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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 >Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure*
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Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure*

机译：用于急性呼吸衰竭机械通风的儿童的多器官功能障碍*

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Measurements and Main Results: Organ dysfunction was defined using criteria published for pediatric sepsis. Multiple organ dysfunction syndrome was defined as respiratory dysfunction one or more extrapulmonary organ dysfunctions. We used multivariable logistic regression to identify risk factors for multiple organ dysfunction syndrome, and logistic or proportional hazards regression to compare clinical outcomes. All analyses accounted for PICU as a cluster variable. Overall, 73% exhibited extrapulmonary organ dysfunction, including 1,547 (63%) with concurrent multiple organ dysfunction syndrome defined by onset on day 0/1 and 244 (10%) with new multiple organ dysfunction syndrome with onset on day 2 or later. Most patients (93%) with indirect lung injury from sepsis presented with concurrent multiple organ dysfunction syndrome, whereas patients with direct lung injury had both concurrent (56%) and new (12%) multiple organ dysfunction syndrome. Risk factors for concurrent multiple organ dysfunction syndrome included older age, illness severity, sepsis, cancer, and moderate/severe lung injury. Risk factors for new multiple organ dysfunction syndrome were moderate/severe lung injury and neuromuscular blockade. Both concurrent and new multiple organ dysfunction syndrome were associated with 90-day in-hospital mortality (concurrent: adjusted odds ratio, 6.54; 95% CI, 3.00-14.25 and new: adjusted odds ratio, 3.21; 95% CI, 1.48-6.93) after adjusting for sepsis, moderate/severe lung injury, and other baseline characteristics.
机译：测量和主要结果：器官功能障碍是根据儿科败血症的标准定义的。多器官功能障碍综合征被定义为呼吸功能障碍一个或多个肺外器官功能障碍。我们使用多变量logistic回归来确定多器官功能障碍综合征的风险因素，并使用logistic或比例风险回归来比较临床结果。所有分析均将PICU作为聚类变量。总的来说，73%的患者表现出肺外器官功能障碍，包括1547例（63%）并发多器官功能障碍综合征（定义为第0/1天发病），244例（10%）新发多器官功能障碍综合征（定义为第2天或之后发病）。大多数脓毒症间接肺损伤患者（93%）同时出现多器官功能障碍综合征，而直接肺损伤患者同时出现多器官功能障碍综合征（56%）和新出现的多器官功能障碍综合征（12%）。并发多器官功能障碍综合征的危险因素包括高龄、疾病严重程度、败血症、癌症和中/重度肺损伤。新的多器官功能障碍综合征的危险因素是中/重度肺损伤和神经肌肉阻滞。在调整败血症、中重度肺损伤和其他基线特征后，并发和新发多器官功能障碍综合征均与90天住院死亡率相关（并发：调整后的优势比，6.54；95%可信区间，3.00-14.25和新发：调整后的优势比，3.21；95%可信区间，1.48-6.93）。

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