Noradrenaline use for septic shock in children: doses, routes of administration and complications

Acta Paediatrica
M E LampinFrancis Leclerc

Abstract

To report our 10 year experience with noradrenaline use in children with septic shock focusing on doses, routes of administration and complications. Retrospective single-centre review of children with septic shock who received noradrenaline between 2000 and 2010. We identified 144 children with septic shock treated with noradrenaline, in 22% as the first-line drug. The median volume resuscitation before vasoactive agent administration was 50 mL/kg interquartile range [IQR: 30-70]. Mean doses of noradrenaline ranged from 0.5 ± 0.4 μg/kg per min (starting dose) to 2.5 ± 2.2 μg/kg per min (maximum dose). Noradrenaline was administered via peripheral venous access or intra-osseous route in 19% of cases for a median duration of 3 h [IQR: 2-4] without any adverse effects. The use of noradrenaline increased over the study period. Mortality rate was 45% with a significant decrease over the study period. Adverse effects included arrhythmia in two children and hypertension in eight children. None of these arrhythmias required treatment and hypertension resolved with the noradrenaline dose reduction. Higher doses of noradrenaline than those suggested in the literature may be necessary to reverse hypotension and hypoperfusion. The use of n...Continue Reading

References

Aug 1, 1998·Pediatrics·G CenevivaJ A Carcillo
Aug 3, 2000·Intensive Care Medicine·S G TordoffA W Williams
Oct 11, 2001·Critical Care Medicine·S Tabbutt
Nov 16, 2002·American Journal of Respiratory and Critical Care Medicine·R Scott WatsonDerek C Angus
Jul 2, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Martha C KutkoBruce M Greenwald
Nov 16, 2004·Critical Care Medicine·Richard J BealeJoseph E Parrillo
Jan 8, 2005·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Brahm GoldsteinUNKNOWN International Consensus Conference on Pediatric Sepsis
Jul 18, 2006·Methods and Findings in Experimental and Clinical Pharmacology·S KatsaragakisI Bramis
Oct 20, 2007·Critical Care : the Official Journal of the Critical Care Forum·Martine MaatJan A Hazelzet
Dec 26, 2007·Critical Care Medicine·R Phillip DellingerUNKNOWN World Federation of Societies of Intensive and Critical Care Medicine
May 27, 2008·Intensive Care Medicine·Andrea WolflerUNKNOWN Italian Pediatric Sepsis Study (SISPe) group
Dec 27, 2008·Médecine et maladies infectieuses·K MenifN Benjaballah
Jan 10, 2009·Archives of Disease in Childhood·D P InwaldUNKNOWN Paediatric Intensive Care Society Study Group (PICS-SG)
Mar 28, 2009·Critical Care Medicine·Hector R WongUNKNOWN Genomics of Pediatric SIRS/Septic Shock Investigators
Mar 5, 2010·The New England Journal of Medicine·Daniel De BackerUNKNOWN SOAP II Investigators
Nov 26, 2010·American Journal of Respiratory and Critical Care Medicine·Steven M Hollenberg

❮ Previous
Next ❯

Citations

Mar 19, 2013·Annals of Intensive Care·Miriam SantschiUNKNOWN members of the Réseau Mère-Enfant de la Francophonie
Jun 22, 2015·The Journal of Emergency Medicine·Graham C Thompson, Charles G Macias
May 8, 2014·British Journal of Clinical Pharmacology·Mehdi OualhaSaïk Urien
Dec 5, 2013·Pediatrics International : Official Journal of the Japan Pediatric Society·Banu Küçükemre AydınFeyza Darendeliler
Feb 8, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Scott L WeissPierre Tissieres
Jun 30, 2019·Annals of Intensive Care·Luc MorinUNKNOWN ESPNIC Refractory Septic Shock Definition taskforce and the Infection, Systemic Inflammation and Sepsis ESPNIC section
Oct 22, 2020·Circulation·Raina M MerchantUNKNOWN Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Life Support, Resuscitation Educa
Mar 16, 2021·Journal of the American College of Emergency Physicians Open·Ramy C CharbelLuc Morin
Mar 29, 2021·Resuscitation·Patrick Van de VoordeIan Maconochie
Apr 18, 2021·Critical Care : the Official Journal of the Critical Care Forum·Victoria S OwenDaniel J Niven
Jun 8, 2021·Notfall & Rettungsmedizin·Patrick Van de VoordeIan Maconochie

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.