Evolution of children with septic shock according to the application of hemodynamic treatment

Abstract

A cohort study was conducted in children diagnosed with septic shock and admitted to the Intensive Care Unit of the Jose Luis Miranda Pediatric University Hospital in Santa Clara, Villa Clara, during the period from January 1, 2004 to December 31, 2007, with the objective of identifying the influence of the hemodynamic treatment in their evolution. For that purpose, the treatment sustained in the guideline recommendations of the American College of Critical Care Medicine was applied. The cohort was composed of 132 patients with the diagnosis outlined above. The evolution was assessed according to discharge status – alive or deceased. The frequency of patients discharged alive increased significantly with increasing the amount of fluid administered in the first hour. Of all combinations of vasoactive drugs, dobutamine and epinephrine was associated with lower frequency of deaths. The development of the acute respiratory distress syndrome was not related to the amount of fluid administered in the first six hours; and the earlier the use of artificial ventilation, the lower the possibility of death, hence the impact of this measure on the favorable evolution of the patients.