TABLE 4.
Demographic, Clinical Characteristics, and Outcomes of Children Requiring Vasopressors While Receiving Continuous Renal Replacement Therapy Based on Median Dose of Vasopressin Received
| Variable | Low-Dose Vasopressin (Median Dose ≤ 0.5 mU/kg/min) (n = 99) | High-Dose Vasopressin (> 0.5 mU/kg/min) (n = 146) | p |
|---|---|---|---|
| Demographics | |||
| Age, yr | 11.1 (4.0–15.9) | 6.8 (1.4–14.9) | 0.042 |
| Sex, female (%) | 46 (46) | 68 (47) | 0.99 |
| Admission weight, kg | 35 (16–54) | 22 (11–53) | 0.033 |
| Admission diagnosis, n (%) | 0.39 | ||
| Shock/infection/major trauma | 44 (44) | 67 (46) | |
| Respiratory failure | 21 (21) | 32 (22) | |
| Post-surgical/minor trauma | 3 (3) | 10 (7) | |
| Primary cardiac | 15 (15) | 20 (14) | |
| Other | 16 (16) | 17 (12) | |
| Comorbidities, n (%) | 0.042 | ||
| 0 | 22 (22) | 21 (14) | |
| 1 | 38 (38) | 83 (57) | |
| 2 | 23 (23) | 24 (16) | |
| > 2 | 16 (16) | 18 (12) | |
| Pediatric Risk of Mortality III | 16 (11–20) | 16 (11–20) | 0.40 |
| Sepsis, n (%) | 57 (58) | 87 (60) | 0.75 |
| CRRT initiation data | |||
| Time from ICU admission to CRRT, d | 2 (1–8) | 3 (1–9) | 0.12 |
| Pediatric Logistic Organ Dysfunction-2 | 7 (5–10) | 7 (4–10) | 0.50 |
| Receipt of vasopressors, n (%) | 91 (92) | 129 (88) | 0.37 |
| Pre-CRRT Vasoactive-Inotropic Score | 20 (10–33) | 25 (10–42) | 0.21 |
| Mechanical ventilation, n (%) | 94 (95) | 143 (99) | 0.12 |
| Urine output 24 hr prior, mL/kg/hr | 0.51 (0.16–1.06) | 0.40 (0.11–1.07) | 0.65 |
| Time to first negative fluid balance, d | 1 (0–2) | 1 (0–1) | 0.25 |
| Outcomes | |||
| 28-d CRRT liberation status, n (%) | 0.002 | ||
| Liberated | 23 (23) | 28 (19) | |
| Liberation not attempted | 41 (41) | 92 (63) | |
| Reinstituted | 35 (35) | 26 (18) | |
| CRRT duration, d | 10 (4–17) | 7 (2–13) | 0.09 |
| %Days 1–7 of CRRT requiring vasopressors | 88 (61–100) | 100 (75–100) | 0.019 |
| 28-d ventilator-free days | 0 (0–27) | 0 (0–7) | 0.002 |
| 28-d ICU-free days | 0 (0–1) | 0 (0–0) | 0.09 |
| In-hospital mortality, n (%) | 46 (46) | 98 (67) | 0.001 |
| Major Adverse Kidney Events at 90 d, n (%) | 74 (75) | 122 (84) | 0.091 |
| 90-d mortality | 43 (43) | 98 (67) | < 0.001 |
| Persistent kidney dysfunction | 20 (20) | 19 (13) | 0.13 |
| Renal replacement therapy dependence | 11 (11) | 5 (3) | 0.02 |
CRRT = continuous renal replacement therapy.
Three of 248 patients who received vasopressin excluded from this analysis due to missing dose data (n = 245). 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.