Vasoactive-Inotropic Score (VIS) and Outcome of Children with Pediatric Septic Shock.

IF 1.5 4区医学 Q2 PEDIATRICS

Indian pediatrics Pub Date : 2025-10-01 Epub Date: 2025-07-31 DOI:10.1007/s13312-025-00130-5

K V Vikas, Arnab Biswas, Moumita Samanta

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引用次数: 0

Abstract

Objective: To assess the effectiveness of the vasoactive-inotropic score (VIS) in predicting outcomes for pediatric sepsis.

Methods: A one-year prospective observational study in a tertiary level pediatric intensive care unit (PICU), enrolled children (1 month to 12 years) with fluid-refractory septic shock. VIS and aggregate VIS (AVIS) was calculated at 6, 12, 24, 48, 72, and 96 h post-hospitalization. The primary outcome assessed was mortality and secondary outcomes included duration of PICU stay, ventilation and inotrope support.

Results: Ninety (64.4% male) patients with median (Q1, Q3) age of 24 [6, 60] months were enrolled. The median (Q1, Q3) duration of PICU stay (days) among survivors (n = 32) was significantly shorter 9 (7, 12) compared to non-survivors (n = 58) was 13 (9, 16) (P < 0.001). Significant correlations were found between AVIS at 96 h (AVIS96) and lactate levels (r = 0.79, P < 0.001), duration of inotrope support (r = 0.73, P < 0.001), and duration of ventilation (r = 0.69, P < 0.001). An AVIS96 cutoff of ≥ 25.4 showed high accuracy for mortality prediction (AUC 0.976, sensitivity 95%, specificity 90%), outperforming pSOFA and lactate levels.

Conclusion: VIS is a reliable predictor of outcomes in pediatric septic shock, with potential for early risk stratification. An AVIS96 cut-off value of 25.4 showed maximum diagnostic accuracy in terms of mortality prediction in this cohort.

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儿童感染性休克的血管活性-肌力评分（VIS）与预后。

目的：评价血管活性-肌力评分（VIS）在预测小儿败血症预后中的有效性。方法：在三级儿科重症监护病房（PICU）进行为期一年的前瞻性观察研究，入组患有液体难治性感染性休克的儿童（1个月至12岁）。分别于住院后6、12、24、48、72和96 h计算VIS和总VIS （AVIS）。评估的主要结局是死亡率，次要结局包括PICU停留时间、通气和肌力支持。结果：纳入90例患者（64.4%为男性），中位（Q1, Q3）年龄为24[6,60]个月。与非幸存者（n = 58）相比，幸存者（n = 32）在PICU的中位（Q1, Q3）停留时间（天）显著缩短（7,12），为13 (9,16)(P结论：VIS是儿童感染性休克结局的可靠预测指标，具有早期风险分层的潜力。AVIS96的临界值为25.4，显示了该队列中死亡率预测的最高诊断准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian pediatrics 医学-小儿科

CiteScore

3.30

自引率

8.70%

发文量

344

审稿时长

3-8 weeks

期刊介绍： The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are: -To publish original, relevant, well researched peer reviewed articles on issues related to child health. -To provide continuing education to support informed clinical decisions and research. -To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics. -To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.