학술논문

Validation of the pediatric refractory septic shock definition: post hoc analysis of a controlled trial
Document Type
article
Source
Annals of Intensive Care, Vol 11, Iss 1, Pp 1-8 (2021)
Subject
Sepsis
Refractory shock
Cardiac dysfunction
Score
Medical emergencies. Critical care. Intensive care. First aid
RC86-88.9
Language
English
ISSN
2110-5820
Abstract
Abstract Background The European Society of Pediatric and Neonatal Intensive Care (ESPNIC) developed and validated a definition of pediatric refractory septic shock (RSS), based on two septic shock scores (SSS). Both bedside SSS (bSSS) and computed SSS (cSSS) were found to be strongly associated with mortality. We aimed at assessing the accuracy of the RSS definition on a prospective cohort from India. Methods Post hoc analysis of a cohort issued from a double-blind randomized trial that compared first-line vasoactive drugs in children with septic shock. Sequential bSSS and cSSS from 60 children (single-center study, 53% mortality) were analyzed. The prognostic value of the ESPNIC RSS definition was tested for 28-day all-cause mortality. Results In this septic shock cohort, RSS was diagnosed in 35 patients (58.3%) during the first 24 h. Death occurred in 30 RSS patients (85.7% mortality) and in 2 non-RSS patients (8% mortality), OR = 60.9 [95% CI: 10.5–676.2], p