Sepsis in the pediatric intensive care unit

Abstract

Early recognition of pediatric severe sepsis and septic shock followed by aggressive protocolized clinical management are the keys to improving mortality outcomes. Timely admission to the pediatric intensive care unit allows ongoing aggressive resuscitation, and early institution of targeted therapy guided by central venous pressure and mixed venous oximetry. This allows optimization of management according to changing hemodynamic patterns. Early application of lung protective strategies before the onset of an acute lung injury, or after its development as well as management of acute kidney injury can reduce morbidity and mortality from sepsis. Increasing experience with extracorporeal membrane oxygenation and plasmapheresis may improve outcomes in septic shock in the future.