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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care</journal-title><trans-title-group xml:lang="ru"><trans-title>Российский вестник детской хирургии, анестезиологии и реаниматологии</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2219-4061</issn><issn publication-format="electronic">2587-6554</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1867</article-id><article-id pub-id-type="doi">10.17816/psaic1867</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case reports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Клинические случаи</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Focused echocardiography as a tool for differential diagnosis of cardiovascular dysfunction in children with infections: Case reports</article-title><trans-title-group xml:lang="ru"><trans-title>Фокусная эхокардиография как инструмент дифференциальной диагностики кардиоваскулярной дисфункции у детей с инфекционными заболеваниями: клинические наблюдения</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>聚焦超声心动图在儿童感染性疾病心血管功能障碍中的应用：临床观察</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1628-1698</contrib-id><contrib-id contrib-id-type="spin">7584-8788</contrib-id><name-alternatives><name xml:lang="en"><surname>Ermolenko</surname><given-names>Kseniya Yu.</given-names></name><name xml:lang="ru"><surname>Ермоленко</surname><given-names>Ксения Юрьевна</given-names></name><name xml:lang="zh"><surname>Ermolenko</surname><given-names>Kseniya Yu.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>ksyu_astashenok@mail.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1113-5296</contrib-id><contrib-id contrib-id-type="spin">8423-4294</contrib-id><name-alternatives><name xml:lang="en"><surname>Pshenisnov</surname><given-names>Konstantin V.</given-names></name><name xml:lang="ru"><surname>Пшениснов</surname><given-names>Константин Викторович</given-names></name><name xml:lang="zh"><surname>Pshenisnov</surname><given-names>Konstantin V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Assistant Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, доцент</p></bio><bio xml:lang="zh"><p>MD, Dr. Sci. (Medicine), Assistant Professor</p></bio><email>Psh_K@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2131-4813</contrib-id><contrib-id contrib-id-type="spin">2225-1630</contrib-id><name-alternatives><name xml:lang="en"><surname>Aleksandrovich</surname><given-names>Yurii S.</given-names></name><name xml:lang="ru"><surname>Александрович</surname><given-names>Юрий Станиславович</given-names></name><name xml:lang="zh"><surname>Aleksandrovich</surname><given-names>Yurii S.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор</p></bio><bio xml:lang="zh"><p>MD, Dr. Sci. (Medicine), Professor</p></bio><email>jalex1963@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1110-9848</contrib-id><contrib-id contrib-id-type="spin">9631-1989</contrib-id><name-alternatives><name xml:lang="en"><surname>Aleksandrovich</surname><given-names>Irina V.</given-names></name><name xml:lang="ru"><surname>Александрович</surname><given-names>Ирина Валерьевна</given-names></name><name xml:lang="zh"><surname>Aleksandrovich</surname><given-names>Irina V.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Cand. Sci. (Medicine)</p></bio><bio xml:lang="ru"><p>канд. мед. наук</p></bio><bio xml:lang="zh"><p>MD, Cand. Sci. (Medicine)</p></bio><email>iralexzz15@bk.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0427-7344</contrib-id><contrib-id contrib-id-type="spin">7458-6203</contrib-id><name-alternatives><name xml:lang="en"><surname>Konev</surname><given-names>Aleksandr I.</given-names></name><name xml:lang="ru"><surname>Конев</surname><given-names>Александр Иванович</given-names></name><name xml:lang="zh"><surname>Konev</surname><given-names>Aleksandr I.</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>icdrkonev@yandex.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Saint Petersburg State Pediatric Medical University</institution></aff><aff><institution xml:lang="ru">Санкт-Петербургский государственный педиатрический медицинский университет</institution></aff><aff><institution xml:lang="zh">Saint Petersburg State Pediatric Medical University</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Federal Scientific and Clinical Center of Infectious Diseases</institution></aff><aff><institution xml:lang="ru">Федеральный научно-клинический центр инфекционных болезней</institution></aff><aff><institution xml:lang="zh">Federal Scientific and Clinical Center of Infectious Diseases</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">North-Western State Medical University named after I.I. Mechnikov</institution></aff><aff><institution xml:lang="ru">Северо-Западный государственный медицинский университет им. И.