Diagnosis and treatment of 36 children with cardiogenic shock
- VernacularTitle:36例小儿心源性休克诊治分析
- Author:
Fan TONG
;
Tao LIU
;
Liping SHI
;
Meiyue SUN
- Publication Type:Journal Article
- Keywords:
Children;
Cardiogenic shock;
Clinical characteristic;
Prognosis;
Treatment
- From:
Chinese Journal of Emergency Medicine
2006;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical characteristics, treatment and prognostic factors of cardiogenic shock in children. Methods A retrospective analysis was done on clinical features,management strategies and outcome in 36 children with cardiogenic shock in Intensive Care Unit of our hospital from February 1994 to December 2005. Results The clinical presentations of 36 patients varied with the different ages and different primary diseases. And the duration between the presentation and the onset of shock varied with the different primary diseases: the duration for paroxysmal supraventricular tachycardia (PST) was (62.2?12.9) hours, cardiomyopathy (CMP) was (42.0?23.0) hours, endocardial fibroelastosis (ECF) was (20.3?11.1) hours, and fulminant myocarditis (FMC) was (15.0?7.8) hours. At the early stage of shock, all patients showed soft heart sounds.Gallop rhythm was found in 15 cases (41.6%)and cardiopulmonary resuscitation was needed in 17 cases (47.2%).All cases had decreased ejection fraction(EF) and fractional shortening(FS) [(0.32?0.11), (0.14?0.05),respectively] on echocardiography.Cardiothoracic ratio increased in 35 cases (97.2%) and arrhythmia developed in 34 cases (94.4%). The duration from initial treatment to shock correction of was related to the prognosis (P=0.002, Wald=9.91).Fluid resuscitation in cardiogenic shock needed close monitor, and the amount of fluid was 5.25 ml?kg -1?h -1,4.48 ml?kg -1?h -1,4.75 ml?kg -1?h -1 in ECF,FMC and CMP,respectively. Conclusion The clinical presentations high in cardiogenic shock in children were various. Early bedside echocardiogram, chest X-ray and electrocardiogram would be helpful in diagnosis. The duration from initial treatment to shock correction was a strong prognostic factor for cardiogenic shock. Compared with other kinds of shock, fluid resuscitation had its features.
