Risk factors of septic shock with acute kidney injury in 89 children / 中国小儿急救医学

ABSTRACT

Objective We analyzed the clinical data of 89 septic shock in children retrospectively to provide evidence of early diagnosis,treatments and improving prognosis for children who had septic shock and acute kidney injury(AKI). Methods Eighty-nine children were selected from June 2013 to December 2018 in the PICU of Children′s Hospital Affiliated to the Capital Institute of Pediatrics. According to whether accompanied by AKI or not,they were divided into two groups56 cases of patients with septic shock accom-panied by AKI in the research group,and 33 cases of patients without AKI in the control group. Then we used SPSS25. 0 software to analyze the clinical data with univariate and multivariate analysis. Results The mor-tality of research group and control group were 46. 4%(26/56) and 39. 4% (13/33),respectively. There were obvious differences between two groups in pediatric critical illness score(PCIS),the number of organ failure,nervous failure,hepatic failure,circulatory failure,lactic acid,γ-glutamyltransferase,creatinine,urea, total bilirubin,direct bilirubin(P<0. 05). Logistic regression showed that hepatic failure( OR 0. 099,95%CI 0. 018~0. 549),PCIS<80(OR 0. 223,95%CI 0. 064~0. 774),lactic acid>4. 1 mmol/L( OR 0. 221,95%CI 0. 055~0. 885) were independent risk factors for septic shock with AKI. Conclusion The mortality of septic shock with AKI is high. Hepatic failure,PCIS<80,lactic acid>4. 1 mmol/L are independent risk fac-tors. Septic shock is a systemic inflammation which can influence all organs. In order to reduce the incidence of AKI,it′s necessary to pay early attention to the changes of microcirculation such as lactic acid.