High-Dose Vasopressor Therapy for Pediatric Septic Shock: When Is Too Much?

J Pediatr Intensive Care

Health Technologies Assessment Center, Federal University of São Paulo, São Paulo, Brazil.

Published: September 2020

AI Article Synopsis

  • * Researchers found that higher vasopressor doses and oliguria (low urine output) were linked to higher mortality rates, with a specific cutoff of 1.3 μg/kg/min indicating increased risk.
  • * The peak vasopressor dose was identified as the most reliable predictor of survival, with a 75% sensitivity and 89% specificity for the 1.3 μg/kg/min threshold.

Article Abstract

It is unknown if the requirement for high dose of vasopressor (HDV) represents a poor outcome in pediatric septic shock. This is a retrospective observational analysis with data obtained from a single center. We evaluated the association between the use of HDV and survival in these patients. A total of 62 children (38 survivors and 24 nonsurvivors) were assessed. The dose of vasopressor (hazard ratio 2.06) and oliguria (hazard ratio 3.17) was independently associated with mortality. The peak of vasopressor was the best prognostic predictor. A cutoff of 1.3 μg/kg/min was associated with mortality with a sensitivity of 75% and specificity of 89%. Vasopressor administration higher than 1.3 μg/kg/min was associated with increased mortality in children with septic shock.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360387PMC
http://dx.doi.org/10.1055/s-0040-1705181DOI Listing

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