
Association between vasoactive-inotropic score and prognosis in children with septic shock
QIN Yan-Ran, LIU Cheng-Jun, XU Feng, LI Jing, XIONG Xiao-Yu
Chinese Journal of Contemporary Pediatrics ›› 2018, Vol. 20 ›› Issue (2) : 106-111.
Association between vasoactive-inotropic score and prognosis in children with septic shock
Objective To investigate the association between vasoactive-inotropic score (VIS) and prognosis in children with septic shock.Methods A total of 117 children with decompensated septic shock who received the treatment with vasoactive agents were enrolled. According to their prognosis, they were divided into death group with 41 children and survival group with 76 children. With the maximum VIS within the first 24 hours (24hVIS max) as the cut-off value (29.5), the children were divided into low VIS group with 78 children and high VIS group with 39 children. The 24hVIS max and the mean VIS within the first 24 hours (24hVIS mean) were calculated for all children. A receiver operating characteristic (ROC) curve analysis was performed for the association between VIS and the prognosis of septic shock.Results Compared with the survival group, the death group had significantly higher 24hVIS max, 24hVIS mean, PRISM Ⅲ score, and level of lactate before the use of vasoactive agents and after 24 hours of use (P < 0.05). 24hVIS max, 24hVIS mean, PRISM Ⅲ score, level of lactate before the use of vasoactive agents and after 24 hours of use, and 24-hour pH had a certain value in predicting the prognosis of septic shock, but 24hVIS max had the largest area under the ROC curve. Compared with the low VIS group, the high VIS group had significantly higher number of deaths, PRISM Ⅲ score, and level of lactate before treatment and after 24 hours of treatment (P < 0.05).Conclusions VIS is associated with the mortality of children with septic shock, and the severity and mortality of patients increase with the increase in VIS.
Septic shock / Vasoactive-inotropic score / PRISM Ⅲ score / Child
[1] Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA, 2016, 315(8):801-810.
[2] Ventura AM, Shieh HH, Bousso A, et al. Double-blind prospective randomized controlled trial of dopamine versus epinephrine as first-line vasoactive drugs in pediatric septic shock[J]. Crit Care Med, 2015, 43(11):2292-2302.
[3] Gaies MG, Gurney JG, Yen AH, et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass[J]. Pediatr Crit Care Med, 2010, 11:234-238.
[4] Barge-Caballero E, Segovia-Cubero J, González-Vilchez F, et al. Evaluation of the preoperative vasoactive-inotropic score as a predictor of postoperative outcomes in patients undergoing heart transplantation[J]. Int J Cardiol, 2015, 185:192-194.
[5] Haque A, Siddiqui NR, Munir O, et al. Association between vasoactive-inotropic score and mortality in pediatric septic shock[J]. Indian Pediatrics, 2015, 52(4):311-313.
[6] 樊寻梅.儿科感染性休克(脓毒性休克)诊疗推荐方案[J].中国小儿急救医学, 2006, 13(4):313-315.
[7] Dellinger RP, Levy MM, Carlet JM, et al. Surviving sepsis campaign:international guidelines for management of severe sepsis and septic shock:2008[J]. Crit Care Med, 2008, 36(1):296-327.
[8] 崔勇丽, 刘晋萍, 赵举, 等. 血管活性药物评分对体外膜式氧合辅助下婴幼儿患者急性肾损伤的预测作用[J]. 中国医药导报, 2013, 10(18):79-81.
[9] Minasyan H. Sepsis and septic shock:Pathogenesis and treatment perspectives[J].J Crit Care, 2017, 40:229-242.
[10] Oba Y, Lone NA. Mortality beneft of vasopressor and inotropic agents in septic shock:a Bayesian network meta-analysis of randomized controlled trials[J]. J Crit Care, 2014, 29:706-710.
[11] Persichini R, Silva S, Teboul JL, et al. Effects of norepinephrine on mean systemic pressure and venous return in human septic shock[J]. Crit Care Med, 2012, 40(12):3146-3153.
[12] Sanil Y, Aggarwal S. Vasoactive-inotropic score after pediatric heart transplant:a marker of adverse outcome[J]. Pediatr Transplant, 2013, 17(6):567-572.
[13] Gaies MG, Jeffries HE, Niebler RA, et al. Vasoactive-inotropic score is associated with outcome after infant cardiac surgery:An analysis from the Pediatric Cardiac Critical Care Consortium and Virtual PICU System Registries[J].Pediatr Crit Care Med, 2014, 15(6):529-537.
[14] Davidson J, Tong S, Hancock H, et al. Prospective validation of the vasoactive-inotropic score and correlation to short-term outcomes in neonates and infants after cardiothoracic surgery[J]. Intensive Care Med, 2012, 38(7):1184-1190.
[15] Doenyasbarak K, Beberashvili I, Marcus R, et al. Lactic acidosis and severe septic shock in metformin users:a cohort study[J]. Crit Care, 2016, 20:10.
[16] 包磊,张敏,颜培夏,等.动脉血乳酸及其清除率预测感染性休克患者预后的回顾性研究[J].中华危重病急救医学, 2015, 27(1):38-42.