Sepsis and Septic Shock

✍ Scribed by Maloney, Patrick J.

• Book ID: 120544191
• Publisher: Elsevier Science
• Year: 2013
• Tongue: English
• Weight: 699 KB
• Volume: 31
• Category: Article
• ISSN: 0733-8627
• DOI: 10.1016/j.emc.2013.04.006

✦ Synopsis

Every physician who cares for children is challenged by the difficult tasks of recognizing and managing sepsis and septic shock. Early recognition and therapy are the cornerstones of acute care of the septic child. The rapidity and appropriateness of therapy administered in the initial hours significantly affects outcome. Septic shock in children is less frequently associated with hypotension than it is in adults. Children are more likely to present with a clinical syndrome referred to as cold shock, in which systemic vascular resistance is high and cardiac output is low. Clinically, these children have tachycardia (although neonates may present with bradycardia), pale, cyanotic, or mottled extremities, and prolonged capillary refill time (>3 seconds). Blood pressures may be normal, low, or high. Management of sepsis and septic shock includes respiratory support, aggressive fluid resuscitation, vasopressor therapy, and early antibiotic therapy. The goal is reversal of tissue hypoperfusion. The ideal choice of vasopressor agents in children with septic shock depends on the clinical appearance and hemodynamic status of the child. Mortality from sepsis in children is significantly lower than in adults.