88 Severe Sepsis and Septic Shock	707

Suggested Reading

1.Khilnani P, Singhi S, Lodha R, et al. Pediatric sepsis guidelines: summary for resourcelimited countries. Indian J Crit Care Med. 2010;14(1):41–52.

Pediatric sepsis guidelines are presented in text and flow chart format, keeping resource limitations in mind for countries such as India and Africa.

2.Brierley J, Carcillo JA. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med. 2009;37:666–88.

The 2007 update continues to emphasize early use of age-specific therapies to attain timesensitive goals, specifically recommending (1) first-hour fluid resuscitation and inotrope therapy directed to goals of threshold heart rates, normal blood pressure, and capillary refill £2 s and

(2)subsequent intensive care unit hemodynamic support directed to goals of central venous oxygen saturation >70% and cardiac index 3.3–6.0 L/min/m.

3.Zimmerman J, Barker R, Cantini C. Effect of adjunctive corticosteroids on clinical outcomes in pediatric sepsis syndrome. Abstr 461. Crit Care Med. 2006;34(Suppl 12):A129.

4.Han YY, Carcillo JA, Dragotta MA, et al. Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome. Pediatrics. 112:793–99.

Early recognition and aggressive resuscitation of pediatric and neonatal septic shock by community physicians can save lives.

5.Rivers E, Nguyen B, Havstad 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. 2001;345(19):1368–77.

Early goal-directed therapy provides significant benefits with respect to outcome in patients with severe sepsis and septic shock.