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早期给予抗生素及对感染性休克的小婴儿进行容量复苏的预测指标

Predictor of Early Administration of Antibiotics and a Volume Resuscitation for Young Infants with Septic Shock.

作者信息

Nomura Osamu, Ihara Takateru, Morikawa Yoshihiko, Sakakibara Hiroshi, Horikoshi Yuho, Inoue Nobuaki

机构信息

Department of Emergency and Disaster Medicine, Hirosaki University, Hirosaki 036-8562, Japan.

Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo 183-8561, Japan.

出版信息

Antibiotics (Basel). 2021 Nov 19;10(11):1414. doi: 10.3390/antibiotics10111414.

Abstract

(1) Background: It is critical to administer antibiotics and fluid bolus within 1 h of recognizing sepsis in pediatric patients. This study aimed to identify the predictor of the successful completion of a 1-h sepsis bundle for infants with suspected sepsis. (2) Methods: This is an observational study using a prospective registry including febrile young infants (aged < 90 days) who visited a pediatric emergency department with a core body temperature of 38.0 °C or higher and 36.0 °C or lower. Univariate and logistic regression analyses were conducted to determine the predictor (s) of successful sepsis bundle completion. (3) Results: Of the 323 registered patients, 118 patients with suspected sepsis were analyzed, and 38 patients (32.2%) received a bundle-compliant treatment. Among potential variables, such as age, sex, and vital sign parameters, the logistic regression analysis showed that heart rate (odds ratio: OR 1.02; 95% confidence interval: 1.00-1.04) is a significant predictor of the completion of a 1-h sepsis bundle. (4) Conclusions: We found that tachycardia facilitated the sepsis recognition and promoted the successful completion of a 1-h sepsis bundle for young infants with suspected septic shock and a possible indicator for improving the quality of the team-based sepsis management.

摘要

(1) 背景:对于儿科患者,在识别脓毒症后1小时内给予抗生素和液体冲击至关重要。本研究旨在确定疑似脓毒症婴儿成功完成1小时脓毒症集束治疗的预测因素。(2) 方法:这是一项观察性研究,使用前瞻性登记系统,纳入体温核心温度为38.0℃或更高以及36.0℃或更低的发热幼婴(年龄<90天),这些幼婴前往儿科急诊科就诊。进行单因素和逻辑回归分析以确定成功完成脓毒症集束治疗的预测因素。(3) 结果:在323名登记患者中,对118名疑似脓毒症患者进行了分析,38名患者(32.2%)接受了符合集束治疗的方案。在年龄、性别和生命体征参数等潜在变量中,逻辑回归分析表明心率(比值比:OR 1.02;95%置信区间:1.00 - 1.04)是成功完成1小时脓毒症集束治疗的显著预测因素。(4) 结论:我们发现心动过速有助于脓毒症的识别,并促进疑似感染性休克幼婴成功完成1小时脓毒症集束治疗,可能是提高基于团队的脓毒症管理质量的一个指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b705/8615069/f30a629d6f9d/antibiotics-10-01414-g001.jpg

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