ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation
Introduction The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation...
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| Veröffentlicht in: | Intensive care medicine 2008-06, Vol.34 (6), p.1065-1075 |
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| creator | de Oliveira, Cláudio F. de Oliveira, Débora S. F. Gottschald, Adriana F. C. Moura, Juliana D. G. Costa, Graziela A. Ventura, Andréa C. Fernandes, José Carlos Vaz, Flávio A. C. Carcillo, Joseph A. Rivers, Emanuel P. Troster, Eduardo J. |
| description | Introduction
The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO
2
≥ 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated.
Objective
The purpose of this study was to compare treatment according to ACCM/PALS guidelines, performed with and without ScvO
2
goal-directed therapy, on the morbidity and mortality rate of children with severe sepsis and septic shock.
Design, participants and interventions
Children and adolescents with severe sepsis or fluid-refractory septic shock were randomly assigned to ACCM/PALS with or without ScvO
2
goal-directed resuscitation.
Measurements
Twenty-eight-day mortality was the primary endpoint.
Results
Of the 102 enrolled patients, 51 received ACCM/PALS with ScvO
2
goal-directed therapy and 51 received ACCM/PALS without ScvO
2
goal-directed therapy. ScvO
2
goal-directed therapy resulted in less mortality (28-day mortality 11.8% vs. 39.2%,
p
= 0.002), and fewer new organ dysfunctions (
p
= 0.03). ScvO
2
goal-directed therapy resulted in more crystalloid (28 (20–40) vs. 5 (0–20) ml/kg,
p
|
| doi_str_mv | 10.1007/s00134-008-1085-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69267913</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1505648111</sourcerecordid><originalsourceid>FETCH-LOGICAL-c473t-f560cca833d4d7706a0103ed55a8c8a12ca1e5a2964b730320b29bf7d9a3679f3</originalsourceid><addsrcrecordid>eNqF0t2KEzEUB_AgilurD-CNBGG9Gzcnma94V4q6QkVBvQ6nmUybdSYZk4xrX8WnNbXFBUG8yQnkd_LBP4Q8BfYSGGuuImMgyoKxtgDWVoW8RxZQCl4AF-19smCi5EVZl_yCPIrxJuumruAhuYBW1LKSsCA_V-v1-6uPq80nukcz-u7gcLSaxnmafEh0N9vODNaZSHsf6ISms5jCUZgpHcve66-vKDrq56T9mGEeJww2ekdvbdrnte73JAM6emeTD9btqDYuBRzod-P8HKn_cdgZRyOmOWCy3j0mD3oconlyrkvy5c3rz-vrYvPh7bv1alPoshGp6KuaaY2tEF3ZNQ2rkQETpqsqbHWLwDWCqZDLutw2ggnOtlxu-6aTKOpG9mJJXpz2nYL_NpuY1GijNsOAzuSLqVry7ED8F0I-ogUBGT7_C974Obj8CMWh5iArXmUEJ6SDjzGYXk3BjhgOCpg6xqtO8aocrzrGq2TueXbeeN6OprvrOOeZweUZYNQ49AGdtvGP46xkAPmLLAk_uTgdszDh7ob_Pv0Xpki_QA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>216219525</pqid></control><display><type>article</type><title>ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>de Oliveira, Cláudio F. ; de Oliveira, Débora S. F. ; Gottschald, Adriana F. C. ; Moura, Juliana D. G. ; Costa, Graziela A. ; Ventura, Andréa C. ; Fernandes, José Carlos ; Vaz, Flávio A. C. ; Carcillo, Joseph A. ; Rivers, Emanuel P. ; Troster, Eduardo J.</creator><creatorcontrib>de Oliveira, Cláudio F. ; de Oliveira, Débora S. F. ; Gottschald, Adriana F. C. ; Moura, Juliana D. G. ; Costa, Graziela A. ; Ventura, Andréa C. ; Fernandes, José Carlos ; Vaz, Flávio A. C. ; Carcillo, Joseph A. ; Rivers, Emanuel P. ; Troster, Eduardo J.</creatorcontrib><description>Introduction
The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO
2
≥ 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated.
