Children with septic shock

Overview

Septic shock is the variety of pathogens and toxins from the body after the invasion caused to the microcirculation, tissue perfusion of blood shortage, leading to an important organ of life of acute dysfunction syndrome, and often occur in toxic bacillary dysentery, and the outbreak of ECM, hemorrhagic necrotizing enterocolitis, sepsis, severe pneumonia and acute biliary tract infection and other infectious diseases on the basis of clinical to looking pale and limbs of the cooler skin Fahua, reduce the amount of urine, blood pressure dropped as the main performance. Pediatrics is one of the common critical illnesses.

Clinical performance

1. Or looking pale lips, Zhizhi cyanosis, skin Fahua.

2. Hand, Foot and a cooler filled capillaries to extend the time.

3. Thin-speed pulse, blood pressure measuring less than even decline, the narrow pulse pressure.

4. Urine output reduction.

5. Fuzzy consciousness, a coma or indifferent expression.

6. Anal toe temperature> 6 ℃.

Diagnosis

1. Are the primary infection.

2. Looking pale, peripheral and mucosal cyanosis, skin-like patterns change, peripheral cold.

3. Pulse of small-speed, filling time again capillary> = 2 seconds.

4. Urine output reduction, mild shock five babies per hour ￣ 10 ml, children 10 ￣ 20 ml, severe shock babies per hour less than 5 ml, children less than 10 ml.

5. Measurement of blood pressure dropped to less than, pulse pressure <4 Kpa (30mmHg), early mild shock to normal blood pressure.

6. Make them apathetic, fuzzy consciousness, respiratory markedly accelerated.

Treatment principle

1. Expansion of blood volume, correct acid poisoning.

2. Microcirculation to lift the vessel spasm.

3. Cardiac treatment.

4. Anti-infection.

5. Application of adrenal glucocorticoid.

6. The protection of critical organ function, prevention and treatment of brain edema, heart failure, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC) and acute renal failure.

Treatment principle

1. Septic shock, according to the incidence of bacteria on the choice of at least two sensitive to antibiotics, intravenous injection, the dose should be enough, treatment should be enough. Pathogens do not know, the choice of two broad-spectrum, highly effective microbicides, and take into account cocci bacteria, identify pathogens, according to drug sensitivity.

2. Shock patients with various degrees of cardiac function decline in the first batch of quick infusion should be used cardiac drugs, with heart failure, it is necessary to appropriately control the speed and the infusion of liquid aggregate limit Hanna hypertonic dehydration solution and the application of .

3. Fulminant ECM with shock, often disseminated intravascular coagulation and fibrinolysis hyperthyroidism exist, the rescue without waiting for laboratory results when, according to clinical signs and symptoms of immediate treatment, while heparin and 6 -- Amino acid.

4. Shock with acute renal failure, should be accurate calculation of access and maintain water and electrolyte balance, improve the application of dopamine and 654-2 renal microcirculation.

5. Naloxone for morphine receptor antagonist, the antagonism of β-brown Fei's role in reversing the shock when low blood pressure, often used in refractory shock will be good effect, when the shock treatment with traditional methods fails And the timely use of naloxone.