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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Therapeutic endpoints for the ongoing management of septic shock in children*[1]

Therapeutic endpoints for the ongoing management of septic shock in children*[1]
  • Capillary refill ≤2 seconds
  • Within threshold heart rate for age (beats/minute):
    • Newborn to <2 years: 110 to 160
    • Infant to preschool (2 to 6 years): 90 to 160
    • Child (7 to 12 years): 70 to 150
  • Normal pulses (central and peripheral pulses equal)
  • Warm extremities
  • Urine output >1 mL/kg/hour
  • Normal mental status
  • Normalization of laboratory studies including lactate and anion gap
  • For patients without invasive monitoring: Normal blood pressure for age
  • For patients with invasive monitoring (CVP and intraarterial pressure monitors):
    • Cardiac index 3.3 to 6.0 L/minute/m2 (if monitoring available)
    • ScVO2 >70%
  • Normalization of glucose and calcium
ScVO2: central venous oxygen saturation; MAP: mean arterial pressure; CVP: central venous pressure.
* Septic shock is being adequately treated when all therapeutic endpoints are achieved.
¶ Not applicable to patients with congenital heart disease with mixing lesions.
Δ The MAP goal is based upon the estimated formula for 50th percentile MAP for a child with 50th percentile height in the healthy population with an expected CVP = 0 mmHg. When the CVP is greater than zero, then the goal MAP should be adjusted accordingly to achieve adequate perfusion pressure. Although suggested by many experts as a therapeutic endpoint, evidence is lacking to guide the optimal target perfusion pressure.
Reference:
  1. Davis AL, Carcillo JA, Aneja RK, et al. American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock. Crit Care Med 2017; 45:1061.
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