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MULTICENTER STUDY
P Van de Voorde, B Emerson, B Gomez, J Willems, D Yildizdas, I Iglowstein, E Kerkhof, N Mullen, C R Pinto, T Detaille, N Qureshi, J Naud, J De Dooy, R Van Lancker, A Dupont, N Boelsma, M Mor, D Walker, M Sabbe, S Hachimi-Idrissi, L Da Dalt, H Waisman, D Biarent, I Maconochie, H Moll, J Benito
UNLABELLED: INTRODUCTION AND PURPOSE OF THE STUDY: With this study we aimed to describe a "true world" picture of severe paediatric 'community-acquired' septic shock and establish the feasibility of a future prospective trial on early goal-directed therapy in children. During a 6-month to 1-year retrospective screening period in 16 emergency departments (ED) in 12 different countries, all children with severe sepsis and signs of decreased perfusion were included. RESULTS: A 270,461 paediatric ED consultations were screened, and 176 cases were identified...
May 2013: European Journal of Pediatrics
#22
JOURNAL ARTICLE
R Phillip Dellinger, Mitchell M Levy, Andrew Rhodes, Djillali Annane, Herwig Gerlach, Steven M Opal, Jonathan E Sevransky, Charles L Sprung, Ivor S Douglas, Roman Jaeschke, Tiffany M Osborn, Mark E Nunnally, Sean R Townsend, Konrad Reinhart, Ruth M Kleinpell, Derek C Angus, Clifford S Deutschman, Flavia R Machado, Gordon D Rubenfeld, Steven A Webb, Richard J Beale, Jean-Louis Vincent, Rui Moreno
OBJECTIVE: To provide an update to the "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," last published in 2008. DESIGN: A consensus committee of 68 international experts representing 30 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict of interest policy was developed at the onset of the process and enforced throughout...
February 2013: Critical Care Medicine
#23
JOURNAL ARTICLE
Rakesh Lodha, Tejo Pratap Oleti, S K Kabra
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...
June 2011: Indian Journal of Pediatrics
#24
JOURNAL ARTICLE
Gérard Chéron, Jean Philippe Jais, Bogdan Cojocaru, Nathalie Parez, Dominique Biarent
We tested the hypothesis that application of the principles learned from the European Paediatric Life Support (EPLS) course improves child health assessment and care. In a retrospective study, residents from five paediatric emergency departments were included. For each of them, we analysed five medical records of infants and children suffering from diarrhoea; three were in ambulatory care and two were in-hospital care with IV hydration. Two independent observers analysed the records using a standardized checklist of 14 clinical points, as well as three items to evaluate the adequacy of treatment according to hydration status...
September 2011: European Journal of Pediatrics
#25
JOURNAL ARTICLE
Andrea T Cruz, Andrew M Perry, Eric A Williams, Jeanine M Graf, Elizabeth R Wuestner, Binita Patel
BACKGROUND: Suboptimal care for children with septic shock includes delayed recognition and inadequate fluid resuscitation. OBJECTIVE: To describe the implementation of an emergency department (ED) protocol for the recognition of septic shock and facilitate adherence to national treatment guidelines. PATIENTS AND METHODS: Root-cause analyses and morbidity and mortality conferences identified system problems with sepsis recognition and management...
March 2011: Pediatrics
#26
JOURNAL ARTICLE
Niranjan Kissoon, Richard A Orr, Joseph A Carcillo
Shock is a major preventable cause of morbidity and mortality in children referred to emergency care. The recently updated American College of Critical Care Medicine guidelines for the management of newborns and children with septic shock emphasize the role of emergency care in improving survival and functional outcomes. Implementation of these guidelines of stepwise use of fluids, antibiotics, and, if necessary, inotropes within the first hour of admission to the emergency department can reduce mortality and neurological morbidity risks 2-fold...
