Abstract
Introduction: Septic shock in children can lead to cardiac dysfunction, leading to increased tissue hypoperfusion and mortality.Arterial elastance is a metric that denotes an arterial vessel’s capacity to elevate arterial pressure and afterload through enhanced flow and rigidity. Dynamic arterial elastance (Eadyn) is regarded as a functional evaluation of arterial tone.
Objective: Investigating Eadyn by the pressure recording analytical method (PRAM) and the correlation between Eadyn and other hemodynamic parameters in children with septic shock.
Methods: An observational cohort study at the Pediatric Intensive Care Unit (PICU), which included children aged 6 months to 18 years with septic shock, body weight >7.5 kg, and no congenital heart disease. Eadyn and other hemodynamic variables (arterial blood pressure, central venous pressure, heart rate, cardiac output, stroke volume, and systemic vascular resistance) were measured using PRAM connected to arterial lines. All patients received initial hemodynamic resuscitation and vasoactive drugs.
Results: Children with septic shock were prospectively analyzed; 8 survived, and 19 died during PICU treatment. From data analysis, we found that Eadyn correlated with cardiac index and systemic vascular resistance on the second and third days of observation, as well as with cardiac power output and stroke volume index across all three days of observation. Eadyn was also higher in the group that survived, with an area under the curve (AUC) of 78% for predicting death, according to the receiver operating characteristic (ROC) analysis.
Conclusion: The evaluation of Eadyn constituted a key element in the assessment of cardiovascular function and could be useful in predicting mortality in children with septic shock.
Arina Setyaningtyas, Soetjipto, Anang Endaryanto, Antonius Hocky Pudjiadi, Retno Handajani, Neurinda Permata Kusumastuti, Bambang Pujo Semedi, Ira Dharmawati, Dwi Putri Lestari
