Pediatric Sepsis Guidelines: summary for resource-limited countries

作者：Rakesh Lodha, Krishan Chugh, Soonu Udani, Suchitra Ranjit, Satish Deopujari, Bala Ramachandran, Rajiv Uttam, Uma Ali, Sunit Singhi, Praveen Khilnani, Indumathi Santhanam, M Jaishree · 发表于：Indian Journal of Critical Care Medicine · 年份：2010 · DOI：10.4103/0972-5229.63029 · 被引用次数：71 · 研究领域：Sepsis Diagnosis and Treatment、Clinical practice guidelines implementation、Nosocomial Infections in ICU

JUSTIFICATION: Pediatric sepsis is a commonly encountered global issue. Existing guidelines for sepsis seem to be applicable to the developed countries, and only few articles are published regarding application of these guidelines in the developing countries, especially in resource-limited countries such as India and Africa. PROCESS: An expert representative panel drawn from all over India, under aegis of Intensive Care Chapter of Indian Academy of Pediatrics (IAP) met to discuss and draw guidelines for clinical practice and feasibility of delivery of care in the early hours in pediatric patient with sepsis, keeping in view unique patient population and limited availability of equipment and resources. Discussion included issues such as sepsis definitions, rapid cardiopulmonary assessment, feasibility of early aggressive fluid therapy, inotropic support, corticosteriod therapy, early endotracheal intubation and use of positive end expiratory pressure/mechanical ventilation, initial empirical antibiotic therapy, glycemic control, and role of immunoglobulin, blood, and blood products. OBJECTIVE: To achieve a reasonable evidence-based consensus on the basis of published literature and expert opinion to formulating clinical practice guidelines applicable to resource-limited countries such as India. RECOMMENDATIONS: Pediatric sepsis guidelines are presented in text and flow chart format keeping resource limitations in mind for countries such as India and Africa. Levels of evidence ...