Surkov D. The forming of the acute heart failure and its correction in critically ill children

The dissertation is dedicated to the acute heart failure in children with respiratory disorders. There has been studied peculiarities of the forming of acute heart failure in different ages, proved staging of it development, revealed relations between diastolic and systolic dysfunction and superiority of the diastolic one in children without organic cardiac diseases. Early diagnostic markers of acute heart insufficiency in children were defined. They include tachycardia, hepatomegalia, increase of the end-diastolic dimension of the left ventricle, inversion of E/A ratio or the one-wave transmitral blood flow. Cardiac effects of different sympathetic amines in various ages were although determined. There has been proved that the treatment of choice is dobutamine infusion 5.0-7.0 mcg/kg/min under Doppler control of cardiac output and diastolic patterns. After circulation becoming normal the dobutamine dose must be decreased to 2.5-3.0 mcg/kg/min. The goal is to support CI 3.0-3.5 l/m2/min.