Vasopressors in Septic Shock
Journal Title: Journal Of Pediatric Critical Care - Year 2018, Vol 5, Issue 5
Abstract
Severe sepsis and septic shock are complications of infection leading to high morbidity and mortality. Hemodynamic outcomes are considered surrogate markers for survival- an ultimate goal of treatment strategies. The goal of vasoactive agents is to improve arterial blood pressure (age related norms) without associated adverse effects. Early initiation of a vasoactive agent in fl uid-refractory septic shock has a signifi cant role in the outcome; initiation within an hour of presentation is recommended and is associated with favorable outcomes. The choice of the correct vasoactive agent in a given scenario has a pivotal role on the desired outcome as well as the duration to achieve it. Cardiac dysfunction is a well recognized complication of septic shock, occurring in about 60% of the patients. So ionotropes may play a role in septic shock patients with associated myocardial dysfunction and signs of organ hypoperfusion despite achieving adequate preload and mean arterial pressure. In children presentation of septic shock is more complex, predominantly vasoconstricted with low cardiac output. Sometimes they can have deranged myocardial contractility and SVR problems requiring combination of inotropes and vasopressors. Hence the choice of inotrope remains empirical. Vasoactive therapy should be guided by clinical end points.
Authors and Affiliations
Dr. Vinay H Joshi, Preetha Joshi, Guruprasad Shanbhag
Keywords
Related Articles
- EP ID EP404599
- DOI 10.21304/2018.0505.00427
- Views 66
- Downloads 0
Decline in platelet count as a prognostic marker in critically ill children
Objectives: To study the variation in platelet count in critically ill children and correlate its association with their outcomes Methods: This was a prospective cross-sectional analysis of 150 critically ill children ad...
A rare case of Glycogen storage disease type XI Fanconi-Bickel Syndrome
Fanconi-Bickel syndrome (FBS) is an example of proximal Renal tubular dysfunction due to a single gene disorder, it is caused by defects in the facilitative glucose transporter 2 gene that codes for the glucose transport...
Pediatric Trauma, It is Time to Act
.
Neurocritical Care Monitoring
Neurocritical care in children is aimed at the prevention and treatment of secondary brain injury. Advanced neuromonitoring tools have gained popularity over the last decade owing to its ability to gather and integrate i...
A rare case of compound heterozygous B-thalassemia and hereditary persistence of fetal hemoglobin with Moya-Moya disease
Beta thalassemia with hereditary persistence of fetal hemoglobin (HPFH) is a rare disease with a clinical presentation different from thalassemia major and HPFH. The association of HPFH with beta-thalassemia mitigates th...