Sepsis, severe sepsis, and septic shock represent a dynamic clinical syndrome involving a systemic inflammatory response, circulatory changes, and end-organ dysfunction from an infection. Early aggressive management to restore perfusion and/or improve hypotension is critical to improving outcomes. Although the basic management principles of early goal-directed therapy for sepsis have not undergone significant changes, there has been a recent shift in recommendations related to the timing and type of inotropic support. The purpose of this article is to review fluid management along with previous and current inotrope recommendations in pediatric sepsis and septic shock.
Fellow (Louden), Assistant Professor (Rutman), Pediatric Emergency Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
The authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interest in, any commercial organizations pertaining to this educational activity.
Reprints: Lori Ellen Rutman, MD, MPH, Emergency Medicine, Seattle Children's Hospital, 4800 Sand Point Way NE, MB. 7.520, Seattle, WA 98105 (e-mail: Lori.Rutman@seattlechildrens.org).