GIÁ TRỊ TIÊN LƯỢNG TỬ VONG CỦA CHỈ SỐ VIS Ở BỆNH NHI SỐC NHIỄM KHUẨN TẠI KHOA HỒI SỨC TÍCH CỰC-CHỐNG ĐỘC BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

Backgroud: Septic shock is a common clinical syndrome in pediatric intensive care units. . In pediatric sepsis, the VIS is independently associated with clinical outcomes such as mortality, duration of mechanical ventilation, and ICU length of stay and can be used as an early predictor. Objectives: To describe clinical characteristics, evaluate treatment effectiveness and determine the association between vasoactive-inotropic score and outcome of pediatric patients with septic shock at the Intensive Care Unit of Can Tho Children's Hospital. Materials and methods: Retrospective study on 44 children diagnosed with septic shock and using vasoactive drugs during the period from January 2021 to January 2022 at the Intensive Care Unit of Can Tho Children's Hospital. Results: Clinical features: The percentage of children with fever, tachypnea, hypotension, diarrhea, lethargy were 58.5%, 90.3%, 83.9%, 43.6%, and 61.5% respectively. The majority of infections originate in the gastrointestinal tract (70%). Treatment results: 100% of septic shock cases use vasoactive drugs. Epinephrine was used the most (78%). Mortality rate is 68.3%, high in children aged 60-143 months, boys. Mortality outcome value of the VIS: VIS score at 12h and 24h has the best ability to separate with ROC of 0.712 (95% CI: 0.549-0.842) and 0.695 (95% CI: 0.532-0.829, respectively). Conclusion: Children with septic shock often have fever, tachypnea, hypotension, diarrhea, lethargy, mostly from the gastrointestinal tract. VIS at 12h and 24h has the best separation ability. VIS at 24h and 48h was negatively correlated with long-term ICU stay with statistical significance (p < 0.05).