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Review
. 2019 Feb 1;117(1):e14-e23.
doi: 10.5546/aap.2019.eng.e14.

Recommendations for the management of pediatric septic shock in the first hour (part one)

[Article in English, Spanish]
Guillermo Kohn Loncarica  1 , Ana Fustiñana  2 , Roberto Jabornisky  3
Affiliations
Free article
Review

Recommendations for the management of pediatric septic shock in the first hour (part one)

[Article in English, Spanish]
Guillermo Kohn Loncarica et al. Arch Argent Pediatr. .
Free article

Abstract
in English, Spanish

In the past two years, different organizations have updated their clinical practice guidelines for hemodynamic support in pediatric septic shock. The studies conducted in adults have questioned the initial management of sepsis in accordance to protocols based on achieving various goals. However, the usefulness of these protocols in children has been demonstrated. The possibility of adhering to guidelines may vary depending on patients and facilities, so it is necessary to update the general aspects of initial care for children with sepsis. The proposal is to shift the paradigm from an "individual practice guideline," which is universal for all, to an "institutional practice guideline" and to assess the factors that should be improved at each facility. This manuscript is divided into two parts. The first part analyzes the bundles for the early detection of septic shock. Part two addresses treatment, stabilization, referral, and process analysis.

En los últimos dos años, diferentes entidades han actualizado las guías de práctica clínica para el soporte hemodinámico en el shock séptico pediátrico. Estudios en adultos han cuestionado el manejo inicial de la sepsis siguiendo protocolos basados en lograr diversas metas. Sin embargo, en niños, la utilidad de estos protocolos ha sido demostrada. Las posibilidades de cumplir las guías pueden diferir entre pacientes e instituciones, por lo que es necesario actualizar los aspectos generales de atención inicial del niño con sepsis. Se propone analizar el cambio de paradigma de "guía de práctica individual", universal para todos, hacia uno de "práctica institucional" y evaluar los factores por mejorar en cada institución. Se divide el manuscrito en dos secciones. La primera analiza los paquetes para la detección temprana de la entidad. La segunda aborda el tratamiento, la estabilización, la referencia y el análisis de procesos.

Keywords: Pediatrics; Ppatient care bundles; Sepsis; Septic shock.

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