TABLE 3.
Demographic, Clinical Characteristics, and Outcomes of Children Requiring Vasopressors While Receiving Continuous Renal Replacement Therapy Based on Timing of Vasopressin Administration
| Variable | Early Vasopressin (n = 168) | Intermediate Vasopressin (n = 49) | Late Vasopressin (n = 31) | p |
|---|---|---|---|---|
| Demographics | ||||
| Age, yr | 9.9 (2.5–15.7) | 6.6 (1.1–14.2) | 10.9 (2.0–17.3) | 0.31 |
| Sex, female (%) | 76 (45) | 25 (51) | 15 (48) | 0.76 |
| Admission weight, kg | 31 (13–60) | 20 (10–47) | 38 (13–54) | 0.14 |
| Admission diagnosis, n (%) | 0.043 | |||
| Shock/infection/major trauma | 87 (52) | 18 (37) | 8 (26) | |
| Respiratory failure | 30 (18) | 14 (29) | 10 (32) | |
| Post-surgical/minor trauma | 9 (5) | 3 (6) | 1 (3) | |
| Primary cardiac | 24 (14) | 5 (10) | 6 (20) | |
| Other | 18 (11) | 9 (18) | 6 (19) | |
| Comorbidities, n (%) | 0.15 | |||
| 0 | 33 (20) | 7 (14) | 4 (13) | |
| 1 | 88 (52) | 25 (51) | 10 (32) | |
| 2 | 27 (16) | 9 (18) | 11 (35) | |
| > 2 | 20 (12) | 8 (16) | 6 (19) | |
| Pediatric Risk of Mortality III | 16 (12–21) | 15 (8–18) | 13 (11–17) | 0.06 |
| Sepsis, n (%) | 102 (61) | 28 (57) | 16 (52) | 0.62 |
| CRRT initiation data | ||||
| Time from ICU admission to CRRT, d | 2 (1–7) | 4 (1–13) | 5 (2–11) | 0.02 |
| Pediatric Logistic Organ Dysfunction-2 | 8.0 (5.0–10.0) | 7.0 (4.0–10.0) | 5.0 (3–9.5) | 0.20 |
| Receipt of vasopressors, n (%) | 160 (95) | 37 (76) | 26 (84) | < 0.001 |
| Pre-CRRT Vasoactive-Inotropic Score | 30 (15–46) | 10 (2–25) | 6 (3–17) | < 0.001 |
| Mechanical ventilation, n (%) | 162 (96) | 47 (98) | 31 (100) | 0.85 |
| %Fluid balance from ICU admission | 11 (50–28) | 11 (4–18) | 13 (5–26) | 0.71 |
| Urine output 24 hr prior, mL/kg/hr | 0.38 (0.10–0.98) | 0.41 (0.16–0.99) | 0.87 (0.41–1.4) | 0.034 |
| Time to first negative fluid balance, d | 1 (0–2) | 1 (0–2) | 1 (0–1) | 0.22 |
| Outcomes | ||||
| 28-d CRRT liberation status, n (%) | 0.022 | |||
| Liberated | 40 (24) | 8 (16) | 5 (16) | |
| Liberation not attempted | 80 (48) | 36 (73) | 18 (58) | |
| Reinstituted | 48 (29) | 5 (10) | 8 (26) | |
| CRRT duration, d | 6 (2–15) | 7 (4–18) | 9 (5–16) | 0.045 |
| %Days 1–7 of CRRT requiring vasopressors | 100 (63–100) | 100 (75–100) | 83 (56–88) | 0.02 |
| 28-d ventilator-free days | 0 (0–21) | 0 (0–0) | 0 (0–12) | 0.017 |
| 28-d ICU-free days | 0 (0,0) | 0 (0,0) | 0 (0,0) | 0.025 |
| In-hospital mortality, n (%) | 92 (55) | 34 (69) | 19 (61) | 0.18 |
| Major Adverse Kidney Events at 90 d, n (%) | 126 (75) | 45 (92) | 26 (84) | 0.030 |
| 90-d mortality | 88 (52) | 35 (71) | 19 (61) | 0.053 |
| Persistent kidney dysfunction | 30 (18) | 4 (8) | 5 (16) | 0.26 |
| Renal replacement therapy dependence | 8 (5) | 6 (12) | 2 (6) | 0.17 |
CRRT = continuous renal replacement therapy.
Early vasopressin group initiated vasopressin on day 0 of CRRT, intermediated vasopressin group initiated vasopressin on days 1–2 of CRRT, and late vasopressin group initiated vasopressin on days 3–7 of CRRT. Continuous variables are reported as median (interquartile range). p values were obtained using Pearson χ2 test, Wilcoxon rank-sum test, or Fisher exact test, as appropriate.