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Bedside Ultrasound and Noninvasive Cardiac Output Monitoring in Children with Septic Shock: A Retrospective
Kang Lei1,2,3, Shi Xiaona1,2,3, Cao Lijing1,2,3
1Department of Pediatric Intensive Care Unit, Hebei Children's Hospital, Shijiazhuang, 050031, Hebei, China.
Pediatric Cardiology
|July 15, 2026
Summary
Point-of-care ultrasound (POCUS) and noninvasive cardiac output monitoring (NICaS) improved outcomes in pediatric septic shock by reducing fluid overload and increasing survival rates compared to conventional care.
Area of Science:
- Pediatric Critical Care Medicine
- Hemodynamic Monitoring
- Point-of-Care Ultrasound (POCUS)
- Noninvasive Cardiac Output Monitoring (NICaS)
Background:
- Pediatric septic shock management requires precise hemodynamic assessment.
- Conventional methods may lack the dynamic insights needed for optimal fluid management.
- Point-of-care ultrasound (POCUS) and noninvasive cardiac output monitoring (NICaS) offer potential advancements.
Purpose of the Study:
- To evaluate the clinical value of POCUS and NICaS in managing pediatric septic shock.
- To compare the effectiveness of POCUS and NICaS against conventional hemodynamic management.
- To assess the impact on fluid balance, vasoactive-inotropic support, and survival rates.
Main Methods:
- Retrospective analysis of 116 children with septic shock.
- Three groups: POCUS-guided therapy (CI, IVCV, LVEF), NICaS-guided therapy (CI, SVV, GGI), and control (conventional management).
- Comparison of peak vasoactive-inotropic score (VIS), fluid volume, time to negative fluid balance, and 28-day survival.
Main Results:
- POCUS and NICaS groups showed significantly lower peak VIS, reduced resuscitation fluid volume, and shorter time to negative fluid balance than the control group.
- The 28-day survival rate was significantly higher in the POCUS and NICaS groups (73.5%, 66.7%) compared to the control group (45.2%).
- No significant differences were found between POCUS and NICaS in key outcome measures, though correlation analysis showed weak correlation but good agreement.
Conclusions:
- POCUS and NICaS are valuable tools in managing pediatric septic shock.
- These advanced monitoring techniques facilitate earlier negative fluid balance, reduce vasopressor needs, and improve survival.
- Both POCUS and NICaS demonstrate comparable efficacy in this patient population.
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