Objective To investigate the guiding value of bedside ultrasound in fluid management of septic shock in children and its influence on clinical prognosis.Methods A total of 60 children with septic shock in our hospital from October 2021 to February 2023 were selected and divided into two groups according to treatment plan,with 30 cases in each group.The control group received targeted liquid resuscitation treatment,and the observation group received bedside ultrasound monitoring on the basis of the control group.Compare the hemodynamic parameters,bedside ultrasound parameters[heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP)],tissue perfusion parameters,lactate,lactate clearance rate,high mobility group protein-1(HMGB1)/interleukin-23/IL-17 inflammatory axis,cumulative infusion volume,urine volume,and positive fluid balance between two groups at different times,and calculate the mortality rate of the two groups of patients within 28 days of treatment.Results The use time and dosage of vasoactive drugs,mechanical ventilation time,ICU stay time,and total hospitalization time in the observation group were less than those in the control group(all P<0.05).After 6,12,and 24 hours of treatment,the HR and respiratory variability of the inferior vena cava diameter decreased significantly in the two groups,while MAP and CVP,the maximum and minimum diameters of the inferior vena cava diameter,and the output per stroke increased significantly(P<0.05).However,there was no statistically significant difference between the two groups(P>0.05);the HR and Pv-aCO2 levels in the observation group were lower than those in the control group at 6,12,and 24 hours of treatment(all P<0.05);the observation group had lower lactate levels and higher lactate clearance rates than the control group at 6,12,and 24 hours of treatment(all P<0.05);the levels of HMGB1,IL-23 and IL-17 in observation group were lower than those in control group at 6 hours,12 hours and 24 h after treatment(all P<0.05);the accumulative infusion volume and positive fluid balance volume of observation group were lower than control group after 12 hours and 24 hours treatment,and urine was higher than control group(all P<0.05);there was no significant difference in 28-day mortality between the two groups(P>0.05).Conclusion Bedside ultrasound has certain guiding value in fluid management of septic shock in children,which can help improve tissue perfusion indexes,reduce inflammatory response,shorten hospital stay,and contribute to the remission of the disease of children.
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