ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation

Oliveira, Cláudio Flauzino de; Oliveira, Débora S. F. de; Gottschald, Adriana F. C.; Moura, Juliana D. G.; Costa, Graziela A.; Ventura, Armando Morais; Fernandes, José Carlos; Vaz, Flávio Adolfo Costa; Carcillo, Joseph A.; Rivers, Emanuel P.; Troster, Eduardo Juan

doi:10.1007/s00134-008-1085-9

Cited by 346 publications

(247 citation statements)

References 35 publications

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“…One RCT476 conforming to the PICO process was found. Application of the American College of Critical Care Medicine (ACCM)/Pediatric Advanced Life Support (PALS) guideline,453 which calls for the continuous monitoring of ScvO 2 , was linked to a decrease in 28‐day mortality rate and a lower incidence of novel organ disorders in comparison to cases where ACCM/PALS was not applied.…”

Section: Cq19: Pediatric Considerationsmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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Section: Cq19: Pediatric Considerationsmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

View full text Add to dashboard Cite

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“…Some studies have added other goals, such as superior vena cava saturations [8]. In that study there was a substantial improvement in mortality in the group where superior vena caval saturations were targeted, but the actual difference in therapy was that these patients received more fluid in the first hour of resuscitation.…”

Section: Respiratory Supportmentioning

confidence: 99%

“…In the 1960s mortality from septic shock in children was close to 100 % [6], and in many countries today mortality from pediatric septic shock is 10 % or less [7,8] (better in previously well children than in those with chronic illness) although there may still be significant associated morbidity [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

Argent

2013

Curr Pediatr Rep

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While there has been a reduction in the number of children dying of septic shock in the richer countries of the world, septic shock remains an important cause of both mortality and morbidity for children across the world. Major reduction in the incidence of septic shock will depend on the implementation of public health measures, including immunization. Improvements in outcome of pediatric septic shock have been closely linked to early recognition (although this may be challenging in many situations); early antibiotic administration; early and appropriate fluid administration and subsequent escalation of critical care. A particular challenge has been the development and implementation of systems to ensure that these elements of management are reliably and efficiently implemented in children (even in well-resourced countries). Recent studies have highlighted the complexity of caring for patients with acute severe sepsis and septic shock in countries with fewer resources, and there is an urgent need for further studies to elucidate the implications of these studies for the management of children with septic shock, particularly in settings where additional critical care support such as inotropic or ventilator support may not be readily available.

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“…com L a determinación del gasto cardiaco (GC) es una herramienta útil para guiar la terapia de pacientes en estado de choque, cuando es incorporado a algoritmos de tratamiento específico [1][2][3] , permitiendo una aproximación más racional y personalizada a la reanimación con fluidos y catecolaminas [4][5][6] . Los signos clínicos para reconocer una entrega de oxígeno (DO 2 ) inadecuada son inespecíficos y la capacidad para estimar un GC reducido en niños sólo con examen físico es muy limitada 7 .…”

unclassified

“…(1) GC a 1/ΔVACO 2 (2) donde VCO 2 es la producción de CO 2 , CaCO 2 y CvCO 2 corresponden al contenido arterial y venoso central de CO 2 , respectivamente. El principio de Fick afirma que el flujo de la difusión de una sustancia es proporcional a la gradiente de la concentración en esa dirección.…”

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Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

et al. 2012

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ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation

Abstract: This study supports the current ACCM/PALS guidelines. Goal-directed therapy using the endpoint of a ScvO(2)> or =70% has a significant and additive impact on the outcome of children and adolescents with septic shock.

Cited by 346 publications

References 35 publications

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

Diferencia veno-arterial de dióxido de carbono como predictor de gasto cardiaco disminuido en modelo pediátrico experimental

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