Role of ultrasound diagnostics in pediatric septic shock intensive care: a review and a clinical case

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The article is devoted to the use of ultrasound diagnostics methods to assess the functional state of the cardiovascular system in critical conditions in children and the choice of optimal hemodynamic support. The need for careful detailed monitoring in patients in pediatric intensive care units has been demonstrated, the low sensitivity and specificity of the currently widely used clinical signs are reflected, which limits their use in the choice of treatment methods. As an alternative, it is proposed to use ultrasound diagnostics that assess cardiac output, allowing you to make an informed decision on medical measures taking into account the current clinical situation. The wide possibilities and numerous advantages of ultrasonic navigation in providing assistance to patients with a wide variety of life-threatening conditions are described. The main advantage is the possibility of obtaining information in real time, directly at the bedside. A clinical case of a target-oriented intensive therapy of left ventricular systolic dysfunction in a nine-year-old child against the background of a septic process using methods of ultrasonic assessment of hemodynamic status is presented. The use of ultrasound imaging methods made it possible to identify the cause of the deterioration of the condition and conduct a reasonable treatment correction, which ensured the fastest regression of hemodynamic disorders and contributed to a favorable outcome of the disease. The simplicity and accessibility of the Teicholz estimate of the ejection fraction was noted, which allows it to be used in routine practice to select the optimal hemodynamic support and assess the effectiveness of treatment over time.

作者简介

Kseniya Ermolenko

St. Petersburg State Pediatric Medical University; Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency

编辑信件的主要联系方式.
Email: ksyu_astashenok@mail.ru

anesthesiologist and intensive care physician of the Intensive Care Unit

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Konstantin Pshenisnov

St. Petersburg State Pediatric Medical University

Email: Psh_k@mail.ru

MD, PhD, Dr. Med. Sci., Associate Professor of Anesthesiology, Intensive Care and Emergency Pediatrics Postgraduate Education

俄罗斯联邦, Saint Petersburg

Yuriy Alexandrovich

St. Petersburg State Pediatric Medical University

Email: jalex1963@mail.ru

MD, PhD, Dr. Med. Sci., Professor, Head of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education

俄罗斯联邦, Saint Petersburg

Aleksandr Konev

St. Petersburg State Pediatric Medical University; Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency

Email: icdrkonev@yandex.ru

Chief of the Intensive Care Unit

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Vyacheslav Ironosov

St. Petersburg State Pediatric Medical University

Email: ironosov@mail.ru

MD, PhD, Associate Professor of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education

俄罗斯联邦, Saint Petersburg

Sevir Nezabudkin

St. Petersburg State Pediatric Medical University

Email: Sevir18@mail.ru

MD, PhD, Dr. Med. Sci., Professor of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics named prof. V.I. Gordeev

俄罗斯联邦, Saint Petersburg

Victor Pogorelchuk

St. Petersburg State Pediatric Medical University

Email: viktor-pogorelchuk@yandex.ru

PhD, MD, Associate Professor of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics named prof. V.I. Gordeev

俄罗斯联邦, Saint Petersburg

Vladimir Evgrafov

St. Petersburg State Pediatric Medical University

Email: Psh_K@mail.ru

PhD, MD, Associate Professor of the Department of Anesthesiology and Intensive Care and Emergency Pediatrics named prof. V.I. Gordeev

