Журнал «Медицина неотложных состояний» Том 16, №3, 2020
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Сlinical predication of arterial hypotension in premature infants with early onset sepsis
Авторы: Сherniavska Yu.I.(1), Pokhylko V.I.(1), Sarychev V.P.(2), Lytovchenko D.M.(2), Hasiuk N.I.(1)
(1) — Ukrainian Medical Stomatological Academy, Poltava, Ukraine
(2) — Municipal Enterprise “Poltava Municipal Children Clinical Hospital of Poltava City Council”, Poltava, Ukraine
Рубрики: Медицина неотложных состояний
Разделы: Медицинские форумы
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Background. Diagnosis and treatment of arterial hypotension (AH) in premature infants is complicated problem, with which the doctors are faced in their daily practice. The purpose of our study was substantiate the diagnostic criteria for determining the syndrome of AH and indications for the appointment of hemodynamic support in premature infants with early onset sepsis.
Materials and methods. A prospective cohort study was conducted. 2 experimental groups were formed – the main group (n = 58), premature babies with early onset sepsis and AH, and control group (n = 62); premature babies with early onset sepsis without AH. Simple and multiple logistic regression analysis (STATA 11.0 application package) were used to determine the relationships between individual indicators and construct predictive clinical models.
Results. Reliable risk factors associated with AH and the main clinical manifestations, were identified and studied, among them: blood glucose less than 2.8 mmol/l (OR 4.63, p = 0.013), stroke index of left ventricle (SILV) (OR 0.3, p = 0.005), venous blood pH (OR 0.002, p = 0.05). Clinical prognostic model for the development of AH-syndrome, which included the left ventricular stroke index, blood pH and blood glucose, had high prognostic characteristics and the largest area under the ROC curve — 0,9878.
Conclusions. The results of our research have become the basis for the definition of “syndrome of arterial hypotension”, which includes the level of mean blood pressure in a child in mmHg less than the gestational age in weeks and the presence of one of the following criteria — SILV less than the age standard, venous blood pH less than 7.2, blood glucose less than 2.8 mmol/l. The presence of this syndrome in a child can serve as an indication for the appointment of medical support for hemodynamics.
Список литературы
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