Objective
The purpose of this study was to compare treatment according to ACCM/PALS guidelines, performed with and without ScvO
2
goal-directed therapy, on the morbidity and mortality rate of children with severe sepsis and septic shock.
Design, participants and interventions
Children and adolescents with severe sepsis or fluid-refractory septic shock were randomly assigned to ACCM/PALS with or without ScvO
2
goal-directed resuscitation.
Measurements
Twenty-eight-day mortality was the primary endpoint.
Results
Of the 102 enrolled patients, 51 received ACCM/PALS with ScvO
2
goal-directed therapy and 51 received ACCM/PALS without ScvO
2
goal-directed therapy. ScvO
2
goal-directed therapy resulted in less mortality (28-day mortality 11.8% vs. 39.2%,
p
= 0.002), and fewer new organ dysfunctions (
p
= 0.03). ScvO
2
goal-directed therapy resulted in more crystalloid (28 (20–40) vs. 5 (0–20) ml/kg,
p
< 0.0001), blood transfusion (45.1% vs. 15.7%,
p
= 0.002) and inotropic (29.4% vs. 7.8%,
p
= 0.01) support in the first 6 h.
Conclusions
This study supports the current ACCM/PALS guidelines. Goal-directed therapy using the endpoint of a ScvO
2
≥ 70% has a significant and additive impact on the outcome of children and adolescents with septic shock.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-008-1085-9</identifier><identifier>PMID: 18369591</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Cardiac Output ; Child ; Child, Preschool ; Critical Care Medicine ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency Medicine ; Female ; Hemodynamics ; Humans ; Intensive ; Intensive care medicine ; Logistic Models ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Monitoring, Physiologic - methods ; Oxygen - blood ; Pain Medicine ; Pediatric Original ; Pediatrics ; Pneumology/Respiratory System ; Practice Guidelines as Topic ; Resuscitation - methods ; Shock, Septic - blood ; Shock, Septic - mortality ; Shock, Septic - physiopathology ; Shock, Septic - therapy ; Treatment Outcome</subject><ispartof>Intensive care medicine, 2008-06, Vol.34 (6), p.1065-1075</ispartof><rights>Springer-Verlag 2008</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-f560cca833d4d7706a0103ed55a8c8a12ca1e5a2964b730320b29bf7d9a3679f3</citedby><cites>FETCH-LOGICAL-c473t-f560cca833d4d7706a0103ed55a8c8a12ca1e5a2964b730320b29bf7d9a3679f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00134-008-1085-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00134-008-1085-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20401114$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18369591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Oliveira, Cláudio F.</creatorcontrib><creatorcontrib>de Oliveira, Débora S. F.</creatorcontrib><creatorcontrib>Gottschald, Adriana F. C.</creatorcontrib><creatorcontrib>Moura, Juliana D. G.</creatorcontrib><creatorcontrib>Costa, Graziela A.</creatorcontrib><creatorcontrib>Ventura, Andréa C.</creatorcontrib><creatorcontrib>Fernandes, José Carlos</creatorcontrib><creatorcontrib>Vaz, Flávio A. C.</creatorcontrib><creatorcontrib>Carcillo, Joseph A.</creatorcontrib><creatorcontrib>Rivers, Emanuel P.</creatorcontrib><creatorcontrib>Troster, Eduardo J.</creatorcontrib><title>ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><addtitle>Intensive Care Med</addtitle><description>Introduction
The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO
2
≥ 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated.
Objective
The purpose of this study was to compare treatment according to ACCM/PALS guidelines, performed with and without ScvO
2
goal-directed therapy, on the morbidity and mortality rate of children with severe sepsis and septic shock.
Design, participants and interventions
Children and adolescents with severe sepsis or fluid-refractory septic shock were randomly assigned to ACCM/PALS with or without ScvO
2
goal-directed resuscitation.
Measurements
Twenty-eight-day mortality was the primary endpoint.
