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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

DONOSO F, ALEJANDRO; ARRIAGADA S, DANIELA; CRUCES R, PABLO  y  DIAZ R, FRANCO. Septic shock in pediatrics II: Current concepts in diagnosis and treatment. Rev. chil. pediatr. [online]. 2013, vol.84, n.6, pp.606-615. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41062013000600003.

Although the basic concepts of diagnosis and therapy of the child with septic shock have remained similar over time, it is undeniable that in recent decades, new and important concepts have been added, and any treating physician either at the Emergency Department or Intensive Care Unit should be fully aware of them. This second part discusses the similarities and differences between pediatric and adult populations, the utility of metabolic resuscitation goals, as well as the initial therapeutic approach in septic patients. The most important concepts of this work make reference to the differences between children and adults with septic shock, specifically regarding to pathophysiology, clinical presentation and treatment. Volume expansion and vasoactive drugs are crucial if there is no response to fluid resuscitation. The therapeutic management should focus on finding the normalization of macrohemodynamic and systemic perfusion targets. Common observation mistakes in the initial treatment of septic patients should be avoided. This condition has a high incidence and mortality rate; therefore an early and aggressive treatment is essential.

Palabras clave : Sepsis; septic shock; resuscitation; capillary refill time; pediatric emergency.

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