November 2010: Pediatric Emergency Care
#27
REVIEW
Cláudio Flauzino de Oliveira
In the whole world, around 29,000 children younger than 5 years die every day, and sepsis is the most common cause of death. Whereas in adult patients vasomotor paralysis represents the predominant cause of mortality, death in pediatric sepsis is associated with severe hypovolemia and low cardiac output. The purpose of this article was to review the recent evidence on early treatment of pediatric severe sepsis and septic shock. Although current American College of Critical Care Medicine-Pediatric Advanced Life Support guidelines represent best practice, stronger evidences are lacking to confirm the components of these recommendations...
September 2010: Shock
#28
MULTICENTER STUDY
Scott M Sutherland, Michael Zappitelli, Steven R Alexander, Annabelle N Chua, Patrick D Brophy, Timothy E Bunchman, Richard Hackbarth, Michael J G Somers, Michelle Baum, Jordan M Symons, Francisco X Flores, Mark Benfield, David Askenazi, Deepa Chand, James D Fortenberry, John D Mahan, Kevin McBryde, Douglas Blowey, Stuart L Goldstein
BACKGROUND: Critically ill children with hemodynamic instability and acute kidney injury often develop fluid overload. Continuous renal replacement therapy (CRRT) has emerged as a favored modality in the management of such children. This study investigated the association between fluid overload and mortality in children receiving CRRT. STUDY DESIGN: Prospective observational study. SETTING & PARTICIPANTS: 297 children from 13 centers across the United States participating in the Prospective Pediatric CRRT Registry...
February 2010: American Journal of Kidney Diseases
#29
JOURNAL ARTICLE
Joe Brierley, Joseph A Carcillo, Karen Choong, Tim Cornell, Allan Decaen, Andreas Deymann, Allan Doctor, Alan Davis, John Duff, Marc-Andre Dugas, Alan Duncan, Barry Evans, Jonathan Feldman, Kathryn Felmet, Gene Fisher, Lorry Frankel, Howard Jeffries, Bruce Greenwald, Juan Gutierrez, Mark Hall, Yong Y Han, James Hanson, Jan Hazelzet, Lynn Hernan, Jane Kiff, Niranjan Kissoon, Alexander Kon, Jose Irazuzta, John Lin, Angie Lorts, Michelle Mariscalco, Renuka Mehta, Simon Nadel, Trung Nguyen, Carol Nicholson, Mark Peters, Regina Okhuysen-Cawley, Tom Poulton, Monica Relves, Agustin Rodriguez, Ranna Rozenfeld, Eduardo Schnitzler, Tom Shanley, Saraswati Kache, Peter Skippen, Adalberto Torres, Bettina von Dessauer, Jacki Weingarten, Timothy Yeh, Arno Zaritsky, Bonnie Stojadinovic, Jerry Zimmerman, Aaron Zuckerberg
BACKGROUND: The Institute of Medicine calls for the use of clinical guidelines and practice parameters to promote "best practices" and to improve patient outcomes. OBJECTIVE: 2007 update of the 2002 American College of Critical Care Medicine Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock. PARTICIPANTS: Society of Critical Care Medicine members with special interest in neonatal and pediatric septic shock were identified from general solicitation at the Society of Critical Care Medicine Educational and Scientific Symposia (2001-2006)...
February 2009: Critical Care Medicine
#30
RANDOMIZED CONTROLLED TRIAL
Cláudio F de Oliveira, Débora S F de Oliveira, Adriana F C Gottschald, Juliana D G Moura, Graziela A Costa, Andréa C Ventura, José Carlos Fernandes, Flávio A C Vaz, Joseph A Carcillo, Emanuel P Rivers, Eduardo J Troster
INTRODUCTION: The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO(2) > or = 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated...
June 2008: Intensive Care Medicine
#31
JOURNAL ARTICLE
R Phillip Dellinger, Mitchell M Levy, Jean M Carlet, Julian Bion, Margaret M Parker, Roman Jaeschke, Konrad Reinhart, Derek C Angus, Christian Brun-Buisson, Richard Beale, Thierry Calandra, Jean-Francois Dhainaut, Herwig Gerlach, Maurene Harvey, John J Marini, John Marshall, Marco Ranieri, Graham Ramsay, Jonathan Sevransky, B Taylor Thompson, Sean Townsend, Jeffrey S Vender, Janice L Zimmerman, Jean-Louis Vincent
OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding...
