| Title |
Refractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition
|
|---|---|
| Published in |
Intensive Care Medicine, October 2016
|
| DOI | 10.1007/s00134-016-4574-2 |
| Pubmed ID | |
| Authors |
Luc Morin, Samiran Ray, Clare Wilson, Solenn Remy, Mohamed Rida Benissa, Nicolaas J. G. Jansen, Etienne Javouhey, Mark J. Peters, Martin Kneyber, Daniele De Luca, Simon Nadel, Luregn Jan Schlapbach, Graeme Maclaren, Pierre Tissieres, ESPNIC Refractory Septic Shock Definition Taskforce the Infection Systemic Inflammation Sepsis section of ESPNIC |
| Abstract |
Although overall paediatric septic shock mortality is decreasing, refractory septic shock (RSS) is still associated with high mortality. A definition for RSS is urgently needed to facilitate earlier identification and treatment. We aim to establish a European society of paediatric and neonatal intensive care (ESPNIC) experts' definition of paediatric RSS. We conducted a two-round Delphi study followed by an observational multicentre retrospective study. One hundred and fourteen paediatric intensivists answered a clinical case-based, two-round Delphi survey, identifying clinical items consistent with RSS. Multivariate analysis of these items in a development single-centre cohort (70 patients, 30 % mortality) facilitated development of RSS definitions based on either a bedside or computed severity score. Both scores were subsequently tested in a validation cohort (six centres, 424 patients, 11.6 % mortality). From the Delphi process, the draft definition included evidence of myocardial dysfunction and high blood lactate levels despite high vasopressor treatment. When assessed in the development population, each item was independently associated with the need for extracorporeal life support (ECLS) or death. Resultant bedside and computed septic shock scores had high discriminative power against the need for ECLS or death, with areas under the receiver operating characteristics curve of 0.920 (95 % CI 0.89-0.94), and 0.956 (95 % CI 0.93-0.97), respectively. RSS defined by a bedside score equal to or higher than 2 and a computed score equal to or higher than 3.5 was associated with a significant increase in mortality. This ESPNIC definition of RSS accurately identifies children with the most severe form of septic shock. |
X Demographics
The data shown below were collected from the profiles of 12 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 5 | 42% |
| France | 1 | 8% |
| Ecuador | 1 | 8% |
| Netherlands | 1 | 8% |
| Italy | 1 | 8% |
| Belgium | 1 | 8% |
| Unknown | 2 | 17% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 8 | 67% |
| Scientists | 3 | 25% |
| Practitioners (doctors, other healthcare professionals) | 1 | 8% |
Mendeley readers
The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 199 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 25 | 13% |
| Researcher | 17 | 9% |
| Student > Postgraduate | 17 | 9% |
| Student > Master | 17 | 9% |
| Student > Ph. D. Student | 14 | 7% |
| Other | 34 | 17% |
| Unknown | 75 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 86 | 43% |
| Nursing and Health Professions | 8 | 4% |
| Agricultural and Biological Sciences | 7 | 4% |
| Biochemistry, Genetics and Molecular Biology | 4 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 2% |
| Other | 9 | 5% |
| Unknown | 82 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 February 2020.
All research outputs
#4,706,576
of 24,903,209 outputs
Outputs from Intensive Care Medicine
#2,416
of 5,328 outputs
Outputs of similar age
#72,617
of 326,078 outputs
Outputs of similar age from Intensive Care Medicine
#59
of 117 outputs
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