patients with severe septic shock. Reported outcomes are center
dependent and
vary from 40 to 79%. Neonatal population has an excellent
response, and recent data from Australia show a 74% survival to
discharge with central, intracardiac cannulation. ECMO is
therefore recommended for refractory pediatric septic shock. [ 22 ]b) Diuresis and CRRT: Significant fluid overload (>20% of dry
weight) is reported as having strong association with poor ICU
outcomes. In treated septic patients, whose shock state has been
reversed, gentle volume removal is recommended by the ACCCM.
Diuretics and CRRT have both been used to manage fluid
overload, allowing for ventilatory weaning and deesclation of other
supportive therapies.
c) IVIg: is not recommended in patients with adult sepsis. However,
it is still considered in pediatric population, particularly in neonates
due to concerns of immature immune system, leading to
consumptive deficit in native immunoglobulines.[ 23 ] The most
recent review showed equivocal results, particularly in the