Is an inotrope score a predictor of mortality and morbidity in children with septic shock?

Şevketoğlu, Esra; Anıl, Ayşe Berna; Kazancı, Selcen Yaroğlu; Yeşilbaş, Osman; Akyol, Mehmet Bedir; Bayraktar, Süleyman; Aksu, Nejat; Hatipoğlu, Sami; Karaböcüoğlu, Meti̇n

doi:10.1186/cc14227

Cited by 6 publications

(4 citation statements)

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“…Inotropic scores at 24 hours and 48 hours can be independent predictors of mortality in critically ill pediatric patients with septic shock. (18) VIS value at 48 hours in this study can predict mortality if it is equal or more than 11 with 74.4% sensitivity and 80% specificity. Children with sepsis having VIS 48 hours cut-off at ≥11 were at 1.99 times greater risk of mortality (95% CI 1.25-3.19) than patients with VIS value less than 11.…”

Section: Discussionmentioning

confidence: 63%

Vasoactive-inotropic Score for Early Detection and Mortality Prediction of Sepsis in Children

Dauhan

Lubis

2021

Indones Biomed J

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BACKGROUND: Early detection and treatment of sepsis can prevent septic shock and reduce mortality rate. Troponin can become a prognostic factor in sepsis. However, not all health facilities are equipped to assess troponin levels. Vasoactive-inotropic score (VIS) is a simpler and more accessible method to describe hemodynamic status. The aim of this study was to assess the suitability of VIS score as early prognosis and mortality predictor of sepsisMETHODS: A retrospective study was conducted to determine the correlation between VIS and troponin levels for sepsis cases in Pediatric Intensive Care Unity (PICU) Haji Adam Malik Hospital, Medan from January 2018 to December 2019. VIS score at 48 hours, maximum VIS score, pediatric logistic organ dysfunction-2 (PELOD-2) score, cardiac troponin levels at 48 hours were taken from medical records.RESULTS: There were 54 samples analyzed. VIS scores were positively correlated (p<0.001) to troponin T and troponin I levels at 48 hours (r=0.670 and r=0.606, respectively). VIS at 48 hours and maximum VIS were related to mortality (p=0.001 and p<0.001, respectively). VIS score at 48 hours could be used as a predictive factor for mortality (area under the curve (AUC): 79.7%, p<0.001) with a cut-off point at 11 (74.4% sensitivity and 80% specificity). High VIS at 48 hours indicated poor outcomes of sepsis in children with odd ratio (OR) value: 1.99 (95% confidence interval (CI): 1.25-3.19).CONCLUSION: Vasoactive-inotropic score was suitable as an alternative to cardiac troponin T and troponin I levels at 48 hours to early detect myocardial dysfunctions and mortality in children.KEYWORDS: troponin, vasoactive-inotropic score, sepsis, children, mortality

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Section: Discussionmentioning

confidence: 63%

Vasoactive-inotropic Score for Early Detection and Mortality Prediction of Sepsis in Children

Dauhan

Lubis

2021

Indones Biomed J

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“…En la actualidad dicho score se ha utilizado como predictor de mortalidad y se ha intentado validar en varios estudios 99---101 . Existen pocos estudios publicados en pacientes con choque séptico y estos concluyen que un Score inotrópico mayor de 20 se considera alto y se asocia con mayores complicaciones asociadas al uso de vasopresores e inotrópicos 100,101 (tabla 2).…”

Section: Score Inotrópicounclassified

Vasopresores e inotrópicos: uso en pediatría

García-Canales

Peña-Juárez

Sandoval-Franco³

2018

Archivos de Cardiología de México

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The cardiovascular system is a dynamic system, which is required to ensure adequate delivery of oxygen, nutrients, and hormones to the tissues that are necessary for cell metabolism. It also synthesises and modifies the vasoactive components that regulate vascular tone and myocardial function. These vasoactive components have demonstrated their beneficial effects in the management of paediatric patients in a critical condition with heart failure and shock. However, their use and abuse brings harmful effects, increases mortality, and is associated with arrhythmias. An increase in myocardial oxygen consumption favours the presence of ischaemia, therefore it is necessary to know the mechanism of action and indications of these drugs to minimise their harmful effects. The purpose of this review is to describe the pharmacology and clinical applications of inotropic and vasopressor agents in the paediatric patient in acritical condition.

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“… At the same time, lack of a stratified presentation so as to what amounts to a low, moderate or a high inotropic dose, adds to the contextual ambiguity. Alternatively, the authors could have incorporated any of the described versions of inotropic scoring systems to assist the stratification of hemodynamic support [5] . In addition, chest X-Ray or CT Scan based component ‘D’, signifying damage to the lungs (graded as none-minimal, moderate or severe) is also far from objective.…”

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confidence: 99%

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confidence: 99%