Early Goal-Directed Therapy of Pediatric Septic Shock

Cumulative evidence from studies of severe sepsis and septic shock has confirmed the importance to patient survival of timely oxygen augmentation targeted at specific goals related to oxygen delivery to the tissues. This work describes the evolution of our understanding of the pathophysiology of septic shock and the integration at our center of the guidelines of the American College of Critical Care Medicine and the Surviving Sepsis Campaign into a step-by-step protocol for early recognition and resuscitation of children with severe sepsis and septic shock in the emergency department. This work is intended to alert emergency room physicians of the critical need for early screening and aggressive efforts to reverse tissue hypoperfusion in pediatric patients with septic shock, even in the presence of normal mental status and blood pressure. MeSH Words: Sepsis, shock, pediatric, emergency, resuscitation