UMEM Educational Pearls

Category: Pediatrics

Title: Pediatric Septic Shock

Keywords: Sepsis, Shock, Tachycardia, Hypotension (PubMed Search)

Posted: 10/19/2007 by Sean Fox, MD (Updated: 12/5/2019)
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Pediatric Septic Shock

  • Sepsis is the most common cause of pediatric deaths worldwide.
  • Recognition is paramount!  Delayed Dx = Higher Mortality
    • Hypotension is a late finding. 
    • Look for other signs of End Organ Hypoperfusion
      • Prolonged Cap Refill, Change in MS
      • Tachycardia, Tachypnea
      • Elevated Lactate / unexplained metabolic acidosis
  • Management strategy is similar to that of adults
    • Get access (Don’t forget your I/O’s if necessary)!
    • Fluid Resuscitation is the most important aspect of the management
      • Get 20-60ml/kg infused within the first 15 minutes
      • Children with septic shock who get >40ml/kg before the first hour have increased survival compared to those who do not.
        • They may require 60-200ml/kg over the first few hours.
    • Get your Abx on board quickly
    • Currently there are Protocols that are based on the Adult Surviving Sepsis Campaign.

Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.  Pediatr Crit Care Med. 2005 Jan;6(1):2-8.