Results
Of the 102 enrolled patients, 51 received ACCM/PALS with ScvO
2
goal-directed therapy and 51 received ACCM/PALS without ScvO
2
goal-directed therapy. ScvO
2
goal-directed therapy resulted in less mortality (28-day mortality 11.8% vs. 39.2%,
p
= 0.002), and fewer new organ dysfunctions (
p
= 0.03). ScvO
2
goal-directed therapy resulted in more crystalloid (28 (20–40) vs. 5 (0–20) ml/kg,
p
< 0.0001), blood transfusion (45.1% vs. 15.7%,
p
= 0.002) and inotropic (29.4% vs. 7.8%,
p
= 0.01) support in the first 6 h.
Conclusions
This study supports the current ACCM/PALS guidelines. Goal-directed therapy using the endpoint of a ScvO
2
≥ 70% has a significant and additive impact on the outcome of children and adolescents with septic shock.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Critical Care Medicine</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Intensive</subject><subject>Intensive care medicine</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monitoring, Physiologic - methods</subject><subject>Oxygen - blood</subject><subject>Pain Medicine</subject><subject>Pediatric Original</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Practice Guidelines as Topic</subject><subject>Resuscitation - methods</subject><subject>Shock, Septic - blood</subject><subject>Shock, Septic - mortality</subject><subject>Shock, Septic - physiopathology</subject><subject>Shock, Septic - therapy</subject><subject>Treatment Outcome</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqF0t2KEzEUB_AgilurD-CNBGG9Gzcnma94V4q6QkVBvQ6nmUybdSYZk4xrX8WnNbXFBUG8yQnkd_LBP4Q8BfYSGGuuImMgyoKxtgDWVoW8RxZQCl4AF-19smCi5EVZl_yCPIrxJuumruAhuYBW1LKSsCA_V-v1-6uPq80nukcz-u7gcLSaxnmafEh0N9vODNaZSHsf6ISms5jCUZgpHcve66-vKDrq56T9mGEeJww2ekdvbdrnte73JAM6emeTD9btqDYuBRzod-P8HKn_cdgZRyOmOWCy3j0mD3oconlyrkvy5c3rz-vrYvPh7bv1alPoshGp6KuaaY2tEF3ZNQ2rkQETpqsqbHWLwDWCqZDLutw2ggnOtlxu-6aTKOpG9mJJXpz2nYL_NpuY1GijNsOAzuSLqVry7ED8F0I-ogUBGT7_C974Obj8CMWh5iArXmUEJ6SDjzGYXk3BjhgOCpg6xqtO8aocrzrGq2TueXbeeN6OprvrOOeZweUZYNQ49AGdtvGP46xkAPmLLAk_uTgdszDh7ob_Pv0Xpki_QA</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>de Oliveira, Cláudio F.</creator><creator>de Oliveira, Débora S. F.</creator><creator>Gottschald, Adriana F. C.</creator><creator>Moura, Juliana D. G.</creator><creator>Costa, Graziela A.</creator><creator>Ventura, Andréa C.</creator><creator>Fernandes, José Carlos</creator><creator>Vaz, Flávio A. C.</creator><creator>Carcillo, Joseph A.</creator><creator>Rivers, Emanuel P.</creator><creator>Troster, Eduardo J.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20080601</creationdate><title>ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation</title><author>de Oliveira, Cláudio F. ; de Oliveira, Débora S. F. ; Gottschald, Adriana F. C. ; Moura, Juliana D. G. ; Costa, Graziela A. ; Ventura, Andréa C. ; Fernandes, José Carlos ; Vaz, Flávio A. C. ; Carcillo, Joseph A. ; Rivers, Emanuel P. ; Troster, Eduardo J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-f560cca833d4d7706a0103ed55a8c8a12ca1e5a2964b730320b29bf7d9a3679f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Cardiac Output</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Critical Care Medicine</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Intensive</topic><topic>Intensive care medicine</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monitoring, Physiologic - methods</topic><topic>Oxygen - blood</topic><topic>Pain Medicine</topic><topic>Pediatric Original</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Practice Guidelines as Topic</topic><topic>Resuscitation - methods</topic><topic>Shock, Septic - blood</topic><topic>Shock, Septic - mortality</topic><topic>Shock, Septic - physiopathology</topic><topic>Shock, Septic - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Oliveira, Cláudio F.</creatorcontrib><creatorcontrib>de Oliveira, Débora S. F.</creatorcontrib><creatorcontrib>Gottschald, Adriana F. C.