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Critical Care Management: Sepsis and Disseminated and Local Infections

  • Caitlin Hurley
  • Matt ZinterEmail author
Chapter

Abstract

Local and systemic infections are a significant cause of morbidity and mortality among immunocompromised children, including but not limited to patients with hematologic and solid malignancies, congenital or acquired immunodeficiencies, or hematopoietic cell or solid organ transplantation patients. Progression to septic shock can be rapid and profound and thus requires specific diagnostic and treatment approaches. This chapter will discuss the diagnosis and the initial hemodynamic management strategies of septic shock in immunocompromised children, including strategies to improve oxygen delivery, reduce metabolic demand, and monitor hemodynamic response to resuscitation. This chapter also discusses strategies to reverse septic shock pathobiology, including the use of both empiric and targeted anti-infective strategies and pharmacologic and cell therapy-based immunomodulation. Specific consideration is also paid to the management of high-risk subpopulations and the care of septic shock patients with resolving injury.

Keywords

Pediatric Sepsis Shock, septic Immunocompromised host Hematopoietic stem cell transplantation Cardiopulmonary resuscitation 

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Copyright information

© Springer International Publishing 2019

Authors and Affiliations

  1. 1.Division of Critical Care Medicine and Department of Bone Marrow TransplantationSt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Department of Pediatrics, Division of Critical Care Medicine, UCSF Benioff Children’s HospitalsUniversity of California, San FranciscoSan FranciscoUSA

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