الفهرس 
Pediatric ShockOnly 14 pages are availabe for public view
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Abstract
Many forms of critical illness may present with shock. Shock is not necessarily defined by hypotension. That is, a patient can be normotensive and have shock in the same time. Accordingly, the definition of shock is mainly based on in adequate oxygen delivery to tissues. When tissue oxygen requirements are not met by the circulatory system, be it due to myocardial function affection, hypovolemia, and/or hypotension, a patient is said to be shocked.
Pediatric septic shock is a sepsis combined with cardiovascular organ dysfunction. Consequently, myocardial dysfunction and circulatory instability are the leading causes of death.
Noninvasive cardiac index(CI), stroke volume index(SVI) and inferior vena cava diameter(IVC) estimation through echocardiography has shown to be an accurate, confident, and easy tool to use in critically ill patients to predict fluid responsiveness among them.
The present study aims to assess the utility of transthoracic echocardiography for the prediction of response of children with septic shock to fluid resuscitation.
Our study was conducted on 46 patients admitted with new onset septic shock to pediatric intensive care unit in Menoufia University Hospital.
Their age was from 1 month to 16 years. 22 were males and 24were females.
All patients gone throw full history taking, clinical examination, laboratory assessment (complete blood count, liver function tests, kidney function tests, C-reactive protein, and blood culture) and echocardiography (including ejection fraction, IVC diameter, delta CI and stroke volume index).
Initial data was recorded before fluid resuscitation and also after fluid resuscitation and patients divided into responders in which there is increase in cardiac index or stroke volume index by > 10-15% and non responders groups.
Our results as regards mechanical ventilation found that mechanical ventilation was significantly lower in the responders group.
PRISM and pSOFA scores was found higher in non responders group versus responders group.
Concerning hospital stay and mortality rates they were significantly higher in non responders group.
Our study concluded that Change in delta cardiac index and IVC diameter of ≥10% after passive leg raising test and fluid bolus was a significant discriminator of fluid responsiveness.