| Diferencias entre adultos y niños en shock séptico |
Differences between adult and pediatric septic shock.
Aneja R, Carcillo J.
Departments of Critical Care Medicine and Pediatrics, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, PA, USA. anejar@upmc.edu
Minerva Anestesiol. 2011 Oct;77(10):986-92.
Abstract
Sepsis is a significant public health problem that affects children and adults alike. Despite some similarities in the approach to pediatric and adult septic shock, there are key differences as it relates to pathophysiology, clinical presentation, and therapeutic approaches. In this review article, we discuss these differences under 4 headings: a) Developmental differences in the hemodynamic response, b) Activated Protein C, c) Thrombocytopenia associated multiple organ failure and d) Hemophagocytic Lymphohistiocytosis (HLH).
http://www.minervamedica.it/en/journals/minerva-anestesiologica/article.php?cod=R02Y2011N10A0986
|
| Niveles de lactato sérico como predictor de la evolución del shock séptico en pediatría |
Serum lactate levels as the predictor of outcome in pediatric septic shock.
Jat KR, Jhamb U, Gupta VK.
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
Indian J Crit Care Med. 2011 Apr;15(2):102-7.
Abstract
BACKGROUND AND AIMS: An association of high lactate levels with mortality has been found in adult patients with septic shock. However, there is controversial literature regarding the same in children. The aim of this study was to find the correlation of serum lactate levels in pediatric septic shock with survival. SETTINGS AND DESIGN: This was a prospective observational study at PICU of a tertiary care center of North India. MATERIALS AND METHODS: A total of 30 children admitted to PICU with diagnosis of septic shock were included in the study. PRISM III score and demographic characteristics of all children were recorded. Serum lactate levels were measured in arterial blood at 0-3, 12, and 24 h of PICU admission. The outcome (survival or death) was correlated with serum lactate levels. RESULTS: Septic shock was the most common (79.3%) type of shock and had 50% mortality. Initial as well as subsequent lactate levels were significantly higher in nonsurvivors. A lactate value of more than 45 mg/dl (5 mmol/l) at 0-3, 12, and 24 h of PICU admission had an odds ratio for death of 6.7, 12.5, and 8.6 (95% CI: 1.044-42.431, 1.850-84.442, 1.241-61.683) with a positive predictive value (PPV) of 38%, 71%, 64% and a negative predictive value (NPV) of 80%, 83%, and 83%, respectively. CONCLUSIONS: Nonsurvivors had higher blood lactate levels at admission as well as at 12 and 24 h. A lactate value of more than 45 mg/dl (5 mmol/l) was a good predictor of death.
http://www.ijccm.org/article.asp?issn=0972-5229;year=2011;volume=15;issue=2;spage=102;epage=107;aulast=Jat
|
|
No hay comentarios:
Publicar un comentario