Clinical Audit on the Use of Vasopressors and Inotropes in Pediatric Intensive Care Unit in Assiut University Children Hospital

Abstract
Background: Shock is a state of circulatory dysfunction where the metabolic demands of the tissue cannot be met by the circulation. The early recognition of signs of shock and aggressive therapy to restore the intravascular volume and reverse the biochemical cascade is believed to improve out-come.
Patients and Methods: The study was done on children with shock admitted to intermediate care unit and PICU in assiut university children hospital in one year duration. An observational checklist based on guidelines of management of shock according to Early Goal Directed Therapy (EGDT) developed by the investigators in order to assess the manage-ment plane and the use of vassopressors and inotropes in pediatric shock.
Results: In management at 0min.; Items of recognition of mental status, skin colour and determination of high flow O2 each were recorded in 99.05%. Establishing IV/IO access was done in 100%. In management at 5min.; fluid therapy was given to 97.14% of patients, in 77.5% of them it was recorded. RBG was done for 96.19% of patients, recorded in 100% of them. Calcium level was assessed in 98.1% of patients, in 96.1% of them it was recorded. The percentage frequency of using inotropes in management of the studied patients at 15min as follow: Dopamine alone was used in 55.3% of cases, dobutamine alone was used in 44.7% of cases, adrenaline was used in 31.4% of cases in combination with other inotrope and noradrenaline was used in 14.2% of cases in combination with other inotrope. In management of shock at 60min. 35.24% of patients were given hydrocortisone.