Unidad Emergencias, Hospital de Pediatria "Prof. Dr. Juan P. Garrahan" - Buenos Aires, Argentina.
Dirección Asociada de Docencia e Investigación, Hospital de Pediatria "Prof. Dr. Juan P. Garrahan" - Buenos Aires, Argentina.
Rev Bras Ter Intensiva. 2020 Oct-Dec;32(4):551-556. doi: 10.5935/0103-507X.20200092.
To analyze the clinical outcome of children with fluid-refractory septic shock initially treated with dopamine or epinephrine.
A retrospective cohort study was conducted at a pediatric emergency department of a tertiary hospital. Population: children admitted because of fluid-refractory septic shock. Clinical outcome was compared between two groups: Dopamine and Epinephrine. Variables evaluated were use of invasive mechanical ventilation, days of inotropic therapy, length of hospital stay, intensive care stay, and mortality. For numerical and categorical variables, we used measures of central tendency. They were compared by the Mann-Whitney U-test and the (2 test.
We included 118 patients. A total of 58.5% received dopamine and 41.5% received epinephrine. The rate of invasive mechanical ventilation was 38.8% for epinephrine versus 40.6% for dopamine (p = 0.84), with a median of 4 days for the Epinephrine Group and 5.5 for the Dopamine Group (p = 0.104). Median time of inotropic therapy was 2 days for both groups (p = 0.714). Median hospital stay was 11 and 13 days for the Epinephrine and Dopamine groups, respectively (p = 0.554), and median stay in intensive care was 4 days (0 - 81 days) in both groups (p = 0.748). Mortality was 5% for the Epinephrine Group versus 9% for the Dopamine Group (p = 0.64).
At our center, no differences in use of invasive mechanical ventilation, time of inotropic therapy, length of hospital stay, length of intensive care unit stay, or mortality were observed in children admitted to the pediatric emergency department with a diagnosis of fluid-refractory septic shock initially treated with dopamine versus epinephrine.
分析最初使用多巴胺或肾上腺素治疗的液体难治性感染性休克儿童的临床结果。
这是一项在一家三级医院儿科急诊进行的回顾性队列研究。研究人群为因液体难治性感染性休克而入院的儿童。临床结局在多巴胺组和肾上腺素组之间进行比较。评估的变量包括使用有创机械通气、儿茶酚胺治疗天数、住院时间、重症监护病房入住时间和死亡率。对于数值和分类变量，使用集中趋势的测量值。通过 Mann-Whitney U 检验和（2 检验进行比较。
共纳入 118 例患者。多巴胺组和肾上腺素组分别占 58.5%和 41.5%。使用有创机械通气的比例分别为肾上腺素组 38.8%和多巴胺组 40.6%（p = 0.84），肾上腺素组中位数为 4 天，多巴胺组中位数为 5.5 天（p = 0.104）。两组儿茶酚胺治疗的中位时间均为 2 天（p = 0.714）。两组的中位住院时间分别为 11 天和 13 天（p = 0.554），两组的中位重症监护病房入住时间分别为 4 天（0-81 天）（p = 0.748）。肾上腺素组死亡率为 5%，多巴胺组死亡率为 9%（p = 0.64）。
在我们中心，最初使用多巴胺或肾上腺素治疗的液体难治性感染性休克儿童在因液体难治性感染性休克而入住儿科急诊时，使用有创机械通气、儿茶酚胺治疗时间、住院时间、重症监护病房入住时间或死亡率方面无差异。
