Open AccessHigh-Dose Vasopressor Therapy for Pediatric Septic Shock: When Is Too Much?
Author(s) -
Paulo Sérgio Lucas da Silva,
Marcelo Cunio Machado Fonseca
Publication year - 2020
Publication title -
journal of pediatric intensive care
Language(s) - English
Resource type - Journals
eISSN - 2146-4618
pISSN - 2146-4626
DOI - 10.1055/s-0040-1705181
Subject(s) - medicine , septic shock , hazard ratio , oliguria , retrospective cohort study , anesthesia , observational study , shock (circulatory) , mortality rate , sepsis , renal function , confidence interval
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.