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Observational Study
. 2025 Oct;62(10):732-737.
doi: 10.1007/s13312-025-00130-5. Epub 2025 Jul 31.

Vasoactive-Inotropic Score (VIS) and Outcome of Children with Pediatric Septic Shock

K V Vikas  1 , Arnab Biswas  2 , Moumita Samanta  3
Affiliations
Observational Study

Vasoactive-Inotropic Score (VIS) and Outcome of Children with Pediatric Septic Shock

K V Vikas et al. Indian Pediatr. 2025 Oct.

Abstract

Objective: To assess the effectiveness of the vasoactive-inotropic score (VIS) in predicting outcomes for pediatric sepsis.

Methods: A one-year prospective observational study in a tertiary level pediatric intensive care unit (PICU), enrolled children (1 month to 12 years) with fluid-refractory septic shock. VIS and aggregate VIS (AVIS) was calculated at 6, 12, 24, 48, 72, and 96 h post-hospitalization. The primary outcome assessed was mortality and secondary outcomes included duration of PICU stay, ventilation and inotrope support.

Results: Ninety (64.4% male) patients with median (Q1, Q3) age of 24 [6, 60] months were enrolled. The median (Q1, Q3) duration of PICU stay (days) among survivors (n = 32) was significantly shorter 9 (7, 12) compared to non-survivors (n = 58) was 13 (9, 16) (P < 0.001). Significant correlations were found between AVIS at 96 h (AVIS96) and lactate levels (r = 0.79, P < 0.001), duration of inotrope support (r = 0.73, P < 0.001), and duration of ventilation (r = 0.69, P < 0.001). An AVIS96 cutoff of ≥ 25.4 showed high accuracy for mortality prediction (AUC 0.976, sensitivity 95%, specificity 90%), outperforming pSOFA and lactate levels.

Conclusion: VIS is a reliable predictor of outcomes in pediatric septic shock, with potential for early risk stratification. An AVIS96 cut-off value of 25.4 showed maximum diagnostic accuracy in terms of mortality prediction in this cohort.

Keywords: Aggregate vasoactive-inotropic score; Mortality; Outcome; PICU; Pediatric intensive care unit; Septicemia.

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Conflict of interest statement

Declarations. Conflict of interest: None. Ethics Approval: Institutional Ethics Committee, NRSMCH, Kolkata; Ref: NRSMC/IEC/164/2022 dated Nov 19, 2022.

References

    1. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, et al. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6:223–30. - DOI - PubMed
    1. Lodha R, Oleti TP, Kabra SK. Management of septic shock. Indian J Pediatr. 2011;78:726–33. - DOI - PubMed
    1. Schlapbach LJ, MacLaren G, Festa M, et al. Prediction of pediatric sepsis mortality within 1 h of intensive care admission. Intensive Care Med. 2017;43:1085–96. - DOI - PubMed
    1. Davidson J, Tong S, Hancock H, et al. Prospective validation of the vasoactive inotropic score and correlation to short-term outcomes in neonates and infants after cardiothoracic surgery. Intensive Care Med. 2012;38:1184–90. - DOI - PubMed - PMC
    1. Kumar M, Sharma R, Sethi SK, et al. Vasoactive Inotrope Score as a tool for clinical care in children post cardiac surgery. Indian J Crit Care Med. 2014;18:653–8. - DOI - PubMed - PMC

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