Pediatric Septic Shock

• Low cardiac output is associated with high mortality in pediatric shock.
• Volume resuscitation is initial goal in treatment of shock
• Use 20ml/kg of NS bolus infuse over 20 min or less  
• May need to repeat 3-4 times, in a pt with healthy heart and kidneys since patient may have third spacing. there is no significant risk of respiratory or cerebral edema
• After 3- 4 boluses of NS if no improvement in perfusion consider inotropes. Epinephrine is drug of choice to start at 0.01mcg/kg/min
• Antibiotics should be started ASAP.
• Remember children can only improve their Cardiac output by increasing the heart rate. hypotension is a LATE and ominous sign of shock.

The information provided is intended as a resource only not medical advice.

Reference Article:  Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock.  Critical Care Medicine 2002 Vol. 30, No 6

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