扩张性血压对儿科耐火性败血症休克结果的影响
En-Pei Lee1, Chen-Wei Yen2, Ming-Shun Hsieh3
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Pediatrics and neonatology
|November 28, 2023
概括
扩张性血压 (DBP) 有效地预测了儿科败血症休克的死亡率,与全身血管阻力指数 (SVRI) 相对应. 较低的DBP独立表明严重败血症儿童28天死亡风险更高.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液动力学 血液动力学
- 败血症的研究研究.
背景情况:
- 败血性休克是一种严重的败血症并发症,涉及心血管功能障碍和高死亡率 (40-80%).
- 血管度的损失是关键特征,腹压血压 (DBP) 可能反映了这一点.
- 预后指标的早期识别对于儿童败血症休克的及时干预至关重要.
研究的目的:
- 调查血液动力学指数,特别是DBP和儿科败血症休克的结果之间的关联.
- 确定DBP是否可以作为该患者群体中死亡率的可靠预测指标.
主要方法:
- 使用PiCCO®系统在患有持续抗甲基胺冲击的儿童中进行侵入性血液动力学监测.
- 在24小时内连续记录心脏指数,全身血管阻力指数 (SVRI),缩血压 (SBP),平均动脉压 (MAP) 和DBP.
- 接收器操作特征 (ROC) 曲线分析,以评估血液动力学参数对28天死亡率的预测值.
主要成果:
- 三十三名儿童被录取;幸存者与非幸存者相比,SVRI,SBP,MAP和DBP显著更高.
- 多变量分析确定SVRI和DBP是28天死亡率的独立预测因素.
- DBP与SVRI有很强的相关性 (r=0.718) 和对死亡率的良好预测准确性 (AUC>0.75).
结论:
- 扩张性血压 (DBP) 是儿科败血症休克死亡率的强有力的预测因素,与SVRI相关性良好.
- 与SBP和MAP相比,DBP是死亡率的优越歧视因素.
- 较低的DBP是一种独立的血液动力学因素,与儿科败血性休克28天死亡率的增加有关.
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