January 2008: Critical Care Medicine
#32
JOURNAL ARTICLE
R Phillip Dellinger, Mitchell M Levy, Jean M Carlet, Julian Bion, Margaret M Parker, Roman Jaeschke, Konrad Reinhart, Derek C Angus, Christian Brun-Buisson, Richard Beale, Thierry Calandra, Jean-Francois Dhainaut, Herwig Gerlach, Maurene Harvey, John J Marini, John Marshall, Marco Ranieri, Graham Ramsay, Jonathan Sevransky, B Taylor Thompson, Sean Townsend, Jeffrey S Vender, Janice L Zimmerman, Jean-Louis Vincent
OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding...
January 2008: Intensive Care Medicine
#33
REVIEW
José Irazuzta, Kevin J Sullivan, Pedro Celiny R Garcia, Jefferson Pedro Piva
OBJECTIVES: Septic shock (SS) is a frequent cause for admission to the pediatric intensive care unit, requiring prompt recognition and intervention to improve outcome. Our aim is to review the relevant literature related to the diagnosis and management of SS and present a sequential management for its treatment. SOURCES: Non-systematic review of medical literature using the MEDLINE database. Articles were selected according to their relevance to the objective and according to the authors' opinions...
May 2007: Jornal de Pediatria
#34
REVIEW
Elliot Melendez, Richard Bachur
PURPOSE OF REVIEW: Sepsis requires prompt recognition and aggressive therapy; early goal-directed therapy decreases morbidity and mortality. Recommendations on the specific management of pediatric sepsis have historically been extrapolated from adult literature and from expert/consensus opinion. This review serves to appraise recent recommendations and determine the applicability of newly promoted adult guidelines for pediatric sepsis. RECENT FINDINGS: The first and most recent recommendations on the management of pediatric sepsis were published in 2002 by expert consensus with the recognition that there were few data from randomized controlled trials or meta-analysis...
June 2006: Current Opinion in Pediatrics
#35
JOURNAL ARTICLE
Søren Kjaergaard, Mathias Paul Goldinger, Anne Søe Højberg
Pediatric septic shock is associated with severe hypovolemia, and children frequently respond well to aggressive volume resuscitation. In recent years, improved outcome has been reported when aggressive volume resuscitation and goal-directed therapies were applied to children with septic shock. We report a case of severe meningococcal septic shock in a child aged 16 months where aggressive volume resuscitation and anticoagulation therapy were applied.
January 16, 2006: Ugeskrift for Laeger
#36
REVIEW
S Dauger, J Llor, S Aizenfisz, M Benayoun, F Beaufils
Despite new understandings in pathophysiology, sepsis mortality remains high in children. Recently, it has been demonstrated that early goal directed therapy may decrease septic shock mortality. The aim of this paper is to propose practical clinical guidelines based on earlier consensus recommendations. Septic shock must be rapidly suspected and early recognized. Bases of treatment are maintenance of adequate oxygenation with use of artificial ventilation if necessary, larger and faster volume resuscitation than recommended before, empiric antibiotherapy and early use of vasopressive agents associated with corticosteroids in particular situations...
August 2004: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
#37
COMPARATIVE STUDY
G Iraci, M Gerosa, L Tomazzoli, K Pardatscher, D L Fiore, R Javicoli, A G Secchi
A series of 24 children with anterior optic gliomas, observed and for the most part operated upon in a neurosurgical service, is reviewed. A low incidence of unilateral nerve tumors and of associated neurofibromatosis, and a rather high frequency of precocious or pseudoprecocious puberty were noted in comparison with other series. Most tumors were low-grade growths. The results of surgical treatment reflect a good prognosis for unilateral tumors and an increasing prognostic ominousness for the posterior neoplastic development...
1981: Child's Brain
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