Header bg
  • Users Online: 92
  • Print this page
  • Email this page
Header bg
ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 3  |  Page : 109-114

The role of focused echocardiography in optimizing lactate clearance in the first 3 h of pediatric sepsis resuscitation


Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Airlangga – Dr Soetomo General Hospital, Surabaya, East Java, Indonesia

Correspondence Address:
Dr. Arie Utariani
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Airlangga – Dr Soetomo General Hospital, Mayjend Prof. Dr. Moestopo Street No. 6-8, Airlangga, Gubeng, Surabaya, East Java 60285
Indonesia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/BJOA.BJOA_43_20

Rights and Permissions

Background: Sepsis causes high morbidity and mortality in pediatric patients globally. Early shock diagnosis and management are important to determine patient survival. Fluid boluses, early inotropic, and vasopressor usage are the keys to improve lactate clearance. Echocardiography helps both determining the type of shock and selecting the hemodynamic therapies. Patients and Methods: A quasi-experimental with one group posttest only design was conducted on 23 pediatric patients who were treated in the resuscitation room of Dr. Soetomo Hospital Surabaya. Patients who met the inclusion and exclusion criteria became the research sample and resuscitated, according to the 1-h sepsis bundle. Patients' hemodynamic status was assessed by echocardiography, and their early blood lactate was checked. Therapies such as fluid adequacy maintenance, cardiac contractility optimization, and vasopressor administration were given according to the type of shock. On the 3rd h, evaluation of clinical improvement, lactate level, and the posttherapy echocardiography were done. Results: As many as 39% of the patients suffered normotension cold shock, 26% with hypotension cold shock, 9% with normotension warm shock, and the rest 26% with hypotension warm shock. Echocardiographic-guided hemodynamic therapy statistically significantly improved the patient's volume status, contractility, and vascular resistance (P < 0.05). Reversal of shock within the first 3 h, which were derived from clinical improvement and echocardiography measurement, was statistically significantly correlated with >10% lactate clearance (P = 0.001; r = 0.558). Conclusion: Focused echocardiography was effective in evaluating the hemodynamics and lowering the clearance of lactate of pediatric patients with septic shock.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed129    
    Printed6    
    Emailed1    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal