الفهرس 
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Abstract
Septic shock is an important cause of death worldwide. Vasoactive inotropic score (VIS) is a quantitative index of pressor support and takes into consideration the use of milrinone, norepinephrine, and vasopressin in addition to dopamine, dobutamine, and epinephrine.
The aim of this work was to assess the use of vasoactive inotropic score in the first 48 hours as a predictor of mortality in pediatric septic shock in patients admitted to pediatric intensive care unit.
This prospective observational study included 35 pediatric septic shock patients. All patients were subjected to full history taking, thorough clinical examination and laboratory investigations. Pediatric index of mortality 2 (PIM2) was calculated upon admission. Echocardiography was performed for all patients. Calculation of maximum Vasoactive inotropic score (VIS) in the first 24 hour (day 1) and subsequent 24 hour (day 2) was performed using the formula described by Gaies et al, Maximum VIS in the first 24 hours and subsequent 24 hours was calculated.
Results showed that Maximum VIS in day 1 was a significant discriminator of mortality with area under the ROC curve (AUC) = 0.916 (95% CI 0.772-0.983). A cutoff point of >45 had a sensitivity of 92.31%, and a specificity of 77.27%. Maximum VIS in day 2 was a significant discriminator of mortality with AUC = 0.970 (95% CI 0.849-0.999). A cutoff point of >55 had a sensitivity of 84.62% and a specificity of 95.45%.
We concluded that maximum VIS in the first 48 hours of admission is an easy inexpensive tool that can predict mortality in pediatric septic shock