TABLE 1.
Hemodynamic Profiles of Multisystem Inflammatory Syndrome in Children Patients Admitted to the ICU Within 48 hr and Requiring Vasoactive Support and Invasive Monitoring
| Hemodynamic Profile of 14 Children From the Onset of Continuous Cardiac Index Monitoring | |||
|---|---|---|---|
| Variable | 0–24 hr | 25–48 hr | p |
| Age-adjusted mean arterial pressure (% from median) | 1 (–8 to 11) | 1 (–6 to 11) | 0.934 |
| Central venous pressure (mm Hg) | 8 (6–11) | 7 (4–11) | 0.140 |
| Stroke volume index (mL/mm2/beat) (normal: 37–47) | 48 (40–66) | 43 (33–53) | 0.036 |
| Cardiac index (L/min/m2) (normal: 2.5–4.0) | 5.0 (4.2–6.6) | 3.7 (3.2–4.8) | < 0001a |
| Systemic vascular resistance index (dynes s/cm5/m2) (normal: 1,970–2,390) | 1,039 (833–1,239) | 1,330 (1,113–1,560) | < 0.001a |
| Median vasoactive doseb | |||
| Epinephrine | 0.01 (0.2–0.05) | 0.02 (0.01–0.02) | < 0.001a |
| Norepinephrine | 0.02 (0.02–0.05) | 0.04 (0.01–0.06) | 0.691 |
| Vasopressin | 0.01 (0.1–0.02) | 0.01 (0.01–0.02) | 0.952 |
| Milrinone | 0 | 0.25 (0.25–0.28) | — |
| Dobutamine | 3 (3–3) | 1 (1–1) | 0.003a |
| Median VIS | 4 (2–7) | 2 (1–4) | < 0.001a |
| Max VIS | 6 (4–12) | 2 (2–5) | 0.003a |
| Arteriovenous oxygen saturation gradient difference (%) | 11 (8–20) | 17 (15–19) | 0.002a |
| Left ventricular functionc | n = 12 | n = 8 | |
| Normal | 6 (50) | 6 (75) | 0.378 |
| Mild | 5 (42) | 1 (13) | |
| Moderate | 1 (8) | 1 (13) | |
| Severe | 0 | 0 | |
VIS = vasoactive-inotropic score.
a
p < 0.003.
b
Vasoactive medication units: epinephrine (µg/kg/min), vasopressinU/kg/min), norepinephrine (µg/kg/min), milrinone (µg/kg/min), dopamine (µg/kg/min), and dobutamine (µg/kg/min).
c
Left ventricular ejection fraction < 30% severely depressed, 30–40% moderately depressed, 40–48% mildly depressed, and > 48% normal.
Hemodynamics were collected as a continuous variable and described as a median (interquartile range) or n (%).