Fluid therapy in children with septic shock in an Intensive Care Unit

Authors

  • Katya Bilbao González Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara
  • Lisdeidy Carmona Espinosa Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara
  • Nelson Lázaro Martell Betancourt Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara
  • Marisela Lima Rodríguez Policlínico “Manuel Fajardo”, Vueltas, Camajuaní, Villa Clara

Keywords:

shock septic, fluid therapy, child

Abstract

Introduction: septic shock is a common cause of death in children worldwide, it is the first cause of admission to the units of non-coronary intensive care and it is an emerging disease. Objective: to describe the results of therapy with fluid in patients with septic shock at “José Luis Miranda” Hospital in one year of study. Method: a descriptive, longitudinal, prospective study between January and December 2012 with patients admitted to the Intensive Care Unit of the hospital was realized. Data were recorded in the statistical professional program SPSS version 15.0, the information was showed in tables and graphs and inferential statistics tests were applied. Results: the most affected age group was that of one month to one year, of male sex; severe acute respiratory infections were the most frequent etiologies; the administration of intravenous fluids contributed to the recovery of clinical parameters related to perfusion at six hours; with the administration of 60ml/kg of intravenous fluids there was a recovery of blood pressure in most children. Conclusions: aggressive and early administration of intravenous fluids contributes to the recovery of clinical parameters related to perfusion at six hours and reducing mortality in children with septic shock.

Downloads

Download data is not yet available.

Author Biographies

Katya Bilbao González, Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara

Especialista de I Grado en Medicina General Integral. Especialista de I y II Grado de Medicina Intensiva y Emergencia Médica Pediátrica. Máster en Urgencias Médicas. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Lisdeidy Carmona Espinosa, Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara

Especialista de I Grado en Terapia Intensiva y Emergencia Pediátrica

Nelson Lázaro Martell Betancourt, Hospital Pediátrico “José Luis Miranda”, Santa Clara, Villa Clara

Especialista de I Grado en Pediatría. Especialista de I Grado en Terapia Intensiva y Emergencia Pediátrica. Profesor Instructor de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

Marisela Lima Rodríguez, Policlínico “Manuel Fajardo”, Vueltas, Camajuaní, Villa Clara

Especialista de I Grado en Medicina General Integral. Profesora Asistente de la Universidad de Ciencias Médicas de Villa Clara “Dr. Serafín Ruiz de Zárate Ruiz”.

References

1. Rohde JM, Odden AJ, Bonham C, Kuhn L, Malani PN, Chen LM, et al. The epidemiology of acute organ system dysfunction from severe sepsis outside of the intensive care unit. J Hosp Med [Internet]. 2013 [citado 28 Sept 2015];8(5):243–247. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23401431

2. Donoso FA, Arraigada SD, Cruces RP, Díaz RF. Shock séptico en pediatría I. Enfoque actual en el diagnóstico y tratamiento. Rev Child Pediatr [Internet]. 2013 [citado 28 Sept 2015];84(5):484-498. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062013000500002

3. Brierley J, Carcillo JA, Choong K, Cornell T, Decaen A, Deymann A, et al. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med [Internet]. 2009 [citado 2 Sept 2015];37(2):666-88. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/19325359

4. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med [Internet]. 2005 [citado 28 Sept 2015];6(1):2-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/15636651

5. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med [Internet]. 2013 [citado 22 Feb 2015];39(2):165-228. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23361625

6. Donoso FA, Arraigada SD, Cruces RP, Díaz RF. Shock séptico en pediatría II. Enfoque actual en el diagnóstico y tratamiento. Rev Chil Pediatr [Internet]. 2013 [citado 28 Sept 2015];84(6):606-615. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062013000600003

7. Shime N, Kawasaki T, Saito O, Akamine Y, Toda Y, Takeuchi M, et al. Incidence and risk factors for mortality in paediatric severe sepsis: results from the national paediatric intensive care registry in Japan. Intensive Care Med [Internet]. 2012 [citado 8 Nov 2015];38(7):1191-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22527068

