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在高度复杂的医院中,败血症儿童的特征和预后因素

Maria Camila Franco¹, Laura F Niño-Serna², Manuela Rendón¹

¹Universidad Pontificia Bolivariana, Medellín, Colombia.

Andes pediatrica : revista Chilena de pediatria

|November 1, 2023

概括

进入拉丁美洲医院的儿童的败血症经常导致器官功能障碍和更高的死亡率. 早期干预措施,如静脉注射液体和抗生素,尽管有指导方针,但经常被推迟.

科学领域:

儿科重症监护医药儿科重症监护医药
传染病传染病传染病
流行病学流行病学

背景情况:

败血症仍然是全球儿童死亡的一个重要原因.
在资源有限的环境中了解败血症特征对于改善结果至关重要.
拉丁美洲在治疗儿科败血症方面面临着独特的挑战.

研究的目的:

描述儿科败血症患者的临床和实验室特征.
为了确定这个高度复杂的医疗保健中心的死亡率预测因素.
评估遵守败血症管理指南的情况.

主要方法:

包括186名被诊断患有败血症的儿科患者 (1个月-17岁) 的描述性观察性研究.
收集关于人口统计,临床和实验室发现以及治疗的数据.
使用奇平方或费舍尔测试来确定死亡率预测因素的统计分析.

主要成果:

伴随疾病 (72%) 和器官功能障碍 (60%) 的高患病率,特别是呼吸系统.
在60%的患者中观察到多器官功能障碍综合征 (MODS).
37%的血液培养结果呈阳性;第一小时的干预低于推剂量 (静脉注射液67%,抗生素36%).
总体死亡率为12%,在器官功能障碍或MODS患者中显著增加.

结论:

器官功能障碍和MODS是常见的,并且与儿科败血症的死亡率增加有关.
按时遵守败血症管理指南 (第一小时输液和抗生素) 是不理想的.
在这个拉丁美洲环境中,需要改进败血症的检测和管理.

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