Background: Septic shock is a not common but severe progress and high mortality. International pediatric sepsis consensus conference 2002 (IPSCC 2002) gave recommendations for early identification shock, fluid resuscitation, using vasoactive drugs were effective in reducing mortality septic shock in children. Objectives: To evaluate the effectiveness of fluid resuscitation on hemodynamic parameters of pediatric patients with septic shock. Methods: prospective, observational study. One hundred and two patients, aged from 1 month to 15 years old with septic shock, admitted to the pediatric intensive care unit of the National Hospital of Pediatrics from January, 2005 to December, 2007. The authors used the IPSCC 2002 guideline for manage,ment of septic shock. Patients were divided in the three groups: Group I: fluid-resistant, dopamine-responsive shock; Group II: fluid-resistant, dopamine-resistantS/lock; and Group III: Catecholamine-resistant shock: Pre- and post fluid resuscitation hemodynamic parameters such as heart rate, mean blood pressure, central venous pressure were compared in the first hour. Results: Mean fluid volume was 44,6 + or - 24,49 ml/kg in first hour, crystalloid fluid Clccounted for 88.2 percent. Normalized systolic blood pressure was increased from 11.8 percent to 34.3 percent after fluid bolus (p 0,0001). Tachycardia was decreased from 77..5 percent to 56.5 percent after fluid bolus (p 10 cmH20 (p=003). Mean fluid bolus volume was lower in non- survived group (p=0.013). Conclusion: Mean fluid volume for resuscitation in the first stage was 40-60 ml/kg. Fluid bolus improved blood pressure, heart rate. Nonsurvivors had lower fluid resuscitation volume and higher CVP.
- Đăng nhập để gửi ý kiến