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Indian Journal of Pediatrics
Published in: Indian Journal of Pediatrics 6/2011

01-06-2011 | Symposium on PICU Protocols of AIIMS

Management of Septic Shock

Authors: Rakesh Lodha, Tejo Pratap Oleti, S. K. Kabra

Published in: Indian Journal of Pediatrics | Issue 6/2011

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Abstract

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.
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Metadata
Title
Management of Septic Shock
Authors
Rakesh Lodha
Tejo Pratap Oleti
S. K. Kabra
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Indian Journal of Pediatrics / Issue 6/2011
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-011-0415-z

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