Liu Rong, Yu Zhicai, Xiao Changxue, Xu Feng, Xiao Shufang, He Juan, Shi Yan, Hua Yuanyuan, Zhou Jimin, Zhang Guoying, Wang Tao, Jiang Jianyu, Xiong Daoxue, Chen Yan, Xu Hongbo, Yun Hong, Sun Hui, Pan Tingting, Wang Rui, Zhu Shuangmei, Huang Dong, Liu Yujiang, Hu Yuhang, Ren Xinrui, Shi Mingfang, Song Sizun, Luo Jumei, He Gang, Zhang Juan
Department of Pediatric Critical Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Department of Pediatric Critical Care, Kunming Children's Hospital, Kunming, China.
Pediatr Crit Care Med. 2024 May 1;25(5):425-433. doi: 10.1097/PCC.0000000000003450. Epub 2024 Feb 14.
To describe the epidemiological characteristics of pediatric sepsis in Southwest China PICUs.
A prospective, multicenter, and observational study.
Twelve PICUs in Southwest China.
The patients admitted to the PICU from April 1, 2022, to March 31, 2023. The age ranged from 28 days to 18 years. All patients met the criteria of severe sepsis or septic shock.
None.
Of the 31 PICUs invited to participate, 12 PICUs (capacity of 292 beds) enrolled patients in the study. During the study period, 11,238 children were admitted to the participating PICUs, 367 (3.3%) of whom met the diagnosis of severe sepsis or septic shock. The most prevalent sites of infection were the respiratory system (55%) and the digestive system (15%). The primary treatments administered to these patients included antibiotics (100%), albumin (61.3%), invasive mechanical ventilation (58.7%), glucocorticoids (55.6%), blood products (51%), gammaglobulin (51%), and vasoactive medications (46.6%). Sepsis-related mortality in the PICU was 11.2% (41/367). Nearly half of the sepsis deaths occurred within the first 3 days of PICU admission (22/41, 53.7%). The mortality rate of septic shock (32/167, 19.2%) was significantly higher than that of severe sepsis (9/200, 4.5%; p < 0.001). The outcomes of a multivariate logistic regression analysis suggested that a higher pediatric Sequential Organ Failure Assessment score, and the use of invasive mechanical ventilation and vasoactive medications were independently associated with PICU mortality in children with sepsis.
This report updates the epidemiological data of pediatric sepsis in PICUs in Southwest China. Sepsis is still a life-threatening disease in children.
描述中国西南地区儿科重症监护病房（PICU）中儿童脓毒症的流行病学特征。
一项前瞻性、多中心观察性研究。
中国西南地区的12个PICU。
2022年4月1日至2023年3月31日期间入住PICU的患者。年龄范围为28天至18岁。所有患者均符合严重脓毒症或脓毒性休克的标准。
无。
在受邀参与的31个PICU中，有12个PICU（床位292张）纳入了研究患者。研究期间，11238名儿童入住参与研究的PICU，其中367名（3.3%）符合严重脓毒症或脓毒性休克的诊断。最常见的感染部位是呼吸系统（55%）和消化系统（15%）。给予这些患者的主要治疗措施包括抗生素（100%）、白蛋白（61.3%）、有创机械通气（58.7%）、糖皮质激素（55.6%）、血液制品（51%）、丙种球蛋白（51%）和血管活性药物（46.6%）。PICU中脓毒症相关死亡率为11.2%（41/367）。近一半的脓毒症死亡发生在入住PICU的前3天内（22/41，53.7%）。脓毒性休克的死亡率（32/167，19.2%）显著高于严重脓毒症（9/200，4.5%；p<0.001）。多因素逻辑回归分析结果表明，较高的儿童序贯器官衰竭评估评分、使用有创机械通气和血管活性药物与脓毒症患儿在PICU的死亡率独立相关。
本报告更新了中国西南地区PICU中儿童脓毒症的流行病学数据。脓毒症在儿童中仍然是一种危及生命的疾病。
