Page 170 - Abstract Book KONIKA 18

Emergency & Pediatric Intensive Care

P-EPIC-018
Pulmonary Abscess in a 4-year-old Girl

Thomas Silaban, Ririe Fachrina Malisie, Wisman Dalimunthe
Department of Child Health, Faculty of Medicine Universitas Sumatera Utara/Haji Adam Malik General Hospital,
Medan, North Sumatera, Indonesia
Abstract
Background Pulmonary abscess or lung abscess is an infection which destroys lung parenchyma leading
to cavitation formed by thick-walled purulent material. Lung abscess can occur at any age, but in children,
morbidity of this disease is lower than adults. Diagnosis of lung abscess usually established radiologically,
even though the clinical symptom was silent. One of the most severe and common complication of pulmonary
abscess is sepsis. Objective To report a case of pulmonary abscess in a girl undergone thoracotomy operation
and surgical drainage procedure. Case A girl aged 4 years, was admitted in Haji Adam Malik General Hospital,
with the main complaint of shortness of breath that has been suffered for 2 weeks before admission. Plain
thorax radiography and Computerized Tomography had been established. Patient had undergone thoracotomy
pneumectomy and surgical drainage due to pulmonary abscess. In Pediatric Intensive Care Unit, patient was
supported with mechanical ventilation to recovered pulmonary edema and maintained oxygenation. Patient
had been treated with antibiotics for 3 weeks to avoid progression of effusion that could develop empyema.
Laboratory tests revealed elevated white blood count, neutrophil to lymphocyte ratio and procalcitonin.
Conclusion Pulmonary abscess was uncommon occurred in children. Wide spectrum antibiotics were needed
for pulmonary abscess with multiple complications eventually consider for surgical drainage. The prognosis
for this patient is favorable.
Keywords: pulmonary abscess; lung abscess; surgical drainage

P-EPIC-019
Hemodynamic Parameters in Pediatric Septic Shock Patients
Patricia Vanessa, Yusrina Istanti, Dewi Ratih, Muhammad Supriatna
Department of Pediatrics, Universitas Diponegoro/Dr. Kariadi General Hospital, Semarang, Central Java, Indonesia
Abstract
Background Septic shock remains a major cause of morbidity and mortality in children in intensive care
unit. Any type of microbes can cause infection leading to septic shock condition. The Ultrasonic Cardiac
Output Monitors (USCOM) device is a non-invasive cardiac output monitor which can determine some
hemodynamic parameters in children with shock. Objective To describe hemodynamic parameters using
USCOM in pediatric septic shock patients. Methods Subjects in this cross-sectional study were children who
were assessed with septic shock and examined using USCOM in Pediatric Intensive Care Unit at Dr. Kariadi
General Hospital Semarang during November 2020 to July 2021. Categorical data were presented with
numbers and frequencies. Results There were 65 children with septic shock. Most of them were 1-12 months
old (32.3%), male (61.5%) and well-nourished (69.2%). The majority result in their blood or urine culture
was sterile (60%). Most of them had poor outcome that the death outcome was found 58.5%. Hemodynamic
parameters that mostly found in these children were low cardiac index (CI) (52.3%) and low stroke volume
index (SVI) (73.8%). Many of them had low (44.6%) or normal (43.1%) corrected flow fime (FTc) as
the preload parameters. The majority of this patients had low inotropy index (49.2%) as the contractility
parameter. Degrees of SVRI as afterload parameter was varied from low (30.8%) to high results (33.8%).
Conclusion Hemodynamic parameters of our septic shock patients are various. The majority of them have
low preload, low contractility and normal afterload. By knowing the characteristics of these parameters, it
is expected to get better experience in providing treatment for children with septic shock.
Keywords: hemodynamic parameters, septic shock, USCOM

122 KONIKA XVIII Abstract Book