Update on pediatric sepsis: a review

Kawasaki, Tatsuya

doi:10.1186/s40560-017-0240-1

Cited by 72 publications

(55 citation statements)

References 121 publications

(178 reference statements)

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“…15 It seems that antibiotics administration in children within 3 hours after diagnosis did not lead to increased mortality. 16,17 It is not suggested that antibiotics can be delayed in children with severe sepsis or septic shock, due to the limitations of this study. Another important key intervention in pediatric sepsis is fluid administration as rapidly as possible.…”

Section: Discussionmentioning

confidence: 93%

Bundle Adherence of Intravenous Antibiotic Fluid Resuscitation and Vasopressor in Children with Severe Sepsis or Septic Shock

Barboza¹,

Valete²,

Silva³

2020

Indian Journal of Critical Care Medicine

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Objective: The aim of this study was to measure the effects of a bundle of interventions in children admitted with severe sepsis or septic shock in the first hour after diagnosis on mortality. Materials and methods: A retrospective study was conducted at a pediatric intensive care unit (PICU) between January 2014 and January 2016. Three interventions (intravenous [IV] antibiotic, fluid boluses, and vasopressor administration) applied in the first hour of severe sepsis or septic shock diagnosis were analyzed according to their adherence rates. The main outcome was mortality. Odds ratios were calculated. Results: Of a total of 530 PICU admissions, 105 patients met the criteria for sepsis, 53 (50.5%) with severe sepsis and 52 (49.5%) with septic shock. Seventy-two (68.6%) patients received IV antibiotic within the first hour, 65 (61.9%) received IV fluid bolus, and 55 (53.3%) received a vasopressor drug. Fifty-two (49.5%) patients received concomitant IV antibiotics and fluid bolus. Blood cultures were collected before IV antibiotic administration in 87 (82.9%) out of 105 patients. Thirteen (12.4%) patients died, 1 with severe sepsis and 12 with septic shock. In a univariate analysis, the odds ratios for death and IV antibiotic were 6.39 (p value = 0.081, 95% CI = 0.795-51.465), 4.77 for fluid bolus between 21 and 40 mL/kg (p value = 0.013, 95% CI = 1.395-16.336), and 3.23 for vasopressor administration (p value < 0.0001, 95% CI = 1.734-6.018). In a multivariate analysis, the odds ratio of fluid bolus between 21 and 40 mL/kg was 42.66 (p value = 0.005, 95% CI = 3.117-583.841) and noradrenaline use was 23.93 (p value = 0.010, 95% CI = 2.124-269.750). Conclusion: Adherence was observed for more than half of the single interventions as IV antibiotic, fluid resuscitation, and vasopressor administration in the first hour. The antibiotic administration alone was not associated with high mortality. Vasopressor administration was related to higher mortality but moderate fluid bolus was a protective factor associated with lower mortality.

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Section: Discussionmentioning

confidence: 93%

Bundle Adherence of Intravenous Antibiotic Fluid Resuscitation and Vasopressor in Children with Severe Sepsis or Septic Shock

Barboza¹,

Valete²,

Silva³

2020

Indian Journal of Critical Care Medicine

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“…В лечении рефрактерного к жидкости и допамину/ добутамину шока используют внутривенное капельное введение эпинефрина/норэпинефрина в зависимости от типа СШ [8]. При холодном шоке эпинефрин в дозе 0,05-0,3 мкг/кг в минуту стимулирует преимущественно -адренорецепторы, оказывая преимущественно инотропное действие: увеличивает силу сердечных сокращений и ударный объем крови, снижает общее периферическое сосудистое сопротивление.…”

Section: лечение шоковых состоянийunclassified

Shock in pediatric infection diseases

Блохин

Гаврютина

2019

Det. infekc.

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Шоковые состояния при острых инфекционных заболеваниях у детей Б. М. БЛОХИН, И. В. ГАВРЮТИНА Российский национальный исследовательский медицинский университет им. Н. И. Пирогова, Москва, Россия Шок -смертельно опасное осложнение инфекционных заболеваний у детей. Основной причиной высокой смертности среди детского населения является поздняя диагностика и нерациональный подход к терапии шока. Вариабельность клинической картины требует формирования четкого алгоритма поиска методов диагностики и тактики лечения детей в зависимости от тяжести состояния. Ключевые слова: шок, сепсис, септический шок, детские инфекции, осложнения Shock is a frequent, lethally dangerous complication of infectious diseases in children. The main reason for high mortality among children population is late diagnostics and irrational therapy. The variability of clinical picture urges to develop a clear algorithm for searching shock markers and therapeutic approaches depending on the severity.

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“…Auf pädiatrischen Intensivstationen, auf denen häufig Kinder mit besonderem Risikoprofil (▶ Tab. 1) behandelt werden, ist die Inzidenz der Sepsis deutlich höher und liegt bei etwa 8-25 % der aufgenommenen Patienten [4,6].…”

Section: Bedeutung Von Akuten Lebensbedrohlichen Infektionenunclassified