Haemodynamic support for paediatric septic shock: a global perspective

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRANJIT, Suchitra
dc.contributor.authorKISSOON, Niranjan
dc.contributor.authorARGENT, Andrew
dc.contributor.authorINWALD, David
dc.contributor.authorVENTURA, Andrea Maria Cordeiro
dc.contributor.authorJABORINSKY, Roberto
dc.contributor.authorSANKAR, Jhuma
dc.contributor.authorSOUZA, Daniela Carla de
dc.contributor.authorNATRAJ, Rajeswari
dc.contributor.authorOLIVEIRA, Claudio Flauzino De
dc.contributor.authorSAMRANSAMRUAJKIT, Rujipat
dc.contributor.authorJAYASHREE, Muralidharan
dc.contributor.authorSCHLAPBACH, Luregn J.
dc.date.accessioned2024-04-05T19:43:41Z
dc.date.available2024-04-05T19:43:41Z
dc.date.issued2023
dc.description.abstractSeptic shock is a leading cause of hospitalisation, morbidity, and mortality for children worldwide. In 2020, the paediatric Surviving Sepsis Campaign (SSC) issued evidence-based recommendations for clinicians caring for children with septic shock and sepsis-associated organ dysfunction based on the evidence available at the time. There are now more trials from multiple settings, including low-income and middle-income countries (LMICs), addressing optimal fluid choice and amount, selection and timing of vasoactive infusions, and optimal monitoring and therapeutic endpoints. In response to developments in adult critical care to trial personalised haemodynamic management algorithms, it is timely to critically reassess the current state of applying SSC guidelines in LMIC settings. In this Viewpoint, we briefly outline the challenges to improve sepsis care in LMICs and then discuss three key concepts that are relevant to management of children with septic shock around the world, especially in LMICs. These concepts include uncertainties surrounding the early recognition of paediatric septic shock, choices for initial haemodynamic support, and titration of ongoing resuscitation to therapeutic endpoints. Specifically, given the evolving understanding of clinical phenotypes, we focus on the controversies surrounding the concepts of early fluid resuscitation and vasoactive agent use, including insights gained from experience in LMICs and high-income countries. We outline the key components of sepsis management that are both globally relevant and translatable to low-resource settings, with a view to open the conversation to the large variety of treatment pathways, especially in LMICs. We emphasise the role of simple and easily available monitoring tools to apply the SSC guidelines and to tailor individualised support to the patient's cardiovascular physiology.eng
dc.description.indexMEDLINE
dc.description.indexPubMed
dc.description.indexScopus
dc.description.indexDimensions
dc.description.indexWoS
dc.identifier.citationLANCET CHILD & ADOLESCENT HEALTH, v.7, n.8, p.588-598, 2023
dc.identifier.doi10.1016/S2352-4642(23)00103-7
dc.identifier.issn2352-4642
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/59262
dc.language.isoeng
dc.publisherELSEVIER SCI LTDeng
dc.relation.ispartofLancet Child & Adolescent Health
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright ELSEVIER SCI LTDeng
dc.subject.otherrandomized controlled-trialeng
dc.subject.othercritically-ill childreneng
dc.subject.otherfluid boluseng
dc.subject.othersepsiseng
dc.subject.othermanagementeng
dc.subject.otherresuscitationeng
dc.subject.otherepinephrineeng
dc.subject.otherchallengeseng
dc.subject.otherguidelineseng
dc.subject.othermortalityeng
dc.subject.wosPediatricseng
dc.titleHaemodynamic support for paediatric septic shock: a global perspectiveeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryÁfrica do Sul
hcfmusp.affiliation.countrySuíça
hcfmusp.affiliation.countryTailândia
hcfmusp.affiliation.countryMéxico
hcfmusp.affiliation.countryInglaterra
hcfmusp.affiliation.countryÍndia
hcfmusp.affiliation.countryCanadá
hcfmusp.affiliation.countryisoin
hcfmusp.affiliation.countryisoca
hcfmusp.affiliation.countryisoza
hcfmusp.affiliation.countryisogb
hcfmusp.affiliation.countryisomx
hcfmusp.affiliation.countryisoth
hcfmusp.affiliation.countryisoch
hcfmusp.author.externalRANJIT, Suchitra:Apollo Childrens Hosp, Paediat Intens Care Unit, Chennai 600008, India
hcfmusp.author.externalKISSOON, Niranjan:Ctr Int Child Hlth, Vancouver, BC, Canada
hcfmusp.author.externalARGENT, Andrew:Univ Cape Town, Red Cross War Mem Childrens Hosp, Dept Paediat & Child Hlth, Cape Town, South Africa
hcfmusp.author.externalINWALD, David:Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Cambridge, England
hcfmusp.author.externalJABORINSKY, Roberto:Northeastern Natl Univ, Corrientes, Argentina; Latin Amer Soc Pediat Intens Care LARed Network, Montevideo, Uruguay; SLACIP Soc Latinoamer Cuidados Intens Pediatr, Monterrey, Mexico
hcfmusp.author.externalSANKAR, Jhuma:Dept Pediat, Div Pediat Pulmonol & Crit Care, AIIMS, New Delhi, India
hcfmusp.author.externalNATRAJ, Rajeswari:Apollo Childrens Hosp, Dept Paediat Intens Care, Chennai, India
hcfmusp.author.externalOLIVEIRA, Claudio Flauzino De:Latin Amer Sepsis Inst, Sao Paulo, Brazil
hcfmusp.author.externalSAMRANSAMRUAJKIT, Rujipat:Chulalongkorn Univ, Fac Med, Dept Pediat, Div Pediat Crit Care, Bangkok, Thailand
hcfmusp.author.externalJAYASHREE, Muralidharan:PGIMER, Adv Pediat Ctr, Pediat Emergency & Intens Care, Chandigarh, India
hcfmusp.author.externalSCHLAPBACH, Luregn J.:Univ Queensland, Child Hlth Res Ctr, Brisbane, Qld, Australia; Univ Childrens Hosp Zurich, Univ Zurich, Dept Intens Care & Neonatol, Zurich, Switzerland; Univ Zurich, Univ Childrens Hosp Zurich, Childrens Res Ctr, Zurich, Switzerland
hcfmusp.citation.scopus6
hcfmusp.contributor.author-fmusphcANDREA MARIA CORDEIRO VENTURA
hcfmusp.contributor.author-fmusphcDANIELA CARLA DE SOUZA
hcfmusp.description.beginpage588
hcfmusp.description.endpage598
hcfmusp.description.issue8
hcfmusp.description.volume7
hcfmusp.origemWOS
hcfmusp.origem.dimensionspub.1160005323
hcfmusp.origem.pubmed37354910
hcfmusp.origem.scopus2-s2.0-85165053589
hcfmusp.origem.wosWOS:001147270400001
hcfmusp.publisher.cityLondoneng
hcfmusp.publisher.countryENGLANDeng
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