793 Management of Acute Circulatory Failure in Children Based on the Evaluation by Echocardiography in Pediatric Intensive Care Unit (PICU)

Abstract

Background and Aims Echocardiography has an important role to perform in the PICU, as it is an efficient, accurate, non invasive diagnostic modality that can aid the intensivist in the management of the acute circulatory failure in children to Improve the hemodynamic Management. The Aim is to describe how echocardiography can answer 3 of the more commonly asked questions that arise in the PICU: Complete the clinical diagnosis, guide the therapeutics, and Repeat the measures for the evaluation. Methods In this prospective study, children who had an acute circulatory failure, the evaluation of the cardiaque output, contractility and the indications of filling were obtained by echocardiography. Each patient had a measurement before therapeutic and after to evalulate treatment. Results In 20 children, 06 patients had septic shock, 09 with sever sepsis and 05 with severe brain injury. Median age was 3.5 years. Intervention Standardized volume expansion (VE) when the Respiratory variations in aortic blood flow (V Peak Ao > 12%), the VE-induced increase in LV stroke volume was > 15%. Treatment inotrope when, is an acute circulatory failure related to impaired myocardial contractility responsible for a decrease in cardiac output (Cardiogenic shock or myocardial dysfunction in the septic shock). Norepinephrine when the mean pressure decrease with normal myocardial contractility and cardiaque output. Conclusion Echocardiography is a incountournable tool in the evaluation and management of acute circulatory failure in children in PICU because its guide therapeutic, evalulate the efficiency of treatment and improve the surveillance.