The warning function of PEWS on septic shock of children with acute lymphoblastic leukemia after chemotherapy / 中华护理杂志

ABSTRACT

Objective To explore the application and effects of pediatric early warning score (PEWS) on the early warning and identification of septic shock in acute lymphoblastic leukemia children with neutropenia and coinfection at bone marrow suppression period after chemotherapy. Methods A retrospective study of 57 acute lymphoblastic leukemia children with neutropenia and coinfection in a tertiary hospital in Changsha from January 2015 to May 2016 was conducted. PEWS was performed based on vital sign monitoring of children. ROC curve was established to evaluate the PEWS warning value when the sick children had septic shock. The obtained PEWS system was applied in the early warning of acute lymphoblastic leukemia children with neutropenia and coinfection from October 2016 to March 2017,and relative intervention measures including setting corresponding monitor level, oxygen uptake and fluid resuscitation were provided according to various PEWS warning value. The incidence of shock,death rate and the time of recovery between two groups before and after intervention were compared. Results The optimal cut off point of PEWS when children with neutropenia and coinfection had septic shock was 3.5. After intervention,the incidence of shock,death rate and the time of recovery were lower than those before intervention (P<0.05). Conclusion PEWS can provide effective early warnings for acute lymphoblastic leukemia children with neutropenia and coinfection. It is beneficial for disease recovery and subsequent chemotherapy of the patients.