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Pediatric Septic Shock
- Sepsis is the most common cause of pediatric deaths worldwide.
- Recognition is paramount! Delayed Dx = Higher Mortality
- Hypotension is a late finding.
- Look for other signs of End Organ Hypoperfusion
- Prolonged Cap Refill, Change in MS
- Tachycardia, Tachypnea
- Elevated Lactate / unexplained metabolic acidosis
- Management strategy is similar to that of adults
- Get access (Don’t forget your I/O’s if necessary)!
- Fluid Resuscitation is the most important aspect of the management
- Get 20-60ml/kg infused within the first 15 minutes
- Children with septic shock who get >40ml/kg before the first hour have increased survival compared to those who do not.
- They may require 60-200ml/kg over the first few hours.
- Get your Abx on board quickly
- Currently there are Protocols that are based on the Adult Surviving Sepsis Campaign.
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005 Jan;6(1):2-8.