И. Мечникова</institution></aff><aff><institution xml:lang="zh">North-Western State Medical University named after I.I. Mechnikov</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-04-23" publication-format="electronic"><day>23</day><month>04</month><year>2025</year></pub-date><volume>15</volume><issue>1</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>101</fpage><lpage>108</lpage><history><date date-type="received" iso-8601-date="2024-12-01"><day>01</day><month>12</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2025-02-17"><day>17</day><month>02</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2025,</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0</ali:license_ref></license></permissions><self-uri xlink:href="https://rps-journal.ru/jour/article/view/1867">https://rps-journal.ru/jour/article/view/1867</self-uri><abstract xml:lang="en"><p>Focused echocardiography is a screening method for evaluating the cardiovascular system in critically ill patients. It is widely utilized worldwide for the differential diagnosis and management of cardiovascular dysfunction in children with infectious diseases requiring treatment in intensive care units. This report presents three clinical cases of cardiovascular dysfunction of unknown origin in pediatric patients admitted to an infectious disease hospital with nonspecific symptoms. Focused echocardiography was performed in all cases, allowing for the identification of the underlying cause of hemodynamic disturbances. The bedside real-time application of focused echocardiography allowed for targeted therapy in all three cases, preventing life-threatening complications — sepsis, cardiac tamponade, and cardiogenic shock — along with continuing standard treatment and facilitating timely decision-making for specialized care. All cases involved cardiac manifestations within the infectious disease process. Each patient achieved full recovery. Focused echocardiography can be used as a simple, reliable, and highly effective tool for the differential diagnosis of cardiovascular dysfunction in children with infectious diseases requiring intensive care. This method deserves broader implementation in routine clinical practice.</p></abstract><trans-abstract xml:lang="ru"><p>Фокусная эхокардиография (от англ. focused echocardiography) — скрининговый метод оценки состояния сердечно-сосудистой системы у пациентов в критическом состоянии, который широко используется в мире с целью дифференциальной диагностики и коррекции кардиоваскулярной дисфункции у детей с инфекционной патологией, нуждающихся в лечении в отделении реанимации и интенсивной терапии. Представлены три клинических случая кардиоваскулярной дисфункции неясного генеза у детей, поступивших в инфекционный стационар с неспецифическими симптомами, которым проводилась фокусная эхокардиография, позволившая установить истинную причину расстройств гемодинамики. Применение фокусной эхокардиографии непосредственно у постели пациента в режиме реального времени позволило во всех трех случаях провести целенаправленную терапию и предотвратить развитие жизнеугрожающих осложнений — сепсиса, тампонады сердца и кардиогенного шока на фоне стандартного общепринятого лечения, приняв своевременное решение об оказании специализированной помощи. У всех пациентов имело место поражение сердца в структуре инфекционной патологии, исход заболевания у всех детей благоприятный — полное выздоровление. Фокусную эхокардиографию можно применять как простой, достоверный и высокоэффективный инструмент дифференциальной диагностики кардиоваскулярной дисфункции у детей с инфекционными заболеваниями, нуждающихся в лечении в отделениях реанимации и интенсивной терапии, заслуживающий широкого внедрения в рутинную практику.</p></trans-abstract><trans-abstract xml:lang="zh"><p>聚焦超声心动图（Focused Echocardiography, FOCUS）是一种用于危重症患者的心血管系统快速评估的筛查工具，在全球范围内广泛用于重症监护和危重病医学科，帮助鉴别诊断和治疗感染性疾病儿童的心血管功能障碍。本文报道了三例因不明原因的心血管功能障碍入院于感染病房的儿童病例，均表现为非特异性症状，并接受了FOCUS超声心动图检查，该方法成功明确了血流动力学异常的真正病因。床旁实时FOCUS超声心动图检查成功确诊了真正的血流动力学异常病因，指导了针对性治疗，并有效预防了败血症、心脏压塞和心源性休克等危及生命的并发症，同时在标准治疗的基础上，及时决策实施专业医疗干预。所有病例均表现出感染性疾病相关的心脏损害，经过精准诊断和及时干预，所有患儿均完全康复。FOCUS超声心动图是一种简便、可靠且高效的心血管功能障碍鉴别诊断工具，特别适用于感染性疾病并需接受重症监护和危重病医学科治疗的儿童患者评估和管理， 值得广泛推广至临床常规诊疗实践。</p></trans-abstract><kwd-group xml:lang="en"><kwd>echocardiography</kwd><kwd>cardiovascular dysfunction</kwd><kwd>children</kwd><kwd>infections</kwd><kwd>intensive care</kwd><kwd>FOCUS protocol</kwd><kwd>case report</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>эхокардиография</kwd><kwd>кардиоваскулярная дисфункция</kwd><kwd>дети</kwd><kwd>инфекции</kwd><kwd>интенсивная терапия</kwd><kwd>FOCUS-протокол</kwd><kwd>клинический случай</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>超声心动图</kwd><kwd>心血管功能障碍</kwd><kwd>儿童</kwd><kwd>感染</kwd><kwd>重症监护</kwd><kwd>FOCUS协议</kwd><kwd>临床病例</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Lekmanov AU, Mironov PI. 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