Predictors of mortality and multiple organ failure in children with sepsis

摘要: Objectives: To assess the markers of perfusion which best discriminate survivors from non-survivors childhood sepsis and to compare information derived gastric tonometry with conventionally measured haemodynamic laboratory parameters. Design: Prospective clinical study children syndrome or septic shock. Setting: Paediatric intensive care unit in a tertiary referral centre. Patients: 31 Interventions: A tonometer was passed into stomach via orogastric route. Measurements main results: The following data were recorded at admission, 12, 24 48 h: heart rate, mean arterial pressure, pH, base deficit, lactate, intramucosal pH (pHi) DCO2 (intramucosal carbon dioxide tension minus partial pressure dioxide). principal outcome measure survival. secondary number organ systems failing h after admission. There 10 deaths 21 survivors. No variable discriminated survival death presentation. Blood lactate level earliest discriminator Using univariate logistic regression, those who died 12 but not (p = 0.049, 0.044 0.062, respectively). area under receiver operating characteristic (ROC) curve for 0.81, 0.88 0.89 h, respectively. At blood > 3 mmol/l had positive predictive value 56 % less 84 %. 71 86 other identified h. Gastric could only be done on 19 children, whom 8 11 survived. In these distinguished survived 0.045 p 0.20, ROC as predictor 0.71. Neither absolute pHi nor trend change any time first this series. (area 0.80 0.78, deficit rate did identify Conclusions: sepsis. group patients, added little that more simply by means.