Left ventriculum diastolic dysfunction in pediatric septic shock

Abstract

Introduction One of the causes of septic mortality is a low cardiac output secondary to preload failure. Same patients demonstrate preload failure after aggressive volume replacement [1]. Methods Ultrasound impulse-wave Doppler evaluation of transmitral flow: VmaxE, VmaxA, ejection time E,A; DT E wave, IVRT of LV. Ultrasound evaluation of end-diastolic and end-systolic LV volume, stroke volume (LVEDV, LVESV, SV) on Teichholz L. EDLVP = 1.06 + 15.15xVTI peakA/ VTI peakE. Coronary perfusion pressure (CPP) = EDLVP - diastolic BP. We evaluate these parameters in 34 patients (age 28.1 +/- 8.0 months) with septic shock (SS) diagnosed according to Consensus 2002. Control (C) - 44 healthy children (age 40.7 +/- 8.5 months). Statistical analyses with t criteria. Results The increase of VmaxA and decrease of VmaxE in patients of SS are demonstrated. IVRT and DT are less than in control group. We evaluated a decrease in E/A proportion. EDLVP in patients was more, and CPP lower, than in controls. See Table 1. (Table presented) Conclusion Pediatric SS accompanied with LV diastolic dysfunction, which decreases the effectiveness of volume restoration therapy, reduces preload and cardiac output.