紧急诊所 败血症 选 计分 工具元素 与低血压相关 在24小时内 患有发烧和心率低下的儿童
Alexandra H Baker, Vanessa M Mazandi, Jackson S Norton1
1Division of Medical Critical Care, Boston Children's Hospital, Boston, MA.
Pediatric emergency care
|March 12, 2024
概括
在急诊室患有发烧和心动减速的儿童中,长时间的毛细血管补充和严重的大脑麻预测到性休克的进展. 这些发现有助于早期识别儿科败血症进展.
科学领域:
- 儿科急救医学 儿科急救医学
- 传染性疾病 传染性疾病
- 关键的护理关键的护理
背景情况:
- 儿科败血症查工具是紧急诊所 (ED) 的标准,用于识别严重的败血症.
- 这些查工具对疾病进展的预测价值仍然不清楚.
研究的目的:
- 确定败血症分离触发器工具的元素是否可以预测ED中患有发烧和心力衰竭的儿童的进展到低血压休克.
- 为了确定与败血症进展相关的特定生命体征或临床症状.
主要方法:
- 对儿童 (≤18岁) 进行了回顾性病例对照研究,这些儿童在发烧和心动减速时提交给ED.
- 病例在24小时内发生低血压休克;对照组没有.
- 主要结局:从败血症分类得分中遇到异常重要/临床症状的比例.
主要成果:
- 分析了94个病例和186个对照组.
- 严重的脑 (aOR 9.4) 和异常的毛细血管补充 (aOR 3.1) 在分类时与进展至低血压休克有显著的关联.
- 在调整后的多变量模型中,这些关联仍然显著.
结论:
- 长时间的毛细血管补充和严重的大脑麻预测了儿科ED患者发烧和心跳动的进展到非补偿性败血性休克的情况.
- 这些发现突出了监测高风险儿童的关键指标,尽管标准的ED护理.
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