Aggiornamento
Lo shock settico in età pediatrica
SEPTIC SHOCK IN CHILDREN
ALBERTO BERARDI, ILARIA MARIOTTI, ROSSELLA PAGANO, FRANCESCA SCIRPOLI, LICIA LUGLI, ELISABETTA GARETTI, MARIA FEDERICA ROVERSI, FABRIZIO FERRARI
Unità di Terapia Intensiva Neonatale, Ospedale Policlinico, Modena Università di Modena e Reggio Emilia
Maggio 2006 - pagg. 289 -297
Abstract
Septic shock is still a leading cause of mortality and morbidity in children. Even if predominant in the first year of life, it can occur at all ages. Early intervention, including ABC of resuscitation, early and aggressive administration of i.v. fluids, and empirical antibiotic therapy changed its prognosis in the last years. Further improvement of septic shock outcome could be obtained in the next future by therapies that can directly modulate inflammatory responses. To increase survival, we underline the need of an early diagnosis, possibly before hospital admission.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Carcillo JA. New developments in the management
of newborn sepsis, shock and multiple
organ failure. Ital J Pediatr 2004;30:383-92.
2. DuPont HL, Spink WW. Infections due to Gram-negative organisms: analysis of 860 patients with bacteremia at the University of Minnesota Medical Center, 1958-1966. Medicine 1969;48:307-32.
3. Stoll BJ, Holman RC, Schuchat A, et al. Decline in sepsis-associated neonatal and infant deaths in the United States, 1979 through
1994. Pediatrics 1998;102:e18.
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5. Carcillo JA, Cunnion RE. Septic Shock. Crit Care Clin 1997;13:553-74.
6. Esmon CT. Protein C anticoagulant pathway and its role in controlling microvascular thrombosis and inflammation. Crit Care Med 2001;29:S48-51.
7. Faust SN, Levin M, Harrison OB, et al. Dysfunction of endothelial protein C activation in severe meningococcal sepsis. N Engl J Med 2001;6:408-16.
8. Bone RC, Sprung CL, Sibbaldd WJ. Definitions for sepsis and organ failure. Crit Care Med 1992;20:724-6.
9. Levy MM, Fink MP, Marshall JC, et al. SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;29:530-8.
10. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6:2-8.
11. Carcillo JA, Fields AI. Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med 2002;30:1365-78.
12. Sparrow A, Willis F. Management of septic shock in childhood. Paediatric Emergency Medicine 2004;16:125-34.
13. Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score. Crit Care Med 1988; 16:1110-16
14. Rivers E, Nguyen B, Havstad S. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 346:1368-77.
15. Mathur NB, Singh A, Sharma VK. Evaluation of risk factors for fatal neonatal sepsis Indian. Pediatrics 2003;112:793-9.
16. Von Rosenstiel N, Von Rosenstiel I, Adam D. Management of sepsis and septic shock in infants and children. Paediatric Drugs 2001; 3:9-27.
17. Parker MM, Hazelzet JA, Carcillo JA. Pediatric considerations. Crit Care Med 2004;32: S591-94.
18. Dauger S, Llor J, Aizenfisz S, Benayoun M, Beaufils F. Approche thérapeutique en 2003 du choc septique de l’enfant dans les deux premières heures. Arch Pediatr 2004;11:1014-7.
19. Powell KR, Sugarman LI, Eskenazi AE. Normalization of plasma arginine vasopressin concentrations when children with meningitis are given maintenance plus replacement fluid therapy. J Pediatr 1990;117:515-22.
20. Feltes TF, Pignatelli R, Kleinert S. Quantitated left ventricular systolic mechanics in children with septic shock utilizing noninvasive wall stress analysis. Crit Care Med 2002;30: 1365-77.
21. Ceneviva G, Paschall JA, Maffei F. Hemodynamic support in fluid refractory pediatric septic shock. Pediatrics 1998;102:e19.
22. Carcillo JA, Davis AL, Zaritsky A. Role of early fluid resuscitation in Pediatric Septic Shock. JAMA 1991;266:1242-5.
23. Castro VL, Astiz ME, Rackow EC. Effect of crystalloid and colloid solutions on blood rheology in sepsis. Shock 1997;8:104-7.
