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

Paulo Sérgio Lucas da Silva; Marcelo Cunio Machado Fonseca

doi:10.1055/s-0040-1705181

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2020; 09(03): 172-180
DOI: 10.1055/s-0040-1705181

Original Article

Georg Thieme Verlag KG Stuttgart · New York

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

Authors

Paulo Sérgio Lucas da Silva

¹Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil
Marcelo Cunio Machado Fonseca

²Health Technologies Assessment Center, Federal University of São Paulo, São Paulo, Brazil

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.

Keywords

mortality - septic shock - vasopressor

Full Text

References

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