Pediatric Septic Shock: Early Recognition and Aggressive Fluid Therapy Improves Outcome

Abstract

Objective: To establish the effect of aggressive fluid resuscitation in reversing the pediatric septic shock at 1 hour in children younger than 5 years of age presenting in the emergency unit of the hospital. Methods:  This was a descriptive, case series study, done for six months, from December 2015 to May 2016, at Pediatric Department of Ayub Medical College Abbottabad. Patients with age range of 1 month to 5 years, presenting in the emergency department with the diagnosis of septic shock having clinical features of tachycardia, tachypnea or hyperthermia along with hypotension and poor capillary refill time were included. All patients received aggressive fluid management. Clinical examination was repeated at the end of one hour for assessment of reversal of shock. Data was collected by self-made Performa. Results: Mean age of study participants was 22.4 ± 17.6 months. Majority of participants 42(57%) were male. Mean weight was 10.3±4.3 kilograms. Mean heart rate was 173.9±17.8 beats per minutes. 67.6% were treated with a third-generation cephalosporin. At the end of one hour of treatment 51 (68.9%) showed the reversal of shock. Conclusion: Majority of childrens who presented with septic shock showed the reversal of shock at one hour of management with weight-based fluid bolus therapy.