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The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock

OBJECTIVE: Follow-up of cardiac index and systemic vascular resistance index by bedside echocardiography until resuscitation. METHODS: A set of hemodynamic parameters was obtained, including cardiac output, stroke volume, cardiac index, systemic vascular resistance index, velocity time integral, myo...

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Autores principales: Abdalaziz, Faten A., Algebaly, Hebat Allah Fadel, Ismail, Reem Ibrahim, El-Sherbini, Seham Awad, Behairy, Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Medicina Intensiva Brasileira - AMIB 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334480/
https://www.ncbi.nlm.nih.gov/pubmed/30672970
http://dx.doi.org/10.5935/0103-507X.20180067
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author Abdalaziz, Faten A.
Algebaly, Hebat Allah Fadel
Ismail, Reem Ibrahim
El-Sherbini, Seham Awad
Behairy, Ahmed
author_facet Abdalaziz, Faten A.
Algebaly, Hebat Allah Fadel
Ismail, Reem Ibrahim
El-Sherbini, Seham Awad
Behairy, Ahmed
author_sort Abdalaziz, Faten A.
collection PubMed
description OBJECTIVE: Follow-up of cardiac index and systemic vascular resistance index by bedside echocardiography until resuscitation. METHODS: A set of hemodynamic parameters was obtained, including cardiac output, stroke volume, cardiac index, systemic vascular resistance index, velocity time integral, myocardial performance index, capillary refill time, and heart rate at 0 hours after fluid boluses before the start of inotropes, and followed up after 6 hours and 24 hours. RESULTS: Included were 45 patients with community-acquired septic shock. Septic foci were gastroenteritis (24%), intestinal perforation requiring emergency surgery (24%), pneumonia (20%), central nervous system infection (22%) and soft tissue infection (8%). Klebsiella and Enterobacter were the most frequent isolates. We estimated the factors affecting the cardiac index: high central venous pressure at zero time (r = 0.33, p = 0.024) and persistently high heart rate at hour 6 (r = 0.33, p = 0.03). The systemic vascular resistance index was high in most patients at 0 and 24 hours and at the time of resuscitation and inversely affected the cardiac index as well as affecting the velocity time integral (r = -0.416, -0.61, 0.55 and -0.295). Prolonged capillary refill time was a clinical predictor of the low velocity time integral at 24 hours (r = -0.4). The mortality was 27%. Lower systemic vascular resistance index and higher cardiac output were observed in nonsurviving patients. CONCLUSION: There was a persistently high systemic vascular resistance index in cold shock patients that influenced the stroke volume index, cardiac index, and velocity time integral. The use of echocardiograms for hemodynamic measurements is important in pediatric septic shock patients to adjust dilators, and vasopressor doses and achieve resuscitation targets in a timely manner.
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spelling pubmed-63344802019-01-24 The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock Abdalaziz, Faten A. Algebaly, Hebat Allah Fadel Ismail, Reem Ibrahim El-Sherbini, Seham Awad Behairy, Ahmed Rev Bras Ter Intensiva Original Article OBJECTIVE: Follow-up of cardiac index and systemic vascular resistance index by bedside echocardiography until resuscitation. METHODS: A set of hemodynamic parameters was obtained, including cardiac output, stroke volume, cardiac index, systemic vascular resistance index, velocity time integral, myocardial performance index, capillary refill time, and heart rate at 0 hours after fluid boluses before the start of inotropes, and followed up after 6 hours and 24 hours. RESULTS: Included were 45 patients with community-acquired septic shock. Septic foci were gastroenteritis (24%), intestinal perforation requiring emergency surgery (24%), pneumonia (20%), central nervous system infection (22%) and soft tissue infection (8%). Klebsiella and Enterobacter were the most frequent isolates. We estimated the factors affecting the cardiac index: high central venous pressure at zero time (r = 0.33, p = 0.024) and persistently high heart rate at hour 6 (r = 0.33, p = 0.03). The systemic vascular resistance index was high in most patients at 0 and 24 hours and at the time of resuscitation and inversely affected the cardiac index as well as affecting the velocity time integral (r = -0.416, -0.61, 0.55 and -0.295). Prolonged capillary refill time was a clinical predictor of the low velocity time integral at 24 hours (r = -0.4). The mortality was 27%. Lower systemic vascular resistance index and higher cardiac output were observed in nonsurviving patients. CONCLUSION: There was a persistently high systemic vascular resistance index in cold shock patients that influenced the stroke volume index, cardiac index, and velocity time integral. The use of echocardiograms for hemodynamic measurements is important in pediatric septic shock patients to adjust dilators, and vasopressor doses and achieve resuscitation targets in a timely manner. Associação de Medicina Intensiva Brasileira - AMIB 2018 /pmc/articles/PMC6334480/ /pubmed/30672970 http://dx.doi.org/10.5935/0103-507X.20180067 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Abdalaziz, Faten A.
Algebaly, Hebat Allah Fadel
Ismail, Reem Ibrahim
El-Sherbini, Seham Awad
Behairy, Ahmed
The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title_full The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title_fullStr The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title_full_unstemmed The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title_short The use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
title_sort use of bedside echocardiography for measuring cardiac index and systemic vascular resistance in pediatric patients with septic shock
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334480/
https://www.ncbi.nlm.nih.gov/pubmed/30672970
http://dx.doi.org/10.5935/0103-507X.20180067
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