Seminars in Nephrology
Volume 28, Issue 5 , Pages 447-456 , September 2008

Pediatric Critical Care Management of Septic Shock Prior to Acute Kidney Injury and Renal Replacement Therapy

  • James D. Fortenberry, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to James D. Fortenberry, MD, FCCM, FAAP, Associate Professor of Pediatrics, Chief, Division of Pediatric Critical Care Medicine, Emory University School of Medicine, Medical Director, Critical Care and Pediatric ECMO, Children's Healthcare of Atlanta, 1405 Clifton Rd NE, Atlanta, GA 30322

References 

  1. Symons JM, Picca S. Acute kidney injury and dialysis in children: illustrative cases. Sem Neph. 2008;28:431–435
  2. Watson RS, Carcillo JA. Scope and epidemiology of pediatric sepsis. Pediatr Crit Care Med. 2005;S3–S56 Suppl
  3. The World Health Care Report. Fighting disease, fostering development. Geneva: World Health Organization; 1996;
  4. The World Health Care Report. Changing history. Geneva: World Health Organization; 1996;
  5. Dobrovsky VY, Martin AA, Sunderram J, et al. Rapid increase in hospitalization and mortality rates from severe sepsis in the United States: a trend analysis from 1993 to 2003. Crit Care Med. 2007;35:1244–1250
  6. Watson RS, Carcillo JA, Linde-Zwirble WT, et al. The epidemiology of severe sepsis in children in the United States. Am J Respir Crit Care Med. 2003;167:695–701
  7. Leclerc F, Leteutre S, Duhamel A, et al. Cumulative influence of organ dysfunctions and septic state on mortality of critically ill children. Am J Respir Crit Care Med. 2005;171:348–355
  8. Nguyen T, Hall M, Han Y, et al. Microvascular thrombosis in pediatric multiple organ failure: is it a therapeutic target?. Pediatr Crit Care Med. 2001;2:187–196
  9. Hinshaw LB. Sepsis/septic shock: participation of the microcirculation: an abbreviated review. Crit Care Med. 1996;24:1072–1078
  10. Grinnell BW, Joyce D. Recombinant human activated protein C: a system modulator of vascular function for treatment of severe sepsis. Crit Care Med. 2001;29:Suppl:S53-61
  11. Massignon D, Lepape , Bienvenu J, et al. Coagulation/fibrinolysis balance in septic shock related to cytokines and clinical state. Haemostasis. 1994;24:36–48
  12. Degan JL. Hemostatic factor and inflammatory disease. Thromb Haemost. 1999;82:858–864
  13. Bierhaus A, Chen J, Liliensiek B, et al. LPS and cytokine-activated endothelium. Semin Thromb Hemost. 2000;26:571–587
  14. Iba T, Kidokoro A, Yagi Y. The role of endothelium in changes in procoagulant activity in sepsis. J Am Coll Surg. 1998;187:321–329
  15. Coughlin SR, Vu TH, Hung DT, et al. Characterization of a functional thrombin receptor. J Clin Invest. 1992;89:351–355
  16. Mammen EF. The haemotological manifestations of sepsis. J Anitimicrob Chemother. 1998;17–2441 Suppl A
  17. Levi M, Cate HT. Disseminated intravascular coagulation. N Engl J Med. 1999;34:586–592
  18. Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitides. Lancet. 2007;369:2196–2210
  19. Kirsch EA, Barton P, Kitchen L, Giroir B. Pathophysiology, treatment and outcome of meningococcemia: a review and recent outcome. Pediatr Infect Dis J. 1996;15:967–979
  20. Dhanani S, Cox P. Infectious syndromes in the pediatric intensive care unit. In:  Fuhrman B,  Zimmerman J editor. Pediatric critical care medicine. Philadelphia: Mosby; 2006;p. 1374–1393
  21. Stephens DS. Conquering the meningococcus. FEMS Microbiol Rev. 2007;31:3–14
  22. Carcillo JA, Fields AI. ACCM Task Force Committee. Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med. 2002;30:1365–1378
  23. Carcillo JA, Davis AL, Zaritsky A. Role of early fluid resuscitation in pediatric septic shock. JAMA. 1991;266:1242–1245
  24. Booy R, Habibi P, Nadel S, et al. Reduction in case fatality rate from meningococcal disease associated with improved healthcare delivery. Arch Dis Child. 2001;85:386–390
  25. Han YY, Carcillo JA, Dragotta MA, Bills DM, Watson RS, Westerman ME, et al. Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics. 2003;112:793–799
  26. Rivers E, Nguyen B, Haystad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2002;345:1368–1377
  27. Goldstein SL, Currier H, Graf JM, et al. Outcome in children receiving continuous venovenous hemofiltration. Pediatrics. 2001;107:1309–1312
  28. Foland JA, Fortenberry JD, Warshaw BL, et al. Fluid overload before continuous hemofiltration and survival in critically ill children: a retrospective analysis. Crit Care Med. 2004;32:1771–1776