俄罗斯联邦, Saint Petersburg

参考

  1. Alexandrovich YuS, Pshenisnov KV. Modern principles of cardiopulmonary resuscitation in pediatric practice. Pediatrician (St. Petersburg). 2016;7(1):5–15. (In Russ.) doi: 10.17816/PED715-15
  2. Alexandrovich YuS, Ivanov DO, Pshenisnov KV. Sepsis novorozhdennykh. Posobie dlya vrachei. Saint Petersburg: SPBGPMU Publ., 2019. 176 p. (In Russ.)
  3. Antonov AA. Gemodinamika dlya klinitsista: uchebnoe posobie. Moscow: LitRes, 2018. 100 p. (In Russ.)
  4. Babukov RM, Bartosh FL. Comparison of echocardiographic techniques Teichholz and Simpson in assessing left ventricular systolic function in patients with coronary heart disease. Diagnostic radiology and radiotherapy. 2015;(1):76–81. (In Russ.) doi: 10.22328/2079-5343-2015-1-76-81
  5. Bokeriya LA, Golukhova EZ. Osnovy semiotiki i funktsional’noi diagnostiki v kardiologii. Moscow: NTSSSKH im. A.N. Bakuleva RAMN, 2015. (In Russ.)
  6. Boronina IV, Aleksandrovich YuS, Popova IN, Oshanova LS. Hemodynamic monitoring on the background of intensive therapy in newborns. Pediatrician (St. Petersburg). 2017;8(5):74–82. (In Russ.) doi: 10.17816/PED8574-82
  7. Bulach TP, Abusuev AA, Aselderova ASh, Lukyanova IYu. Ultrasound technologies for anesthesiologists-resuscitators: present and future. Bulletin of the Dagestan State Medical Academy. 2021;(2):67–73. (In Russ.)
  8. Bykov MV, Lazarev VV, Bykova LV, et al. New possibilities of diagnosing volume status disorders in children in acute infectious diseases. Infectious diseases. 2017;15(2):4–69. (In Russ). doi: 10.20953/1729-9225-2017-2-64-69
  9. Gromov VS, Ageev AN, Alasheev AM, et al. Perfusion-metabolic interaction in acute cerebral insufficiency. Acips study part I. Cerebral blood flow evaluation. Russian journal of Anaesthesiology and Reanimatology. 2013;(4):37–41. (In Russ.)
  10. Ermolenko KYu, Aleksandrovich YuS, Pshenisnov KV, et al. Assessing the accuracy of prognostic scales in children with neuroinfections. Infectious diseases. 2021;19(2):76–82. (In Russ.) doi: 10.20953/1729-9225-2021-2-76-82
  11. Iovenko ІA, Kobelyatsky YuYu, Tsarev AV, et al. Hemodynamic monitoring in practice of intensive care unit. Emergency medicine. 2016;(5):42–46. (In Russ.)
  12. Konstantinov BA. Fiziologicheskie i klinicheskie osnovy khirurgicheskoi kardiologii. Leningrad: Nauka, 1981. 262 p. (In Russ.)
  13. Lekmanov AU, Mironov PI, Aleksandrovich YuS, et al. Sepsis in children: federal clinical guideline (draft). Russian Journal of Pediatric Surgery, Anesthesia and Intensive. 2021;11(2):241–292. (In Russ.) doi: 10.17816/psaic969
  14. Makarov LM, Ivanov DO, Pozdnyakov AV, et al. Computer visualization of results biomedical research article title. Visualization in medicine. 2020;2(3):3–7. (In Russ.)
  15. Marchenko SP, Khubulava GG, Naumov AB, et al. Pathophysiological principles for evaluating hemodynamic. Pediatrician (St. Petersburg). 2014;5(4):110–117. (In Russ.) doi: 10.17816/PED54110-117
  16. Mit’kov VV, Sandrikov VA. Klinicheskoe rukovodstvo po ul’trazvukovoi diagnostike. Moscow: Vidar, 1998. (In Russ.)
  17. Mukhin NA. Propedevtika vnutrennikh boleznei: uchebnik dlya meditsinskikh vuzov. Moscow: GEHOTAR-Media, 2012. 848 p. (In Russ.)
  18. Perrino AS, Skott TR. Transpishchevodnaya ehkhokardiografiya: prakticheskoe rukovodstvo. Moscow: MIA, 2013. 516 p. (In Russ.)
  19. Rybakova MK, Mit’kov VV. Ehkhokardiografiya v tablitsakh i skhemakh: prakticheskoe rukovodstvo. Moscow: Vidar, 2011. 288 p. (In Russ.)
  20. Sokol’skaya NO, Kopylova NS. The evolution of methods of ultrasonic diagnostics in intensive practice. Bakoulev Scientific Center for Cardiovascular Surgery RAMS, Russian journal. 2017;18(4):353–367. (In Russ.) doi: 10.24022/1810-0694-2017-18-4-353-367
  21. Strukov DV, Alexandrovich YuS, Vasiliev AG. Actual aspects of sepsis and septic shock. Pediatrician (St. Petersburg). 2014;5(2):81–87. (In Russ.) doi: 10.17816/PED5281-87
  22. Feigenbaum KH. Ehkhokardiografiya. 5-e izd. Moscow: Vidar, 1999. 512 p. (In Russ.)
  23. Finogeev YuP. Infectious myocarditis (clinic, diagnostics, principles of treatment). Jurnal infektologii. 2016;8(3):28–39. (In Russ.)
  24. Flakskampf FA. Prakticheskaya ehkhokardiografiya. Rukovodstvo po ehkhokardiograficheskoi diagnostike: uchebnoe posobie. Moscow: MEDpress-inform, 2013. 872 p. (In Russ.)
  25. Shiller N, Osipov MA. Klinicheskaya ehkhokardiografiya. 2-e izd. Moscow: MEDpress-inform, 2018. (In Russ.)
  26. Ilercil A, O’Grady MJ, Roman MJ, et al. Reference values for echocardiographic measurements in urban and rural populations of differing ethnicity: the Strong Heart Study. J Am Soc Echocardiogr. 2001;14(6):601–611. doi: 10.1067/mje.2001.113258
  27. Lang RM, Bierig M, Devereux RB, et al. Recommendations for Chamber Quantification: A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. J Amer Society of Echocardiography. 2005;18(12):1440–1463. doi: 10.1016/j.echo.2005.10.005
  28. Singh Y, Villaescusa JU, da Cruz EM, et al. Recommendations for hemodynamic monitoring for critically ill children-expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care. 2020;24:620. doi: 10.1186/s13054-020-03326-2

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2. Fig. 1. Dynamics of catecholamine index against the background of extracorporeal hemocorrection

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3. Fig. 2. Water balance in the first three days of treatment in ICU

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4. Fig. 3. Change injection fraction after correction of treatment

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版权所有 © Ermolenko K., Pshenisnov K., Alexandrovich Y., Konev A., Ironosov V., Nezabudkin S., Pogorelchuk V., Evgrafov V., 2022

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