血管活性-内热学评分 (VIS) 和患有儿科败血症休克的儿童的结果
K V Vikas1, Arnab Biswas2, Moumita Samanta3
1Department of Pediatrics, Nil Ratan Sircar Medical College and Hospital (NRSMCH), Kolkata, West Bengal, India. paedsdocvikkv97@gmail.com.
Indian pediatrics
|July 31, 2025
概括
血管活性-无热积分 (VIS) 可靠地预测了儿科败血症休克的结果. 在96小时 (AVIS96) 的总VIS (AVIS) ≥25.4准确识别死亡风险.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
背景情况:
- 儿科败血症和败血性休克是儿童死亡和发病的重要原因.
- 准确和早期的风险分层对于优化治疗和改善儿科败血症休克的结果至关重要.
- 现有的评分系统在预测这一脆弱群体的结果方面可能存在局限性.
研究的目的:
- 评估血管活性-无热积分 (VIS) 在预测败血症儿童的临床结果方面的有效性.
- 确定VIS和总体VIS (AVIS) 对儿科败血症休克死亡率和其他关键结果的预测准确性.
- 确定用于早期风险分层的特定AVIS门.
主要方法:
- 一项前性观察性研究是在三级儿科重症监护病房 (PICU) 进行的一年.
- 纳入1个月至12岁的患有耐液性败血症的儿童.
- 在多个时间点 (6,12,24,48,72,96小时) 计算VIS和AVIS;主要结果是死亡率,次要结果包括PICU停留,通风和异能持续时间.
主要成果:
- 90名患者被录取;58人 (64.4%) 是没有幸存者.
- 96小时后的总体VIS (AVIS96) 与乳酸水平 (r=0.79),内支持持续时间 (r=0.73) 和通风持续时间 (r=0.69) 强烈相关.
- 在预测死亡率方面,AVIS96的切线≥25.4显示出高准确度 (AUC 0.976,灵敏度95%,特异性90%),表现优于pSOFA和乳酸.
结论:
- 血管活性-无热点评分 (VIS) 是对儿科败血症休克结果的可靠预测指标.
- 总体96小时VIS (AVIS96) 显示了早期风险分层的巨大潜力.
- 25.4的AVIS96截止值为此儿科队列中死亡率预测的最大诊断准确度.
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