Assessment of Hemodynamic Status and Perfusion Markers in Critically Ill Children with Septic Shock

Abstract

S epsis is defined as life-threatening organ dysfunction due to dysregulated host response to infection. Severe sepsis causes release of inflammatory mediators and an associated redistribution of intravascular volume together with depression of myocardial function which manifests as hemodynamic pattern of low cardiac output, low systemic vascular resistance, hypotension, hyperlactatemia and signs of altered tissue perfusion such as oliguria and prolonged capillary refill time. Hence, determination of hemodynamic status includes monitoring of cardiac output and markers of perfusion. As regards perfusion markers, the inflammatory mediators of sepsis may worsen tissue hypoxia. Blood lactate levels supposed to reflect the magnitude of anaerobic metabolism related to cellular hypoxia. Blood lactate levels is the earliest discriminator of survival, survivors had an early reduction of lactate level and better lactate clearance. Our study aimed to assess hemodynamic status in critically ill children with sepsis and septic shock. The study was conducted on fourty critically ill children, their ages ranged from one month to ten years,