Objective To analyse the characteristics of the diagnosis and managements of septic shock after congenital heart operation.Methods From June to October in 2006,we successively observed 422 patients under cardiac operation.Our diagnostic criterion of septic shock after congenital heart operation was below:(1) body temperature above 38.5℃ after 72 hours post-operatively,or after a period of normal temperature;(2) low blood pressure and/or obvious low organs perfusion not related to the operation,or inexplicably hemodynamic changes which had not been resolved after operation;(3) focus of infection;(4) WBC count>20×109/L or 85%,Hb and PLT decreased sharply;(6) CRP increased rapidly;(7) PCT increased rapidly;(8) positive culture.If the patient showed (1),(2) and one of (3)~(8),we should diagnose him/her septic shock after heart operation.The therapy included:(1) volume resuscitation should be used conservatively,usually at 5~10ml/(kg·h);(2) dopamine,dobutamine and milrinone were used routinely,epinephrine [0.05~0.5μg/(kg·min)] added if necessary;(3) if hemodynamics was not stable after the management,norepinephrine [0.2~0.5·min)] would be used with continuous fluid 5~10ml/(kg·h);(4) After 1~2 hours of treatment,if hemodynamics was still unsatisfied,vasopressin 0.1~0.8U/h should be necessary;(5) 5~10ml/(kg·h) liquid should be continued to 4~8 hours.Results Fourteen children were diagnosed with septic shock in all of 422 patients and the mobility was 3.31%.The BP and organ perfusion ameliorated prominently after treatment.Ten patients survived to discharge.Conclusion There are characteristics in the diagnosis and therapy of these patients.Prompt diagnosis and rational management can enhance the survival rate,but the appropriate indication of the operation and satisfactory correction of the anomalies are crucial for better outcome. Key words: Congenital heart disease; Septic shock; Norepinephrine; Vasopressin