24. Chio PTL, Gordon Y, Quinonez LG. Crystalloids vs colloids in fluid resuscitation: a systemic review. Crit Care Med 1999;27:200-3.
25. Beale RJ, Hollenberg SM, Vincent JL. Vasopressor and inotropic support in septic shock: an evidence-based review. Crit Care Med 2004;32:S455-65.
26. Lindsay C, Barton P, Lawless S, et al. Pharmacokinetics and pharmacodinamics of milrinone lactate in pediatric patients with septic shock. J Pediatr 1998;132:329-34.
27. Masutani S, Senzaki H, Ishido H. Vasopressin in the treatment of vasodilatory shock in children. Pediatrics International 2005;47: 132-6.
28. Benitz We, Malachowski N, Cohen RS, et al. Use of sodium nitroprusside in neonates: Efficacy and safety. J Pediatr1988;106:102-10.
29. Lott JW. Neonatal bacterial sepsis. Crit Care Nurs Clin N Am 2003;15:35-46.
30. Keh D, Sprung CL. Use of corticosteroid therapy in patients with sepsis and septic shock: An evidence-based review. Crit Care Med 2004;32:527-33.
31. Hatherill M, Tibby SM, Hilliard T, et al. Adrenal insufficiency in septic shock. Arch Dis Child 1999;80:51-5.
32. Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699-709.
33. Vincent JL, Angus DC, Artigas A, et al. Effects of drotrecogin alfa (activated) on organ disfunctions in the PROWESS trial. Crit Care Med 2003;31:834-40.
34. Barton PB, Kalil C, Nadel S, et al. Safety, pharmacokinetics of drotrecogin alfa (activated) in children with severe sepsis. Pediatrics 2004;113:7-17.
35. Smith OP, White B, Vaughan B, et al. Use of protein-C concentrate, heparin and haemodiafiltration in Meningococcus-induced purpura fulminans. Lancet 1997;350:1590-3.
36. Rintala E, Kauppila M, Seppala OM, et al. Protein C substitutiom in sepsis-associated purpura fulminans. Crit Care Med 2000;28: 2373-8.
37. Leclerc F, Cremer R, Leteurtre S, Martinot A, Fourier C. Protein C concentrate and recombinant tissue plasminogen activator in meningococcal septic shock. Crit Care Med 2000;28:1694-7.
38. De Klein FD, de Groot R, Hack CE, et al. Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans: a randomized, double-blinded, placebo-controlled, dose finding study. Crit Care Med 2003;31:1839-47.
2. DuPont HL, Spink WW. Infections due to Gram-negative organisms: analysis of 860 patients with bacteremia at the University of Minnesota Medical Center, 1958-1966. Medicine 1969;48:307-32.
3. Stoll BJ, Holman RC, Schuchat A, et al. Decline in sepsis-associated neonatal and infant deaths in the United States, 1979 through
1994. Pediatrics 1998;102:e18.
4. Advanced Life Support Group. Advanced Paediatric Life Support, terza edizione, London; BMJ publishing group 2001.
5. Carcillo JA, Cunnion RE. Septic Shock. Crit Care Clin 1997;13:553-74.
6. Esmon CT. Protein C anticoagulant pathway and its role in controlling microvascular thrombosis and inflammation. Crit Care Med 2001;29:S48-51.
7. Faust SN, Levin M, Harrison OB, et al. Dysfunction of endothelial protein C activation in severe meningococcal sepsis. N Engl J Med 2001;6:408-16.
8. Bone RC, Sprung CL, Sibbaldd WJ. Definitions for sepsis and organ failure. Crit Care Med 1992;20:724-6.
9. Levy MM, Fink MP, Marshall JC, et al. SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;29:530-8.
10. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005; 6:2-8.
11. Carcillo JA, Fields AI. Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med 2002;30:1365-78.
12. Sparrow A, Willis F. Management of septic shock in childhood. Paediatric Emergency Medicine 2004;16:125-34.
13. Pollack MM, Ruttimann UE, Getson PR. Pediatric risk of mortality (PRISM) score. Crit Care Med 1988; 16:1110-16
14. Rivers E, Nguyen B, Havstad S. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 346:1368-77.
15. Mathur NB, Singh A, Sharma VK. Evaluation of risk factors for fatal neonatal sepsis Indian. Pediatrics 2003;112:793-9.
