Comparison of Predictive Powers for Mortality between Systemic Vascular Resistance Index and Serum Lactate in Children with Persistent Catecholamine‐Resistant Shock

Lee, En-Pei; Chu, Sheng-Chih; Hsia, Shao‐Hsuan; Chen, Kuan-Fu; Chan, Oi-Wa; Lin, Chih-Kuang; Su, Ya-Ting; Lin, Jainn-Jim; Wu, Han-Ping

doi:10.1155/2020/1341326

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Previous reports have shown that lower SVRI is associated with mortality in adults with septic shock [20,21]; however, the clinical utilization of SVRI has not been well surveyed in pediatric septic shock. Our previous study with the same group reported that SVRI was a predictor for in-hospital mortality in pediatric septic shock [22]. The current study was an expansion of the previous one, which demonstrated the importance of SVRI in the different time points of pediatric septic shock.…”

Section: Discussionsupporting

confidence: 58%

Cutoff Values of Hemodynamic Parameters in Pediatric Refractory Septic Shock

et al. 2022

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Background: Refractory septic shock can cause severe morbidities and mortalities in children. Resuscitation based on hemodynamics is important in children with critical illness. Thus, this study aimed to identify the hemodynamics of refractory septic shock associated with poor prognosis at an early stage to allow for timely interventions. Methods: We evaluated children with refractory septic shock admitted to a pediatric intensive care unit (PICU) and monitored their hemodynamics using a pulse index continuous cardiac output (PiCCO) system. The serial cardiac index (CI), systemic vascular resistance index (SVRI), and vasoactive–inotropic score (VIS) were recorded during the first 72 h after PICU admission. Results: Thirty-three children with refractory septic shock were enrolled. The SVRI and VIS were both associated with fatality from septic shock. The non-survivors had lower serial SVRI and higher VIS (both p < 0.05). Based on the area under the ROC curve, the SVRI was the predictor during the early resuscitative stage (first 36 h) in pediatric refractory septic shock. Conclusions: Both SVRI and VIS are predictors of mortality in children with refractory septic shock, and the SVRI is the powerful predictor of mortality in the early resuscitative stage. A low serial SVRI may allow for the early awareness of disease severity and strategies for adjusting vasoactive–inotropic agents to increase the SVRI.

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Section: Discussionsupporting

confidence: 58%

Cutoff Values of Hemodynamic Parameters in Pediatric Refractory Septic Shock

et al. 2022

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“…1 ). 23 26 27 28 29 30 31 32 33 34 35 36 Of these 12 studies, 4 (33%) included patients after cardiac surgery, 3 (25%) included patients with shock, and the remainder included patients with various diagnoses. Out of the 2,099 patients, 357 (17%) experienced mortality.…”

Section: Resultsmentioning

confidence: 99%

Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the Magic Number?

Loomba

Farias

Villarreal

et al. 2022

J Pediatr Intensive Care

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The primary objective of this study was to determine if serum lactate level at the time of hospital admission can predict mortality in pediatric patients. A systematic review was conducted to identify studies that assessed the utility of serum lactate at the time of admission to predict mortality in pediatric patients. The areas under the curve from the receiver operator curve analyses were utilized to determine the pooled area under the curve. Additionally, standardized mean difference was compared between those who survived to discharge and those who did not. A total of 12 studies with 2,099 patients were included. Out of these, 357 (17%) experienced mortality. The pooled area under the curve for all patients was 0.74 (0.67–0.80, p < 0.01). The pooled analyses for all admissions were higher in those who experienced mortality (6.5 vs. 3.3 mmol/L) with a standardized mean difference of 2.60 (1.74–3.51, p < 0.01). The pooled area under the curve for cardiac surgery patients was 0.63 (0.53–0.72, p < 0.01). The levels for cardiac surgery patients were higher in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a standardized mean difference of 1.80 (0.05–3.56, p = 0.04). Serum lactate at the time of admission can be valuable in identifying pediatric patients at greater risk for inpatient mortality. This remained the case when only cardiac surgery patients were included.

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Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction

Zhang,

Wang,

Zhang

et al. 2024

Front. Cardiovasc. Med.

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ObjectiveThe left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertension-related heart failure with preserved ejection fraction (HT-HFpEF).MethodsThe study involved 62 healthy subjects and 163 patients with HT (112 patients in simple HT group and 51 patients in HT-HFpEF group). Each patient performed exercise stress test and standard ultrasonic images were evaluated. A comprehensive evaluation of atrioventricular function, along with investigation into the correlation between these functional parameters and exercise capacity. And further to investigate the feasibility of predicting exercise intolerance using three-dimensional derived left atrial strain index (LASI) (E/e'/LASr and E/e'/LASr-c).ResultsCompared to healthy subjects, HT group demonstrated the elevation in left atrial volume accompanied by decrease in strain value (P < 0.05). In HT-HFpEF group, further significant reductions were observed in both longitudinal (LASr) and circumferential strain (LASr-c, LASct-c) (P < 0.05). Univariate regression demonstrated that both E/e'/LASr and E/e'/LASr-c were significantly correlated with metabolic equivalents (METs) (r = −0.462, P < 0.001; r = −0.381, P < 0.001). The E/e'/LASr demonstrates comparable diagnostic efficacy to exercise-E/e' in assessing exercise intolerance in HT-HFpEF patients (AUC: 0.836 vs. 0.867, P = 0.239).ConclusionProgressive LA remodeling contributes to decreased atrioventricular compliance in HT and HT-HFpEF patients.E/e'/LASr serves as an independent indicator of exercise intolerance in patients with HT-HFpEF.

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Comparison of Predictive Powers for Mortality between Systemic Vascular Resistance Index and Serum Lactate in Children with Persistent Catecholamine‐Resistant Shock

Cited by 4 publications

References 31 publications

Cutoff Values of Hemodynamic Parameters in Pediatric Refractory Septic Shock

Cutoff Values of Hemodynamic Parameters in Pediatric Refractory Septic Shock

Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the Magic Number?

Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction

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