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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Epidemiology of Pediatric Severe Sepsis in Main PICU Centers in Southwest China*
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Epidemiology of Pediatric Severe Sepsis in Main PICU Centers in Southwest China*

机译：中国西南部主要PICU中心儿科严重脓毒症流行病学*

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Objectives: To estimate the prevalence, management, and outcomes of pediatric severe sepsis in the main PICUs in Southwest China. Design: A prospective, observational, and multicenter study. Setting: Eight PICUs in Southwest China with 19 (13-24) beds and 1,322 (1,066-1,452) annual admissions each. Patients: A total of 10,598 patients (29 d to 18 yr old) were consecutively admitted between September 1, 2016, and August 31, 2017. All patients were screened and evaluated for severe sepsis or septic shock. Of them, 10,353 patients were excluded due to incomplete data or not meeting the consensus criteria for severe sepsis or septic shock; 245 patients were included with complete data. Interventions: None. Measurements and Main Results: Finally, 245 patients who were diagnosed with severe sepsis or septic shock were included in the study, with an incidence rate of 2.3%. Of them, 64.0% of the enrolled patients were male with 80.8% being less than 5 years old and 60.8% being from rural areas. The respiratory system was the most common organ system in which dysfunction was observed (76.7%) as well as the most frequently infected site (37.6%). The primary therapies were antibiotics (99.0%), immunoglobulin (88.3%), mechanical ventilation (78.4%), vasoactive infusions (59.6%), and corticosteroids (46.1%). Among the 188 patients who had respiratory dysfunction, 173(92%) required mechanical ventilation and 39 (20.7%) met the criteria for pediatric acute respiratory distress syndrome. Seven of the patients with pediatric acute respiratory distress syndrome died (7/39, 17.9%). The median durations for mechanical ventilation and vasoactive medications were 123.5 hours (35.25-226.00 hr) and 2 days (1-5 d), respectively. Eighty-six percent of patients had multiple organ dysfunction syndrome at the point at which severe sepsis was recognized, and 31% had underlying conditions. The hospital mortality rate was 18.8%. Conclusions: This report is the first to present the prevalence, treatment, and outcomes of pediatric severe sepsis in the main PICU centers in Southwest China. The mortality rate remains high; therefore, improved clinical management and implementation of large-scale clinical trials are necessary to improve early diagnoses and treatment.
机译：目标：估算中国西南部主要皮带中儿科严重脓毒症的患病率，管理和结果。设计：预期，观察和多中心的研究。设置：中国西南8家皮瓣，19（13-24）张（13-24张）床和1,322（1,066-1,452）每年入学。患者：2016年9月1日至2017年8月31日，共有10,598名患者（29 d至18岁）。所有患者均针对严重的败血症或脓毒症休克进行筛查和评估。其中，10,353名患者由于数据不完整或不符合严重脓毒症或脓毒症休克的共识标准而被排除在外。 245名患者包含完整数据。干预措施：没有。测量和主要结果：最后，在研究中纳入了245名被诊断患有严重脓毒症或脓毒症休克的患者，发病率为2.3％。其中，64.0％的注册患者均为80.8％的男性，少于5岁，来自农村的60.8％。呼吸系统是最常见的器官系统，其中观察到功能障碍（76.7％）以及最常见的感染部位（37.6％）。主要疗法是抗生素（99.0％），免疫球蛋白（88.3％），机械通气（78.4％），血管活性输注（59.6％）和皮质类固醇（46.1％）。在具有呼吸功能障碍的188名患者中，173名（92％）所需的机械通气和39（20.7％）达到小儿急性呼吸窘迫综合征的标准。七位患有儿科急性呼吸窘迫综合征的患者死亡（7/39,17.9％）。机械通气和血管活性药物的中值持续时间分别为123.5小时（35.25-226.00小时）和2天（1-5 d）。百分之八十六名患者在严重脓毒症认识到的重点时有多个器官功能障碍综合征，31％的潜在条件。医院死亡率为18.8％。结论：本报告是第一个在中国西南部主要PICU中心提供儿科严重脓毒症的患病率，治疗和结果。死亡率仍然很高;因此，有必要改善临床管理和大规模临床试验的实施，以改善早期诊断和治疗。

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