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Septic shock
1Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Pittsburgh, Pennsylvania, USA.
Insights
Despite advances in understanding septic shock, bedside management remains supportive, with high mortality rates in both pediatric and adult patients. This review highlights similarities, differences, and novel therapeutic investigations.
Area of Science:
- Critical Care Medicine
- Pediatric and Adult Septic Shock Pathophysiology
- Translational Research in Sepsis
Background:
- Growing molecular understanding of septic shock contrasts with stagnant bedside management over two decades.
- Current treatment remains primarily supportive, leading to persistently high morbidity and mortality.
- Significant similarities and subtle differences exist between pediatric and adult septic shock presentations.
Purpose of the Study:
- To review the major similarities and minor differences in pediatric and adult septic shock.
- To emphasize current clinical management practices for septic shock.
- To discuss recent clinical investigations into novel therapeutic strategies for septic shock.
Main Methods:
- Comprehensive literature review of current clinical practice in septic shock management.
- Analysis of recent clinical investigations and trials for novel septic shock therapies.
- Comparative review focusing on pediatric versus adult septic shock characteristics.
Main Results:
- Treatment for both pediatric and adult septic shock remains largely supportive.
- Despite gradual improvements, morbidity and mortality rates in septic shock remain high.
- Key similarities and minor differences between pediatric and adult septic shock are identified.
Conclusions:
- Current bedside management of septic shock has seen minimal change despite increased molecular insights.
- There is an urgent need for more effective therapeutic interventions beyond supportive care.
- Further research into novel therapies is crucial for improving outcomes in pediatric and adult septic shock.
Abstract:
Although our understanding of molecular events in septic shock is growing exponentially, bedside management has changed only incrementally over the last 20 years. In pediatric and adult patients alike, treatment continues to be largely supportive. Morbidity and mortality, though gradually improving, continue to be high. The major similarities, as well as the minor differences, between pediatric and adult septic shock are reviewed in this article, with an emphasis on current clinical practice and recent clinical investigations of novel therapies.