الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Severe sepsis causes release of inflammatory mediators and an associated redistribution of intravascular volume together with depression of myocardial function which manifests as hemodynamic pattern of low cardiac output, low systemic vascular resistance, hypotension, hyperlactatemia and signs of altered tissue perfusion such as oliguria and prolonged capillary refill time. Aim of the Work: To assess hemodynamic status together with the perfusion markers (lactate) in critically ill children with septic shock. Patients and Methods: This single cohort study was conducted on 40 patients recruited from the pediatric intensive care units (PICU) at: Ain Shams university hospital, Al-Galaa Military medical complex and Ghamra Military hospital from December 2017 to August 2018. Results: Only four cases of cases with septic shock developed ejection fraction below 55% denoting myocardial dysfunction during the duration of assessment (first 24 hours of diagnosis). There was negative correlation between cardiac functions represented by hemodynamic measures on one side and SOFA score, PIM 2 score and serum lactate levels on the other side. However, by studying the performance of the parameters included in our study in predicting death; only lactate-24 ≥2.0 (mmoL/L) had statistically significant moderate diagnostic performance, other studied measurements had weak diagnostic performance. Conclusion: Myocardial dysfunction was found to be common in children having septic shock. Close monitoring and hemodynamic assessment is important to avoid missing these cases. In addition, serum blood lactate level is an important biomarker that should be carefully monitored as it is a good prognostic tool that can predict outcome in pediatric sepsis and septic shock.