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Septic shock in children 

Septic shock in children
Chapter:
Septic shock in children
Author(s):

Sainath Raman

DOI:
10.1093/med/9780198794592.003.0001
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date: 27 July 2021

Chapter 1 begins by examining the definitions of sepsis and septic shock as subsets of the systemic inflammatory response syndrome, discusses the epidemiology of paediatric sepsis, and provides a structured approach to the assessment of a child with suspected sepsis. The evidence for and limitation of investigations, such as lactate measurement and attempted quantification of cardiac function in paediatric sepsis, is examined. Optimal management strategies for paediatric sepsis remain much studied and debated. This chapter addresses the use of inotropes—both early inotropes and choice of inotropes, intravenous fluids, including the current evidence base for choice of fluids, and the increasingly studied areas of fluid overload and fluid removal (de-resuscitation) following the initial phases of resuscitation. The evidence base for use and timing of antibiotics and steroids is discussed, along with the roles of the supportive therapies renal replacement therapy and extracorporeal membrane oxygenation. Finally, the chapter examines some of the key aspects of the care of patients with sepsis of relevance to intensivists: early goal-directed therapy; sepsis bundles; and the Surviving Sepsis Campaign.

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