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9.5 - Paediatric Sepsis

from Section 9 - Paediatric Care

Published online by Cambridge University Press:  27 July 2023

By
Andrew J. Jones  and
Thomas Brick
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Sepsis remains a major cause of death in the paediatric population.

  2. 2. Mortality is higher in children with co-morbidities than in those without.

  3. 3. Volume resuscitation is still the mainstay of initial resuscitation.

  4. 4. Adrenaline is a rational choice as a first-line vasoactive agent.

  5. 5. Combining clinical examination with plasma lactate can be used to guide resuscitation.

Keywords

paediatric sepsisseptic shockfluid resuscitationgoal-directed therapylactate
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 703 - 707
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Bhaskar, P, Dhar, AV, Thompson, M, Quigley, R, Modem, V. Early fluid accumulation in children with shock and ICU mortality: a matched case-control study. Intensive Care Med 2015;41:1445–53.CrossRefGoogle ScholarPubMed
Daniels, R, Nutbeam, T, McNamara, G, Galvin, C. The sepsis six and the severe sepsis resuscitation bundle: a prospective observational cohort study. Emerg Med J 2011;28:507–12.CrossRefGoogle ScholarPubMed
Goldstein, B, Giroir, B, Randolph, A; International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005;6:2–8.CrossRefGoogle ScholarPubMed
Han, YY, Carcillo, JA, Dragotta, MA, et al. Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics 2003;112:793–9.CrossRefGoogle ScholarPubMed
Maitland, K, Kiguli, S, Opoka, RO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med 2011;364:2483–95.CrossRefGoogle ScholarPubMed
Weiss, SL, Fitzgerald, JC, Pappachan, J, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med 2015;191:1147–57.CrossRefGoogle ScholarPubMed
Weiss, SL, Peters, MJ, Alhazzani, W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med 2020;46(Suppl 1):10–67.CrossRefGoogle ScholarPubMed

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