  29. Ceneviva G, Paschall A, Maffei F, Carcillo JA. Hemodynamic support in fluid-refractory pediatric septic shock. Pediatrics. 1998;102:e19
  30. US Food and Drug Administration. Information for healthcare professionals. http://www.fda.gov/cder/drug/InfoSheets/HCP/ceftriaxone.htm2007;
  31. Faust SN, Pollard AJ, Nadel S, Ninis N, Levin M. Ceftriaxone drug alert: no longer for first line use in meningococcal sepsis (letter). Arch Dis Child. 2008;93:184–185
  32. Zimmerman JJ. A history of adjunctive glucocorticoid treatment for pediatric sepsis: moving beyond steroid pulp fiction toward evidence-based medicine. Pediatr Crit Care Med. 2007;8:530–539
  33. Riordan FA, Thomson AP, Ratcliffe JM, et al. Admission cortisol and ACTH levels in children with meningococcal disease: evidence of adrenal insufficiency?. Crit Care Med. 1999;27:2257–2261
  34. Hatherill M, Tibby SM, Tillard T, et al. Adrenal insufficiency in septic shock. Arch Dis Child. 1999;80:51–55
  35. De Kleijn ED, Joosten KF, Van Rijn B, et al. Low serum cortisol in combination with high ACTH concentrations are associated with poor outcome in children with severe meningococcal disease. Pediatr Infect Dis J. 2002;21:330–336
  36. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858–873
  37. Annane D, Sebille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862–871
  38. Sprung CL, Annane D, Keh D, Moreno R, Singer M, Freivogel K, et al. Hydrocortisone therapy for patients with septic shock. N Engl J Med. 2008;358:111–124
  39. van Deuren M, Brandtzaeg P, van der Meer JW. Update on meningococcal disease with emphasis on pathogenesis and clinical management. Clin Microbiol Rev. 2000;13:144–166
  40. McMaster P, Shann F. The use of extracorporeal techniques to remove humoral factors in sepsis. Pediatr Crit Care Med. 2003;4:2–7
  41. deKleijn E, de Groot R, Hack CE, Mulder PG, Engl W, Moritz B, et al. Activation of protein C following infusion of protein C concentrate in children with severe meningococcal sepsis and purpura fulminans. Crit Care Med. 2003;31:1839–1847
  42. Nadel S, Goldstein B, Williams MD, Dalton H, Peters M, Macias WL, et al. Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomized clinical trial. Lancet. 2007;369:836–843
  43. Zenz W, Zoehrer B, Levin M, Fanconi S, Hatzis T, Knight G, et al. Use of recombinant tissue plasminogen activator in children with meningococcal purpura fulminans: a retrospective study. Crit Care Med. 2004;32:1777–1780
  44. Bailey AR, Burkett KR. Effect of low-dose dopamine on serum concentrations of prolactin in critically ill patients. Br J Anaesthesia. 1997;78:97–99
  45. Srinivasan V, Spinella PC, Drott HR, Roth CL, Helfaer MA, Nadkarni V. Association of timing, duration and intensity of hyperglycemia with ICU mortality in critically ill children. Pediatr Crit Care Med. 2004;5:329–336
  46. Abraham E, Singer M. Mechanisms of sepsis-induced organ dysfunction. Crit Care Med. 2007;35:2408–2416
  47. Marotto M, Marotto P, Sztajnbok , Seguro A. Outcome of acute renal failure in meningococcemia. Ren Fail. 1997;19:807–810
  48. Martin K, Borgel D, Lerolle N, Feys HB, Trinquart L, Vanhoorelbeke K, et al. Decreased ADAMTS-13 is associated with a poor prognosis in sepsis-induced organ failure. Crit Care Med. 2007;35:2375–2382
  49. Slack R, Hawkins K, Gilhooley L, Addison M, Lewis M, Webb NJ. Long-term outcome of meningococcal sepsis-associated acute renal failure. Pediatr Crit Care Med. 2005;6:477–479
  50. Bartlett RH, Roloff DW, Custer JR, Younger JG, Hirschl RB. Extracorporeal life support: the University of Michigan experience. JAMA. 2000;283:904–908
  51. Fortenberry JD, Paden ML. Extracorporeal therapies in sepsis: experience and promise. Semin Pediatr Infect Dis. 2006;17:72–79
  52. MacLaren G, Butt W, Best D, Donath S, Taylor A. Extracorporeal membrane oxygenation for refractory septic shock in children: one institution's experience. Pediatr Crit Care Med. 2007;8:447–451
  53. Goldman A, Kerr S, Butt W, et al. Extracorporeal support for intractable cardiorespiratory failure due to meningococcal disease. Lancet. 1997;349:466–469
  54. Luyt DK, Pridgeon J, Brown J, et al. Extracorporeal life support for children with meningococcal septicemia. Acta Pediatr. 2004;93:1608–1611

PII: S0270-9295(08)00112-5

doi: 10.1016/j.semnephrol.2008.05.004

Seminars in Nephrology
Volume 28, Issue 5 , Pages 447-456 , September 2008