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.
