• Marco Piastra, Ersilia Luca, Sonia Mensi, Federico Visconti, Daniele De Luca, Francesca Vitale, and Domenico Pietrini.
• Pediatric ICU, Catholic University Medical School, Rome, Italy. marco.piastra@rm.unicatt.it
• Curr Drug Targets. 2012 Jun 1; 13 (7): 900-5.

AbstractCirculatory failure recognition and treatment represents an important issue in critically ill infants and children. Early diagnosis and prompt institution of adequate treatment may be life-saving for pediatric patients with cardiocirculatory instability in the setting of intensive care. However, the hemodynamic status of the critically ill child is poorly reflected by baseline vital parameters or laboratory blood tests. A reliable tool for diagnosis and monitoring of evolution of both heart performance and vascular status is strictly needed. Advanced hemodynamic monitoring consists - among others - of measuring cardiac output, predicting fluid responsiveness and calculating systemic oxygen delivery. Identification and quantifying of pulmonary edema has also been recently appreciated in pediatric critical care. In the last decade, the number of vasoactive drugs has increased, together with a better understanding of clinical application of both different monitoring devices and treatment strategies.

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