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MERCIER JEAN-CHRISTOPHE MD; BEAUFILS, FRANÇOIS MD; HARTMANN, JEAN-FRANÇOIS MD; AZEMA, DANIELE MD
Critical Care Medicine: January 1988
Clinical Investigations: PDF Only

Meningococcal shock still is associated with high mortality. Along with antibiotics and control of metabolic derangements, standard therapy involves monitoring and maintaining numerous cardiorespiratory variables. From 1980 to 1985, 39 children with meningococcal shock were treated in our pediatric ICU. We obtained full hemodynamic monitoring in 18 (12 survivors, six nonsurvivors). Two hemodynamic patterns were observed: hypovolemia and cardiac failure. Early death was generally related to refractory hypovolemia, probably secondary to severe capillary leak. Survival usually occurred when noticeable cardiac failure was controlled with early use of catecholamines and judicious fluid management. Because cardiac failure only slowly recovered, a therapeutic approach that aims not at normal variables but, rather, at survival variables seems appropriate.

© Williams & Wilkins 1988. All Rights Reserved.