| Objective:The value of right heart function in children with severe pneum onia and heart failure was explored by Ultrasonic Cardiac Output Monitor(US COM).Methods:Retrospective study between January 2019 and March 2020,Kunming medical university affliated children's hospital of respiratory and critical care branch line of BNP,hs-cTnT,CK-MB and USCOM right heart function monitoring 35 patients with severe pneumonia complicated with heart failure as the case group(group A),the department at the same time on the same line with above indicators monitoring in 30 patients with severe pneumonia(group B)and 35 patients with general pneumonia as the control group(group C).USCOM was used to measure the right ventricular related indicators(FTc,SV,CO,SMII,SVR)and blood sampling for BNP,hs-cTnT and CK-MB in the case group on the day of admission and in the recovery period,and in the control group on the day after admission.To analyze the correlation between USCOM right ventricular relevant indicators and serum BNP in group A.Results:1.A group of children with acute period serum BNP(pg/ml)[164.00(111.00,345.00)],hs-cTnT(pg/ml)[78.77(61.09,90.00)]and CK-MB(u/L)[37.00(23.00,46.00)]levels were higher than group B[51.75(48.88,66.80);61.37(38.55,74.17);22.10(18.00,34.78)]and group C[17.70(9.20,35.10);26.47(10.07,38.48);23.00(18.90,34.00)](all P<0.05).2.A group of children with acute period USCOM right ventr icular indicators FTc(ms)[323.00(311.00,332.00)]?SV(ml)[8.40(7.30,10.00)]·CO(L/min)[1.50(1.30,1.80)]?SM?(w/m2)[(1.20±0.25)]were lower than group B[349.00(343.75,356.50);12.45(12.00,13.00);1.88(1.73,1.98);(1.50±0.20)]and group C[385.00(372.00,395.00);16.30(14.00,19.00);2.00(1.90,2.20);(1.86±0.36)],while the SVR(d.s.cm'5)[4800.00(4111.00,4982.00)]was higher than group B[2582.50(2493.75,2734.50)]and group C[2145.00(1784.00,2653.00)](all P<0.05).3.A group of chil dren with acute period serum BNP(pg/ml)[164.00(111.00,345.00)],hs-cTnT(pg/ml)[78.77(61.09,90.00)],CK-MB(u/L)[37.00(23.00,46.00)],SVR(d.s.cm'5)[4800.00(4111.00,4982.00)]levels were significantly higher than the recovery period[34.00(14.20,69.90);17.80(10.20,33.30);15.90(12.80,22.90);2362.00(1977.00,2735.00)],FTc(ms)[323.00(311.00,332.00)]?SV(ml)[8.40(7.30,10.00)]?CO(L/min)[1.50(1.30,1.80)]?S MII(w/m2)[(1.20±0.25)]were significantly lower than the recovery period[379.00(370.00,394.00);17.00(15.00,18.00);2.10(1.80,2.40);1.85±0.40].The differences wer e statistically significant(all P<0.05).4.In group A,the acute period USCOM rig ht ventricular indicators SVR was positively correlated with serum BNP(r=0.607,P<0.05),while FTc,SV,CO,SMII were negatively correlated with it(r=-0.601,-0.527,-0.647,-0.744,P<0.05)and positively correlated with SVR(r=0.607,P<0.05).Conclusion(s):1.USCOM right ventricular relevant indicators(FTc,SV,CO,SMII and SVR)have a good correlation with BNP level,which all can reflect the changs of right cardiac function sensitively and accurately the right cardiac function changes of ventricular function of children with severe pneumonia without heart failure and severe pneumonia complicated with heart failure.2.USCOM has great clinical application value and it is worthy of promotion. |
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