title: The golden hours in paediatric septic shock--current updates and recommendations.
abstract: BACKGROUND
  Paediatric sepsis is a global health problem. It is the leading cause of mortality in infants and children worldwide. Appropriate and timely initial management in the first hours, often termed as the "golden hours", has great impact on survival. The aim of this paper is to summarise the current literature and updates on the initial management of paediatric sepsis.
  
  
  METHODS
  A comprehensive literature search was performed via PubMed using the search terms: 'sepsis', 'septic shock', 'paediatric' and 'early goal-directed therapy'. Original and review articles were identified and selected based on relevance to this review.
  
  
  RESULTS
  Early recognition, prompt fluid resuscitation and timely administration of antibiotics remain key in the resuscitation of the septic child. Use of steroids and tight glycaemic control in this setting remain controversial.
  
  
  CONCLUSIONS
  The use of early goal-directed therapy has had significant impact on patient outcomes and protocolised resuscitation of children in septic shock is recommended.
authors.affiliation: Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore.
authors.forename: Shu Ling
authors.initials: SL
authors.lastname: Chong
authors.forename: Gene Y K
authors.initials: GY
authors.lastname: Ong
authors.forename: Anantharaman
authors.initials: A
authors.lastname: Venkataraman
authors.forename: Yoke Hwee
authors.initials: YH
authors.lastname: Chan
mesh_terms: D002648:Child; D006801:Humans; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000592:standards; D012772:Shock, Septic / Q000628:therapy*