Unnecessary harm is avoided by reliable paediatric index of mortality2 scores without arterial gas sampling
| Autor: | Lars Lindberg, Håkan Kalzén, Peter J. Radell, Ola Ingemanson, Tova Hannegård Hamrin, Staffan Eksborg |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent PIM2 Pain Procedural Intensive Care Units Pediatric 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Fraction of inspired oxygen medicine Humans Sampling (medicine) 030212 general & internal medicine Child business.industry Mortality rate Paediatric intensive care Infant Newborn Infant Reproducibility of Results General Medicine respiratory tract diseases Harm Standardized mortality ratio Child Preschool Acute Disease Child Mortality Pediatrics Perinatology and Child Health Emergency medicine Arterial blood Female Blood Gas Analysis business circulatory and respiratory physiology |
| Zdroj: | Acta Paediatrica. 108:670-675 |
| ISSN: | 0803-5253 |
| Popis: | Aim: To investigate whether unnecessary harm could be avoided in children admitted to paediatric intensive care (PICU), we analysed the impact of arterial blood gas on the paediatric index of mortality score2 (PIM2) and the derived predicted death rate (PDR). Methods: From January 1, 2008 to December 31, 2010, 1793 consecutive admissions, newborn infants to 16 years of age (median 0.71 years) from a single, tertiary PICU in Gothenburg Sweden, were collected. Admission information on arterial oxygen tension (PaO2) and fraction of inspired oxygen (FiO2) was extracted from 990 admissions. Results: There was close agreement between PIM2 score and PDR regardless of whether the PaO2/FiO2 ratio was omitted or not. In the subgroup of admissions with a respiratory admission diagnosis, the inclusion of the PaO2/FiO2 ratio increased the accuracy of the PIM2 score as well as the PDR. The standard mortality ratio was slightly but not significantly overestimated by excluding the PaO2/FiO2 ratio. Conclusion: To avoid unnecessary harm to children admitted to PICU, an arterial blood gas analysis should only be performed if clinically indicated or if the child has a respiratory admission diagnosis. Estimation of the PIM2 score and PDR will not be less accurate by this approach. |
| Databáze: | OpenAIRE |
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