been associated with an increased risk of mortality. Current treatment guidelines suggest the use of a peripheral vascular line (PVL) for inotropic administration in fluid-refractory septic shock when a central vascular line is not already in place. The aim of this study was to report local adverse effects associated with inotropic drug administration through a PVL at a pediatric emergency department setting in the first hour of treatment of septic shock.
A prospective, descriptive, observational cohort study of patients with septic shock requiring PVL inotropic administration was conducted at the pediatric emergency department of a tertiary care pediatric hospital. For the infusion and postplacement care of the PVL for vasoactive drugs, an institutional nursing protocol was used.
We included 49 patients; 51% had an underlying disease. Eighty-four percent of the children included had a clinical "cold shock." The most frequently used vasoactive drug was epinephrine (72%). One patient presented with local complications.
At our center, infusion of vasoactive drugs through a PVL was shown to be safe and allowed for adherence to the current guidelines for pediatric septic shock.
儿科感染性休克患者的死亡率仍然高得令人无法接受。血管加压药物的给药延迟与死亡率增加有关。目前的治疗指南建议，在液体难治性感染性休克时，如果尚未建立中央血管通路，则应使用外周血管通路（PVL）给予正性肌力药物。本研究的目的是报告在感染性休克治疗的第一个小时内，通过儿科急诊部门的 PVL 给予正性肌力药物时的局部不良事件。
对一家三级儿科医院儿科急诊部门需要 PVL 正性肌力药物治疗的感染性休克患者进行了前瞻性、描述性、观察性队列研究。对于 PVL 血管活性药物的输注和后置护理，使用了机构护理协议。
我们纳入了 49 名患者；51%有潜在疾病。84%的患儿存在临床“冷休克”。最常使用的血管活性药物是肾上腺素（72%）。1 名患者出现局部并发症。
在我们中心，通过 PVL 输注血管活性药物被证明是安全的，并符合儿科感染性休克的当前指南。
