Vasoactive-inotropic score and pediatric septic shock mortality: Correspondence.

Dear Editor,

We would like to share ideas on “Validation of the vasoactive-inotropic score in predicting pediatric septic shock mortality: A retrospective cohort study.”[1] Pudjiadi et al. concluded that “vasoactive-inotropic score VIS >11 has a good ability to predict mortality in children with septic shock.”[1] We agree that vasoactive-inotropic score might be a good predictive clinical parameter. However, there are some concerns. First, mortality depends on several factors including the treatment given to the patient. Second, an inclusion criteria for subjects “1 month to 18 years” means heterogenicity of participants. Pathophysiology in small children is different from late adolescence. Finally, the reliability of the vasoactive-inotropic score is still an issue for assessment.[2] Pitfalls are reported and the important limitation of the score is no universally recognized version that consists of all commonly used vasoactive drugs.[3]

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