摘要
Abstract
Objective To investigate the clinical application of fresh frozen plasma(FFP)in pediatric patients with sepsis and its association with prognosis.Methods A retrospective analysis was conducted on 262 pediatric patients with sepsis admitted to the PICU of Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science & Technology between January 2023 and December 2024.Patients were categorized into an FFP transfusion group and a non-transfusion group based on whether they received FFP during hospitalization.Differences in characteristics,laboratory findings,clinical interventions,and prognostic outcomes between the two groups were compared.Results Significant differences were observed between the transfusion group(n=87)and the non-transfusion group(n=175)in laboratory parameters,including white blood cell count(P=0.007),platelet count(P=0.000),coagulation function(P=0.000),clinical interventions(P=0.000),and prognosis(P=0.000).Multivariate binary logistic regression analysis revealed that FFP transfusion(HR 6.079,95％CI 1.336-27.661,P=0.020),mechanical ventilation(HR 16.107,95％CI 4.637-55.949,P=0.000),and PRISM Ⅲ score≥15(HR 7.865,95％CI 1.539-40.208,P=0.013)were independent predictors of in-hospital mortality in pediatric patients with sepsis.Additionally,FFP transfusion(HR 3.242,95％CI 1.277-8.227,P=0.013),lactate dehydrogenase levels(HR 1.001,95％CI 1.000-1.002,P=0.018),and PRISM Ⅲ score≥15(HR 5.308,95％CI 1.420-19.840,P=0.013)were identified as independent predictors of multiple organ dysfunction syndrome(MODS).Except for children over 10 years old,the transfusion group exhibited significantly higher mortality and MODS rates across all age groups(all P＜0.05).Notably,children receiving FFP doses＞60 mL/kg,frequency＞3 times,or FFP infusion within 24 hours demonstrated the highest mortality and MODS rates.Conclusion FFP transfusion is significantly associated with increased in-hospital mortality and MODS occurrence in pediatric patients with sepsis,suggesting that clinicians should evaluate the necessity of FFP administration to reduce its irrational use.关键词
新鲜冰冻血浆/脓毒血症/儿科/住院死亡率/多器官功能障碍综合征Key words
Fresh frozen plasma/Sepsis/Pediatrics/In-hospital mortality/Multiple organ dysfunction syndrome分类
医药卫生
