The IX t h Makassed Medical Congress - American University of Beirut

19. Jones AE, Shapiro NI, Trzeciak S, et al. Lactate clearance vs central venous oxygen saturation as goals
of early sepsis therapy: a randomized clinical trial. JAMA 2010;303:739-746.
20. Brierley J, Carcillo JA, Choong K, et al. Clinical practice parameters for hemodynamic support of
pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine.
Critical care medicine 2009;37:666-688.
21. Leclerc F, Botte A, Binoche A, et al. Choc septique : définitions, physiopathologie, circonstances de
survenue et perspectives thérapeutiques. Doin ed. Paris; 2010.
22. Martin C, Brun-Buisson C. [Initial management of severe sepsis in adults and children]. Annales francaises
d’anesthesie et de reanimation 2007;26:53-73.
Table 1. Resuscitation bundle that must be completed within 6 hours (adapted to children).
Resuscitation bundle elements
1. Measure serum lactate.
2. Obtain blood cultures prior to antibiotic administration.
3. Administer broad-spectrum antibiotic within 1 hour of ED or non-ED admission.
4. In the event of hypotension [< 45 mm Hg (< 1 month); < 50 mm Hg ( 4 mmol/L: a. Deliver an initial
minimum of 20 mL/kg of crystalloid or an equivalent b. Apply vasopressors for
hypotension not responding to initial fluid resuscitation
to maintain mean arterial pressure (MAP): > 45 mm Hg (< 1 month);
> 50 mm Hg; ( 4 mmol/L: a. Achieve a
central venous pressure (CVP) of >8 mm Hg b. Achieve a central venous
oxygen saturation (ScvO2) > 70% or mixed venous
6. oxygenn saturation (SvO2) > 65%
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