Contribution of Inferior Vena Cava Ultrasound Monitoring in the Management of Septic Shock in Children at the CHU-MEL

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Introduction: Septic shock is a complication of sepsis leading to circulatory and metabolic abnormalities. Cardiac ultrasound allows the assessment of vascular filling by measuring the diameter of the IVC (inferior vena cava) and detecting myocardial dysfunction. Objective: To assess the contribution of IVC ultrasound in the management of septic shock in children in the pediatric department of CHU-MEL. Methods: This was a prospective, descriptive, and analytical study conducted over a period of four months (February 2 to May 31, 2024). Results: The prevalence of septic shock was 4.9%. The most affected age group was infants under 12 months (62.5%). The most significant failures were renal (78.1%) and neurological (71.9%). The total amount of fluids administered with vascular filling monitoring by IVC ultrasound varied from 0 to 65ml/kg. It was adapted to each child based on IVC dilation. The vasoactive drug of choice was norepinephrine. Shock resolution was achieved in 31.3%. The mortality rate was 84.4%. Conclusion: IVC ultrasound helped avoid both hypovolemia and harmful excessive fluid administration by adapting the amount of fluids to each child based on their IVC diameter. Adequate training in bedside echocardiography would allow pediatricians to improve the hemodynamic management of septic shock in children.

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