• Pediatr Int · Oct 2014

    Case Reports

    Peripheral blood flow monitoring in an infant with septic shock.

    • Akio Ishiguro, Sayaka Sakazaki, Ryuta Itakura, Sumie Fujinuma, Shuntaro Oka, Yukiko Motojima, Hisanori Sobajima, and Masanori Tamura.
    • Department of Pediatrics, Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
    • Pediatr Int. 2014 Oct 1; 56 (5): 787-9.

    AbstractSeptic shock is associated with impaired vasoregulation, and treatment includes vasoactive drugs. Therefore, evaluation of vasoregulatory change is important. The present report describes the successful characterization of vasoregulatory change in response to a vasoactive drug during septic shock. A male infant born at 23 weeks' gestation developed septic shock. Severe hypotension developed, and treatment with colloid fluid and dopamine failed to increase blood pressure. With continuous measurement of skin blood flow using laser Doppler, noradrenaline was started. Based on changes in the blood flow, the dose was increased. At a dose of 1 μg/kg per min, skin blood flow in the foot decreased without any change in blood pressure. Subsequent blood transfusion succeeded in increasing both blood pressure and skin blood flow. It is concluded that decrease in foot blood flow reflects the vasoconstrictive effect of noradrenaline, although this finding must be validated in larger studies.© 2014 Japan Pediatric Society.

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