Morin, L;
Kneyber, M;
Jansen, NJG;
Peters, MJ;
Javouhey, E;
Nadel, S;
Maclaren, G;
... ESPNIC Refractory Septic Shock Definition taskforce and the Infe; + view all
(2019)
Translational gap in pediatric septic shock management: an ESPNIC perspective.
Annals of Intensive Care
, 9
, Article 73. 10.1186/s13613-019-0545-4.
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Abstract
Background: The Surviving Sepsis Campaign and the American College of Critical Care Medicine guidelines have provided recommendations for the management of pediatric septic shock patients. We conducted a survey among the European Society of Pediatric and Neonatal Intensive Care (ESPNIC) members to assess variations to these recommendations. Methods: A total of 114 pediatric intensive care physicians completed an electronic survey. The survey consisted of four standardized clinical cases exploring seven clinical scenarios. Results: Among the seven diferent clinical scenarios, the types of fuids were preferentially non-synthetic colloids (albumin) and crystalloids (isotonic saline) and volume expansion was not limited to 60 ml/kg. Early intubation for mechanical ventilation was used by 70% of the participants. Norepinephrine was stated to be used in 94% of the PICU physicians surveyed, although dopamine or epinephrine is recommended as frst-line vasopressors in pediatric septic shock. When norepinephrine was used, the addition of another inotrope was frequent. Specifc drugs such as vasopressin or enoximone were used in <20%. Extracorporeal life support was used or considered by 91% of the physicians audited in certain specifc situations, whereas the use of high-fow hemofltration was considered for 44%. Conclusions: This pediatric septic shock management survey outlined variability in the current clinician-reported practice of pediatric septic shock management. As most recommendations are not supported by evidence, these fndings outline some limitation of existing pediatric guidelines in regard to context and patient’s specifcity.
| Type: | Article |
|---|---|
| Title: | Translational gap in pediatric septic shock management: an ESPNIC perspective |
| Location: | Germany |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s13613-019-0545-4 |
| Publisher version: | https://doi.org/10.1186/s13613-019-0545-4 |
| Language: | English |
| Additional information: | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10078019 |
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