Affiliations: Division of Critical Care, BC Children's Hospital,
University of British Columbia, Vancouver, British Columbia, Canada
Note: [] Correspondence: Niranjan Kissoon, MD, CPE, University of British
Columbia, British Columbia Children's Hospital, Room K4-105, 4480 Oak Street,
Vancouver, British Columbia V6H 3V4, Canada. Tel.: +1 604 875 2507; Fax: +1 604
875 3076; E-mail: nkissoon@cw.bc.ca
Abstract: Early recognition of pediatric severe sepsis and septic shock
followed by aggressive protocolized clinical management are the keys to
improving mortality outcomes. Timely admission to the pediatric intensive care
unit allows ongoing aggressive resuscitation, and early institution of targeted
therapy guided by central venous pressure and mixed venous oximetry. This
allows optimization of management according to changing hemodynamic patterns.
Early application of lung protective strategies before the onset of an acute
lung injury, or after its development as well as management of acute kidney
injury can reduce morbidity and mortality from sepsis. Increasing experience
with extracorporeal membrane oxygenation and plasmapheresis may improve
outcomes in septic shock in the future.
Keywords: Sepsis, septic shock, intensive care, management, child
