Document Detail


Management of Septic Shock.
MedLine Citation:
PMID:  21541646     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Septic shock is an important cause of mortality in children with sepsis. The incidence of septic shock is 2-4% of admissions in western pediatric intensive care units and 40%-67% for Indian PICUs. Early goal-directed resuscitation that includes aggressive fluid resuscitation of up to 60 mL/kg as boluses of 20 mL/kg by IV push, to achieve desired heart rates and blood pressure, has emerged as mainstay of treatment in the initial stage. Crystalloids are the preferred fluids, while colloids may be used in some situations. Fluid refractory shock warrants use of vasoactive drugs. Dopamine is the first choice. Dobutamine and low dose epinephrine are the preferred inotropic drugs while nor-epinephrine is a vasopressor. Children with cold shock and normal blood pressure may benefit from nitrosodilators like nitroprusside and nitroglycerine. Inodilators such as milrinone are also useful in this situation. Targeting clinical therapeutic end-points assists the management. Good supportive care is also essential for improving the outcomes.
Authors:
Rakesh Lodha; Tejo Pratap Oleti; S K Kabra
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-4
Journal Detail:
Title:  Indian journal of pediatrics     Volume:  -     ISSN:  0973-7693     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417442     Medline TA:  Indian J Pediatr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India, rakesh_lodha@hotmail.com.
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