Predicting Fluid Responsiveness in Children with Shock: POCUS Can Guide

Excerpt

Children with septic shock often have fluid deficit, decreased vascular tone, and myocardial dysfunction [1]. Therefore, fluid resuscitation and vasoactive agents are important components of septic shock management. However, it has been demonstrated that fluid bolus led to improvement in cardiac output in only 40–50% of patients; it was sustained in <10% patients at 60 min [1, 2]. Moreover, fluid boluses have been shown to worsen cardiac function and endothelial glycocalyx injury; cause arterial vasodilatation and worsening of hemodynamics; higher need of mechanical ventilation; and increased mortality [1, 3]. Therefore, it is pertinent to administer fluid bolus to only those who are fluid responsive and fluid tolerant. The ideal method to determine fluid responsiveness is still elusive. …