Septic shock in ICU: Advanced therapeutics, immunoparalysis and genomics. State of the art

Arriagada, D; Donoso, A.; Cruces P.; Diaz, F.

Keywords: septic shock, sepsis, treatment, resuscitation, genomics, extracorporeal support, immunoparalysis

Abstract

New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive care unit must be fully aware of them to improve patient care in the critical care unit. It should be considered the use of immune therapy only in selected groups of patients. Continuous renal replacement therapies are well tolerated and their early use prevents deleterious fluid overload. Removal of inflammatory mediators by using high volume hemofiltration may play a role in hyperdynamic septic patients. The use of plasmapheresis is recommended in patients with thrombocytopenia-associated multiple organ failure. Extracorporeal support use should be considered in those with refractory septic shock despite goals directed therapy. The immunoparalysis has been associated with nosocomial infections and late mortality. The information from genetic markers may allow early intervention and preventive genomicsbased medicine.

Más información

Título según WOS: Septic shock in ICU: Advanced therapeutics, immunoparalysis and genomics. State of the art
Título según SCOPUS: Septic shock in ICU: Advanced therapeutics, immunoparalysis and genomics. State of the art [Shock séptico en la Unidad de Cuidados Intensivos. Terapéutica avanzada, inmunoparálisis y genómica. Estado del arte]
Título de la Revista: ARCHIVOS ARGENTINOS DE PEDIATRIA
Volumen: 112
Número: 4
Editorial: Sociedad Argentina de Pediatria
Fecha de publicación: 2014
Página de inicio: 358
Página final: 365
Idioma: Spanish
DOI:

10.5546/aap.2014.358

Notas: ISI, SCOPUS