Septic shock in intensive care units. Current focus on treatment

Revista chilena de pediatría
Daniela Arriagada SFranco Díaz R

Abstract

Essential therapeutic principles in children with septic shock persist over time, although some new concepts have been recently incorporated, and fully awareness of pediatricians and intensivists is essential. Fluid resuscitation is a fundamental intervention, but the kind of ideal fluid has not been established yet, as each of these interventions has specific limitations and there is no evidence supportive of the superiority of one type of fluid. Should septic shock persists despite adequate fluid resuscitation, the use of inotropic medication and/or vasopressors is indicated. New vasoactive drugs can be used in refractory septic shock caused by vasopressors, and the use of hydrocortisone should be considered in children with suspected adrenal insufficiency, as it reduces the need for vasopressors. The indications for red blood cells transfusion or the optimal level of glycemia are still controversial, with no consensus on the threshold value for the use of these blood products or the initiation of insulin administration, respectively. Likewise, the use of high-volume hemofiltration is a controversial issue and further study is needed on the routine recommendation in the course of septic shock. Nutritional support is crucial, ...Continue Reading

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Citations

Jan 19, 2016·Revista chilena de pediatría·Daniela Arriagada Santis, Alejandro Donoso Fuentes
Feb 10, 2016·Revista chilena de pediatría·Raúl Bustos B
Dec 21, 2019·Biomédica : revista del Instituto Nacional de Salud·María José Sevilla-SánchezSantiago Ayerbe-González

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