Aggiornamento
Lo shock settico nei primi tre mesi di vita
Septic shock in the first three months of life
Sara Crestani1, Erica Passini1, Valentina Spaggiari1, Carlotta Toffoli1, Alessandra Boncompagni2, Luca Bedetti2,3, Eugenio Spaggiari2, Laura Lucaccioni4, Licia Lugli2, Federica Roversi2, Katia Rossi2, Lorenzo Iughetti4, Alberto Berardi2
1Scuola di Specializzazione in Pediatria, Azienda Ospedaliero-Universitaria Policlinico di Modena
2Terapia Intensiva Neonatale, AOU Policlinico di Modena
3PhD Program in Clinical and Experimental Medicine, Università di Modena e Reggio Emilia
4UO di Pediatria, AOU Policlinico di Modena
Novembre 2021 - pagg. 567 -575 | DOI: 10.53126/MEB40567
Abstract
Shock is a generalized tissue hypoperfusion that leads to severe cellular distress and complicates some cases of paediatric and neonatal sepsis. Although a reduction in associated sepsis mortality has been observed in the last decades, it remains one of the most important causes of death or long-term neurodevelopmental disabilities in children. Prompt recognition of this condition is therefore essential to improve survival and long-term outcome. The paediatrician and the neonatologist must therefore be able to promptly recognize the signs and symptoms of sepsis and septic shock to set up an adequate treatment according to the most recent international guidelines. This article provides epidemiological data from Italian and international studies, describes the pathophysiology and clinical manifestations of sepsis and septic shock, as well as the therapeutic indications according to very recent recommendations.
Riassunto
Lo shock settico è uno stato di ipoperfusione tissutale generalizzata che conduce a grave sofferenza cellulare e che complica una parte dei casi di sepsi pediatriche e neonatali. Nonostante negli ultimi decenni si sia osservata una riduzione della mortalità sepsi associata, essa rimane una della più importanti cause di decesso o esiti a lungo termine in età pediatrica. Il pronto riconoscimento di questa condizione è perciò essenziale per migliorare la sopravvivenza e l’outcome a lungo termine. Il pediatra e il neonatologo devono perciò essere in grado di riconoscere tempestivamente i segni e i sintomi di sepsi e shock settico per impostare un trattamento adeguato secondo le più recenti linee guida internazionali. Il presente articolo fornisce dati epidemiologici provenienti da studi italiani e internazionali, descrive la fisiopatologia e le manifestazioni cliniche della sepsi e dello shock settico, nonché le indicazioni terapeutiche secondo recentissime raccomandazioni.
Parole chiave
Classificazione MeSH
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Corrispondenza: alberto.berardi@unimore.it