16. Von Rosenstiel N, Von Rosenstiel I, Adam D. Management of sepsis and septic shock in infants and children. Paediatric Drugs 2001; 3:9-27.
17. Parker MM, Hazelzet JA, Carcillo JA. Pediatric considerations. Crit Care Med 2004;32: S591-94.
18. Dauger S, Llor J, Aizenfisz S, Benayoun M, Beaufils F. Approche thérapeutique en 2003 du choc septique de l’enfant dans les deux premières heures. Arch Pediatr 2004;11:1014-7.
19. Powell KR, Sugarman LI, Eskenazi AE. Normalization of plasma arginine vasopressin concentrations when children with meningitis are given maintenance plus replacement fluid therapy. J Pediatr 1990;117:515-22.
20. Feltes TF, Pignatelli R, Kleinert S. Quantitated left ventricular systolic mechanics in children with septic shock utilizing noninvasive wall stress analysis. Crit Care Med 2002;30: 1365-77.
21. Ceneviva G, Paschall JA, Maffei F. Hemodynamic support in fluid refractory pediatric septic shock. Pediatrics 1998;102:e19.
22. Carcillo JA, Davis AL, Zaritsky A. Role of early fluid resuscitation in Pediatric Septic Shock. JAMA 1991;266:1242-5.
23. Castro VL, Astiz ME, Rackow EC. Effect of crystalloid and colloid solutions on blood rheology in sepsis. Shock 1997;8:104-7.
24. Chio PTL, Gordon Y, Quinonez LG. Crystalloids vs colloids in fluid resuscitation: a systemic review. Crit Care Med 1999;27:200-3.
25. Beale RJ, Hollenberg SM, Vincent JL. Vasopressor and inotropic support in septic shock: an evidence-based review. Crit Care Med 2004;32:S455-65.
26. Lindsay C, Barton P, Lawless S, et al. Pharmacokinetics and pharmacodinamics of milrinone lactate in pediatric patients with septic shock. J Pediatr 1998;132:329-34.
27. Masutani S, Senzaki H, Ishido H. Vasopressin in the treatment of vasodilatory shock in children. Pediatrics International 2005;47: 132-6.
28. Benitz We, Malachowski N, Cohen RS, et al. Use of sodium nitroprusside in neonates: Efficacy and safety. J Pediatr1988;106:102-10.
29. Lott JW. Neonatal bacterial sepsis. Crit Care Nurs Clin N Am 2003;15:35-46.
30. Keh D, Sprung CL. Use of corticosteroid therapy in patients with sepsis and septic shock: An evidence-based review. Crit Care Med 2004;32:527-33.
31. Hatherill M, Tibby SM, Hilliard T, et al. Adrenal insufficiency in septic shock. Arch Dis Child 1999;80:51-5.
32. Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med 2001;344:699-709.
33. Vincent JL, Angus DC, Artigas A, et al. Effects of drotrecogin alfa (activated) on organ disfunctions in the PROWESS trial. Crit Care Med 2003;31:834-40.
34. Barton PB, Kalil C, Nadel S, et al. Safety, pharmacokinetics of drotrecogin alfa (activated) in children with severe sepsis. Pediatrics 2004;113:7-17.
35. Smith OP, White B, Vaughan B, et al. Use of protein-C concentrate, heparin and haemodiafiltration in Meningococcus-induced purpura fulminans. Lancet 1997;350:1590-3.
36. Rintala E, Kauppila M, Seppala OM, et al. Protein C substitutiom in sepsis-associated purpura fulminans. Crit Care Med 2000;28: 2373-8.
37. Leclerc F, Cremer R, Leteurtre S, Martinot A, Fourier C. Protein C concentrate and recombinant tissue plasminogen activator in meningococcal septic shock. Crit Care Med 2000;28:1694-7.
38. De Klein FD, de Groot R, Hack CE, et al. Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans: a randomized, double-blinded, placebo-controlled, dose finding study. Crit Care Med 2003;31:1839-47.
Corrispondenza: berardi.alberto@policlinico.mo.it