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Role of ScvO2 in the Management of Fluid Refractory and Cathecholamine Resistant Shock among Children: A Hospital Based Randomized Controlled Trial

Pratibha M. Patil, Assistant Professor, Department of Paediatrics, Ashwini Rural Medical College, Hospital and Research Centre, Kumbhari, Solapur, Maharashtra 413006, India. , Manisha Vidyanand Chavan* , Pratibha Milind Patil** , Mandar Haval***

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Indian Journal of Trauma and Emergency Pediatrics 9(4):p 227-234, Oct-Dec 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.9417.5

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Abstract

Background: The highest mortality rates are observed in children under five years in developing countries. Shock is the result of various etiologies and the leading causes of shock in children younger than 5 years of age. More specifically, the outcome benefit of further optimizing metabolic parameters, namely ScvO2, directed therapy remains unknown. Even though current ACCM/PALS guidelines represent best practice, prospective randomized trials are lacking to confirm all components of these recommendations. Hence the present study was undertaken to assess the role of ScvO2 in management of fluid refractory. Methods: The study design was one year randomized controlled trial. Institutional Ethical Clearance was obtained for the study prior beginning of the study. Children fulfilling the selection criteria were selected After obtained written informed consent, demographic data was recorded and history was taken. Clinical examination was done for all patients and findings were recorded on predesigned and pretested proforma. Result: 31.37% children in group A and 27.45% in group B presented with fever. Majority of the children were hypotensives. 66.67% of patients in both the groups had ephedrine. Outcome among children with group B was significantly better (94.12%) compared to group A (80.39%) supporting the current ACCM/PALS guidelines. Conclusion: It may be concluded that, ScvO2 in management of fluid refractory and catecholamine resistant shock has reduced the mortality but did not influence the hospital stay.

 

Keywords: ScvO2; Shock; Fluid Refractory; Hospital Stay. 


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DOI: DOI: http://dx.doi.org/10.21088/ijtep.2348.9987.9417.5

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