Journal
SEMINARS IN NEPHROLOGY
Volume 28, Issue 5, Pages 447-456Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.semnephrol.2008.05.004
Keywords
septic shock; meningococcemia; children; septic acute kidney injury; pediatric sepsis; corticosteroids
Categories
Ask authors/readers for more resources
A high index of suspicion for bacterial sepsis and recognition of the potential for rapid deterioration is essential for impacting patient outcome. Meningococcemia produces a stereotypical clinical and biochemical constellation of profound septic shock and purpura fulminans with marked inflammatory disturbance and a complex disruption of coagulation. Meningococcal infections preferentially affect infants and young children, but adolescents are also at risk. Aggressive fluid resuscitation, hemodynamic management, and clinical monitoring are based on understanding of pathophysiologic disturbances typical of the pediatric cardiovascular response and guided by evidence-based guidelines. Appropriate antibiotic choice is important, and corticosteroid use may be beneficial. A variety of efforts to manipulate the coagulation abnormalities may be considered, although evidence is lacking. Extracorporeal support remains a consideration both for the failing cardiorespiratory systems but also potentially for the use of plasma exchange. A team approach between the intensivist and subspecialist is important in managing the frequent multiorgan complications seen with meningococcemia.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available