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Pediatric Sepsis Guidelines: summary for resource-limited countries

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Author(s): Khilnani Praveen | Singhi Sunit | Lodha Rakesh | Santhanam Indumathi | Sachdev Anil | Chugh Krishan | Jaishree M | Ranjit Suchitra | Ramachandran Bala | Ali Uma | Udani Soonu | Uttam Rajiv | Deopujari Satish

Journal: Indian Journal of Critical Care Medicine
ISSN 0972-5229

Volume: 14;
Issue: 1;
Start page: 41;
Date: 2010;
Original page

Keywords: Pediatric | sepsis | septic shock

ABSTRACT
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 are indicated wherever applicable. It is anticipated that once the guidelines are used and outcomes data evaluated, further modifications will be necessary. It is planned to periodically review and revise these guidelines every 3-5 years as new body of evidence accumulates.

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