</creatorcontrib><creatorcontrib>Moura, Juliana D. G.</creatorcontrib><creatorcontrib>Costa, Graziela A.</creatorcontrib><creatorcontrib>Ventura, Andréa C.</creatorcontrib><creatorcontrib>Fernandes, José Carlos</creatorcontrib><creatorcontrib>Vaz, Flávio A. C.</creatorcontrib><creatorcontrib>Carcillo, Joseph A.</creatorcontrib><creatorcontrib>Rivers, Emanuel P.</creatorcontrib><creatorcontrib>Troster, Eduardo J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Oliveira, Cláudio F.</au><au>de Oliveira, Débora S. F.</au><au>Gottschald, Adriana F. C.</au><au>Moura, Juliana D. G.</au><au>Costa, Graziela A.</au><au>Ventura, Andréa C.</au><au>Fernandes, José Carlos</au><au>Vaz, Flávio A. C.</au><au>Carcillo, Joseph A.</au><au>Rivers, Emanuel P.</au><au>Troster, Eduardo J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation</atitle><jtitle>Intensive care medicine</jtitle><stitle>Intensive Care Med</stitle><addtitle>Intensive Care Med</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>34</volume><issue>6</issue><spage>1065</spage><epage>1075</epage><pages>1065-1075</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>Introduction
The ACCM/PALS guidelines address early correction of paediatric septic shock using conventional measures. In the evolution of these recommendations, indirect measures of the balance between systemic oxygen delivery and demands using central venous or superior vena cava oxygen saturation (ScvO
2
≥ 70%) in a goal-directed approach have been added. However, while these additional goal-directed endpoints are based on evidence-based adult studies, the extrapolation to the paediatric patient remains unvalidated.
Objective
The purpose of this study was to compare treatment according to ACCM/PALS guidelines, performed with and without ScvO
2
goal-directed therapy, on the morbidity and mortality rate of children with severe sepsis and septic shock.
Design, participants and interventions
Children and adolescents with severe sepsis or fluid-refractory septic shock were randomly assigned to ACCM/PALS with or without ScvO
2
goal-directed resuscitation.
Measurements
Twenty-eight-day mortality was the primary endpoint.
Results
Of the 102 enrolled patients, 51 received ACCM/PALS with ScvO
2
goal-directed therapy and 51 received ACCM/PALS without ScvO
2
goal-directed therapy. ScvO
2
goal-directed therapy resulted in less mortality (28-day mortality 11.8% vs. 39.2%,
p
= 0.002), and fewer new organ dysfunctions (
p
= 0.03). ScvO
2
goal-directed therapy resulted in more crystalloid (28 (20–40) vs. 5 (0–20) ml/kg,
p
< 0.0001), blood transfusion (45.1% vs. 15.7%,
p
= 0.002) and inotropic (29.4% vs. 7.8%,
p
= 0.01) support in the first 6 h.
Conclusions
This study supports the current ACCM/PALS guidelines. Goal-directed therapy using the endpoint of a ScvO
2
≥ 70% has a significant and additive impact on the outcome of children and adolescents with septic shock.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>18369591</pmid><doi>10.1007/s00134-008-1085-9</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Intensive care medicine, 2008-06, Vol.34 (6), p.1065-1075 |
| issn | 0342-4642 1432-1238 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Cardiac Output Child Child, Preschool Critical Care Medicine Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency Medicine Female Hemodynamics Humans Intensive Intensive care medicine Logistic Models Male Medical sciences Medicine Medicine & Public Health Monitoring, Physiologic - methods Oxygen - blood Pain Medicine Pediatric Original Pediatrics Pneumology/Respiratory System Practice Guidelines as Topic Resuscitation - methods Shock, Septic - blood Shock, Septic - mortality Shock, Septic - physiopathology Shock, Septic - therapy Treatment Outcome |
| title | ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation |
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