HEMODYNAMIC MONITORING IN CRITICALLY ILL PATIENTS IN PAEDIATRIC ICU

Abstract

epsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection and “septic shock” the subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality. It is reasonable to begin vasoactive infusions after 40–60 mL/kg of fluid resuscitation if the patient continues to have evidence of abnormal perfusion, or sooner if fluid overload develops. Echocardiography is a rapid, noninvasive, comprehensive cardiac assessment option for patients presenting with hemodynamic instability. Doppler-based renal resistive index (RRI) measurement is a rapid and non-invasive tool that may be useful to detect renal hypoperfusion and to measure resistance to arterial blood flow in renal vessels in intensive care unit (ICU) patients. I-FABP (Intestinal fatty acid-binding protein) is present in the cytoplasm of mature enterocytes in the small and large intestine and is released as soon as the cell membrane integrity is compromised, thus reflecting the extent of gut damage. It is used as a biomarker of mucosal injury and other diseases affecting the intestine The aim of the current study was the assessment of hemodynamic effects of different vasoactive drugs doapamine, adrenaline and noradrenaline in septic shock in pediatric age group and comparing their effects on renal artery resistive index and gut ischemia indicated by IFABP.