Advances in Shock Management and Fluid Resuscitation in Children
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Date
2023-03
Authors
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Journal ISSN
Volume Title
Publisher
Dr. K C Chaudhuri Foundation
Abstract
Shock in children is associated with signifcant mortality and morbidity, particularly in resource-limited settings. The principles of management include early recognition, fuid resuscitation, appropriate inotropes, antibiotic therapy in sepsis, supportive therapy for organ dysfunction, and regular hemodynamic monitoring. During the past decade, each step has undergone several changes and evolved as evidence that has been translated into recommendations and practice. There is a paradigm shift from protocolized-based care to personalized management, from liberal strategies to restrictive strategies in terms of fuids, blood transfusion, ventilation, and antibiotics, and from clinical monitoring to multimodal monitoring using bedside technologies. However, uncertainties are still prevailing in terms of the volume of fuids, use of steroids, and use of extracorporeal and newer therapies while managing shock. These changes have been summarized along with evidence in this article with the aim of adopting an evidence-based approach while managing children with shock.
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Keywords
Septic shock, Fluid resuscitation, Protocolized care, Multimodal monitoring, Surviving sepsis campaign guidelines, Dynamic indices
Citation
Gupta Samriti, Sankar Jhuma. Advances in Shock Management and Fluid Resuscitation in Children. Indian Journal of Pediatrics. 2023 Mar; 90(3): 280–288