Abstract
Objectives: To survey the management of pediatric septic shock in Japanese pediatric intensive care units (PICUs) and obtain the basic data for improving the practices in the management of pediatric sepsis. Methods: A questionnaire concerning the management of pediatric septic shock using a case scenario was sent to ICU and PICU medical directors of 29 units in Japan. Results: Responses were obtained from 27 units. Of these, only 33% of the facilities obtained 2 sets of blood cultures before starting antibiotic administration. A total of 52% of the facilities gave antibiotics within 1 hr of septic shock recognition, and 59% considered starting vasopressors if a patient was still hypotensive despite 40-60 ml/kg of fluid resuscitation. The vasopressors chosen were dopamine (33%), noradrenaline (30%), and adrenaline (26%). Arterial lactate, an arterial blood gas analysis, and central venous oxygen saturation (ScvO2) values were used to determine the severity of septic shock. Conclusion: The performance of multiple sets of blood cultures and earlier administration of appropriate antibiotics need to be encouraged in order to improve the practices in pediatric septic shock.
