INTENSIVE TREATMENT OF SEPTIC SHOCK IN PEDIATRIC PRACTICE
https://doi.org/10.52485/19986173_2024_2_61
Abstract
In pediatric practice, septic shock (SS) is a serious, urgent condition with a high incidence and increased risk of death. Intensive therapy in this condition is based on provision of volume-expansion fluid management, prescription of antibiotic medications, and vasopressor support. Urgent care for children is provided in an intensive care unit and includes mandatory determination of the aetiology of SS (by inoculation of blood samples for sterility), provision of venous access and continuous monitoring of vital signs with measurement of lactate levels. The intensity of respiratory support changes according to the following stepwise logic: oxygen therapy – non-invasive ventilation – mechanical ventilation. When providing fluid management to a patient with SS, preference is given to crystalloid solutions. Antibacterial therapy is devised empirically and must be administered within the first hour of ICU admission. If fluid management proves insufficient to ensure stable hemodynamic parameters, vasopressor support is provided by administering inotropic agents, vasodilators and inodilators (norepinephrine, epinephrine, dopamine and dobutamine). Evidence on the effectiveness of corticosteroids in children and adolescents with SS is lacking. Knowledge of the latest algorithms of intensive treatment of SS in pediatric practice will enhance the quality of care and improve the therapeutic prognosis in this category of patients.
About the Authors
Yu. V. Bykov
Stavropol State Medical University; City Children's Clinical Hospital named after G.K. Filippsky
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017;
5 Ponomareva str., Stavropol, 355002
A. N. Obedin
Stavropol State Medical University; Stavropol Regional Clinical Perinatal Center No. 1
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017;
3/1 Semashko str., Stavropol, 355002
O. V. Zinchenko
Stavropol State Medical University
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017
A. А. Muravyeva
Stavropol State Medical University
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017
I. V. Yatsuk
Stavropol State Medical University; Stavropol City Clinical Emergency Hospital
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017;
17 Tukhachevsky str., Stavropol, 355032
E. V. Volkov
Stavropol State Medical University; Stavropol Regional Clinical Hospital
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017;
1 Semashko str., Stavropol, 355002
V. V. Fischer
Stavropol State Medical University; Shpakovskaya District Hospital
Russian Federation
Russian Federation
310 Mira str., Stavropol, 355017;
1 Lenin str., Stavropol, 356240
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Review
For citations:
Bykov Yu.V., Obedin A.N., Zinchenko O.V., Muravyeva A.А., Yatsuk I.V., Volkov E.V., Fischer V.V. INTENSIVE TREATMENT OF SEPTIC SHOCK IN PEDIATRIC PRACTICE. Transbaikalian Medical Bulletin. 2024;(2):61-72. (In Russ.) https://doi.org/10.52485/19986173_2024_2_61
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