Early recognition and prompt management are critical in pediatric sepsis and septic shock. Initial steps include rapid assessment of airway, breathing, and circulation, followed by immediate fluid resuscitation with isotonic crystalloids (20 mL/kg boluses), reassessing after each bolus. Early administration of broad-spectrum antibiotics, ideally within the first hour, is essential to improve outcomes. If shock persists after fluid resuscitation, vasoactive agents like epinephrine or norepinephrine are initiated to maintain adequate perfusion. Monitoring includes vital signs, urine output, lactate levels, and mental status. Source control—such as drainage of abscesses or removal of infected devices—is also vital. Supportive care includes oxygen, mechanical ventilation if needed, and correction of metabolic imbalances. Management should follow updated guidelines such as those from the Surviving Sepsis Campaign. Multidisciplinary care in a pediatric intensive care unit (PICU) setting significantly improves survival and reduces complications in children with sepsis and septic shock.
Alumni- St Mary’s Hospital
Lead Pediatric Critical Care Consultant, Yashoda Hospitals, Hyderabad