Management of Pediatric Septic Shock and Acute Respiratory Distress Syndrome in Thailand: A Survey of Pediatricians

被引:0
|
作者
Puttiteerachot, Pasita [1 ]
Anantasit, Nattachai [1 ]
Chaiyakulsil, Chanapai [2 ]
Vaewpanich, Jarin [1 ]
Lertburian, Rojjanee [1 ]
Chantra, Marut [1 ]
机构
[1] Mahidol Univ, Ramathibodi Hosp, Div Pediat Crit Care, Dept Pediat,Fac Med, Bangkok, Thailand
[2] Thammasat Univ, Thammasat Univ Hosp, Div Pediat Crit Care, Dept Pediat,Fac Med, Bangkok, Thailand
来源
FRONTIERS IN PEDIATRICS | 2022年 / 9卷
关键词
septic shock; acute respiratory distress syndrome; survey; pediatrician; Thailand; ACUTE LUNG INJURY; CRITICAL-CARE; SEVERE SEPSIS; STRATEGIES; MORTALITY; ATROPINE; CHILDREN; OUTCOMES;
D O I
10.3389/fped.2021.792524
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Introduction: Pediatric septic shock and acute respiratory distress syndrome (pARDS) are major causes of morbidity and mortality in pediatric intensive care units (PICUs). While standardized guidelines for sepsis and pARDS are published regularly, their implementation and adherence to guidelines are different in resource-rich and resource-limited countries. The purpose of this study was to conduct a survey to ascertain variation in current clinician-reported practice in pediatric septic shock and acute respiratory distress syndrome, and the clinician skills in a variety of hospital settings throughout Thailand.Methods: We conducted an electronic survey in pediatricians throughout the country between August 2020 and February 2021 using multiple choice questions and clinical case scenarios based on the 2017 American College of Critical Care Medicine's Consensus guideline for pediatric and neonatal septic shock and the 2015 Pediatric Acute Lung Injury Consensus Conference.Results: The survey elicited responses from 255 pediatricians (125 general pediatricians, 38 pulmonologists, 27 cardiologists, 32 intensivists, and 33 other subspecialists), with 54.5% of the respondents having <5 years of PICU experience. Among the six sepsis scenarios, 72.5 and 78.4% of the respondents had good adherence to the guidelines for managing fluid refractory shock and sedation for intubation, respectively. The ICU physicians reported greater adherence during more complex shock. In ARDS scenarios, 80.8% of the respondents reported having difficulty diagnosing ARDS mimic conditions and used lesser PEEP than the recommendation. Acceptance of permissive hypercapnia and mild hypoxemia was accepted by 62.4 and 49.4% of respondents, respectively. The ICU physicians preferred decremental PEEP titration, whereas general pediatricians preferred incremental PEEP titration.Conclusion: This survey variation could be the result of resource constraints, knowledge gaps, or ambiguous guidelines. Understanding the perspective and rationale for variation in pediatricians' practices is critical for successful guideline implementation.
引用
收藏
页数:8
相关论文
共 50 条
  • [31] Diabetes mellitus: A negative predictor for the development of acute respiratory distress syndrome from septic shock
    Frank, JA
    Nuckton, TJ
    Matthay, MA
    [J]. CRITICAL CARE MEDICINE, 2000, 28 (07) : 2645 - 2646
  • [32] Low endocan levels are predictive of Acute Respiratory Distress Syndrome in severe sepsis and septic shock
    Gaudet, Alexandre
    Parmentier, Erika
    Dubucquoi, Sylvain
    Poissy, Julien
    Duburcq, Thibault
    Lassalle, Philippe
    Caires, Nathalie De Freitas
    Mathieu, Daniel
    [J]. JOURNAL OF CRITICAL CARE, 2018, 47 : 121 - 126
  • [33] Gonococcal septic shock, acute respiratory distress syndrome, and multisystem organ failure: a case report
    Landy, Joshua
    Djogovic, Dennis
    Sligl, Wendy
    [J]. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, 2010, 14 : E239 - E241
  • [34] A Case of Reverse McConnell's Sign Associated With Acute Respiratory Distress Syndrome and Septic Shock
    Curtis, Brett
    Ha, Albert
    Xie, Jeffrey
    Hyzy, Robert
    Helms, Adam S.
    [J]. CUREUS JOURNAL OF MEDICAL SCIENCE, 2024, 16 (01)
  • [35] Pediatric Acute Respiratory Distress Syndrome: Much More Than Little Acute Respiratory Distress Syndrome
    Rotta, Alexandre T.
    Piva, Jefferson P.
    [J]. PEDIATRIC CRITICAL CARE MEDICINE, 2015, 16 (05) : 483 - 484
  • [36] Biomarkers in pediatric acute respiratory distress syndrome
    Carlton, Erin F.
    Flori, Heidi R.
    [J]. ANNALS OF TRANSLATIONAL MEDICINE, 2019, 7 (19)
  • [37] Acute respiratory distress syndrome in pediatric patients
    Durand, P
    LePommelet, C
    Orbach, D
    Devictor, D
    Huault, G
    [J]. ARCHIVES DE PEDIATRIE, 1997, 4 (01): : 61 - 77
  • [38] Steroids in pediatric acute respiratory distress syndrome
    Monteverde-Fernandez, Nicolas
    Cristiani, Federico
    McArthur, Jenniffer
    Gonzalez-Dambrauskas, Sebastian
    [J]. ANNALS OF TRANSLATIONAL MEDICINE, 2019, 7 (19)
  • [39] Sepsis and Pediatric Acute Respiratory Distress Syndrome
    Yehya, Nadir
    Thomas, Neal J.
    [J]. JOURNAL OF PEDIATRIC INTENSIVE CARE, 2019, 8 (01) : 32 - 41
  • [40] Predicting Mortality in Children With Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study
    Yehya, Nadir
    Harhay, Michael O.
    Klein, Margaret J.
    Shein, Steven L.
    Pineres-Olave, Byron E.
    Izquierdo, Ledys
    Sapru, Anil
    Emeriaud, Guillaume
    Spinella, Philip C.
    Flori, Heidi R.
    Dahmer, Mary K.
    Maddux, Aline B.
    Lopez-Fernandez, Yolanda M.
    Haileselassie, Bereketeab
    Hsing, Deyin Doreen
    Chima, Ranjit S.
    Hassinger, Amanda B.
    Valentine, Stacey L.
    Rowan, Courtney M.
    Kneyber, Martin C. J.
    Smith, Lincoln S.
    Khemani, Robinder G.
    Thomas, Neal J.
    [J]. CRITICAL CARE MEDICINE, 2020, 48 (06) : E514 - E522