8. Carcillo JA. Capillary refill time is a very useful clinical sign in early recognition and treatment of very sick children. Pediatr Crit Care Med [Internet]. 2012 [citado 28 Sept 2015];13(2):210-2. Disponible en: http://journals.lww.com/pccmjournal/Citation/2012/03000/Capillary_refill_time_is_a_very_useful_clinical.28.aspx

9. Crook J, Taylor RM. The agreement of fingertip and sternum capillary refill time in children. Arh Dis Child [Internet]. 2013 [citado 28 Sept 2015];98(4):265-8. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/23396679

10. Cruz AT, Perry AM, Williams EA, Graf JM, Wuestner ER, Patel B. Implementation of goal-directed therapy for children with suspected sepsis in the emergency department. Pediatrics [Internet]. 2011 [citado 2 Jun 2015];127(3):e758-66. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21339277

11. Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A, et al. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med [Internet]. 2015 [citado 28 Sept 2015];191(10):1147-1157. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/25734408

12. McIntyre L, Fergusson DA, Rowe B, Cook DJ, Arabi Y, Bagshaw SM, et al. The PRECISE RCT: evolution of an early septic shock fluid resuscitation trial. Transfus Med Rev [Internet]. 2012 [citado 15 Sept 2015];26(4):333-41. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22222146

13. Woodcock TE, Woodcock TM. Revised starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy. Br J Anaesth [Internet]. 2012 [citado 28 Sept 2015];108(3)384-94. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/22290457

14. Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A, et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. N Engl J Med [Internet]. 2012 [citado 28 Sept 2015];367:124-134. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJMoa1204242

15. Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med [Internet]. 2012 [citado 12 May 2015];367:1901-11. Disponible en: http://www.nejm.org/doi/full/10.1056/NEJMoa1209759#t=article

16. Harvey G, Foster G, Manan A, Thabane L, Parker MJ. Factors affecting pediatric isotonic fluid resuscitation efficiency: a randomized controlled trial evaluating the impact of syringe size. BMC Emergency Med [Internet]. 2013 [citado 28 Sept 2015];13:14. Disponible en: http://bmcemergmed.biomedcentral.com/articles/10.1186/1471-227X-13-14

17. Chopra A, Kumar V, Dutta A. Hypertonic versus normal saline as initial fluid bolus in pediatric septic shock. Indian J Pediatr [Internet]. 2011 [citado 28 Sept 2015];78(7):833-7. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/21290201

18. Arraigada DS, Donoso FA, Cruces RP, Díaz RF. Shock séptico en unidad de cuidados intensivos. Enfoque actual en el tratamiento. Rev Chil Pediatr [Internet]. 2015 [citado 28 Sept 2015];86(4):224-235. Disponible en: http://www.sciencedirect.com/science/article/pii/S037041061500159X

19. Loza Vázquez, León Gil C, León Regidor A. Nuevas alternativas terapéuticas para la sepsis grave en el paciente crítico. Revisión. Med Intensiva [Internet]. 2011 [citado 18 Mar 2015];35:236-45. Disponible en: http://www.medintensiva.org/es/nuevas-alternativas-terapeuticas-sepsis-grave/articulo/S0210569110002706/

20. Arraigada DS, Donoso FA, Cruces RP, Díaz RF. Shock séptico en la Unidad de Cuidados Intensivos. Terapéutica avanzada, inmunoparálisis y genómica. Estado del arte. Arch Argent Pediatr [Internet]. 2014 [citado 28 Sept 2015];112(4):358-365. Disponible en: http://repositorio.unab.cl/xmlui/handle/ria/937

How to Cite

1.
Bilbao González K, Carmona Espinosa L, Martell Betancourt NL, Lima Rodríguez M. Fluid therapy in children with septic shock in an Intensive Care Unit. Acta Méd Centro [Internet]. 2017 Jan. 1 [cited 2025 Jul. 1];11(1):2-12. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/784

Issue

Section

Original Articles