Article Text

FLUID THERAPY AND RENAL FUNCTIONS IN PAEDIATRIC SEPTIC SHOCK
  1. J Krastins1,
  2. V Grinbergs1,
  3. A Tomina1
  1. 1Pediatric Intensive Care Unit, Children’s University Hospital, Riga, Latvia

Abstract

Objective The aim of our study was to recognise relationships between the amount of fluid given in paediatric septic shock patients and their outcomes.

Methods Retrospective study was performed on 17 patients with septic shock treated between the years 2004 and 2007 in our institution. Mean age of patients was 10.14 ± 64.55 months, weight from 7.8 kg to 70 kg (mean 33.4 ± 17.3 kg). In four cases multiple organ dysfunction syndrome developed and renal replacement with haemodialysis/haemofiltration (in three patients) or peritoneal dialysis (in one patient) was performed. 13 patients (76.5%) needed mechanical ventilation. The amount of fluid administered during the first 12 and 24 h, doses of vasopressors and inotropes and duration of therapy were calculated.

Results 15 of 17 patients survived (88.2%). The amount of fluid given during the first 12 h in survivors and non-survivors was 76.70 ± 6.77 and 180.30 ± 74.7 ml/kg, respectively. The amount of fluid given in patients with normal renal function and patients with subsequent renal failure during 12 h was 76.70 ± 6.77 and 59.13 ± 3.05 ml/kg, respectively. There was a statistically significant difference (p = 0.031) in the amount of fluids infused during the first 12 h between patients who received renal replacement therapy versus patients with normal renal function.

Conclusions We found a statistically significant difference (p = 0.031) in the amount of fluids given during the first 12 h of treatment in septic shock patients with normal renal function versus patients with subsequent renal failure (76.7 ± 6.77 vs 59.13 ± 5.28 ml/kg). Aggressive fluid resuscitation during the 1st hour of treatment is of paramount importance. An essential part of septic shock management is the administration of vasoactive and inotrope substances.

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