title: [Septic shock in ICU: advanced therapeutics, immunoparalysis and genomics. State of the art].
abstract: New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive care unit must be fully aware of them to improve patient care in the critical care unit. It should be considered the use of immune therapy only in selected groups of patients. Continuous renal replacement therapies are well tolerated and their early use prevents deleterious fluid overload. Removal of inflammatory mediators by using high volume hemofiltration may play a role in hyperdynamic septic patients. The use of plasmapheresis is recommended in patients with thrombocytopenia-associated multiple organ failure. Extracorporeal support use should be considered in those with refractory septic shock despite goals directed therapy. The immunoparalysis has been associated with nosocomial infections and late mortality. The information from genetic markers may allow early intervention and preventive genomics-based medicine.
authors: Programa de Medicina Intensiva en Pediatría, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo.
authors: Daniela
authors: D
authors: Arriagada S
authors: Programa de Medicina Intensiva en Pediatría, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo.
authors: Alejandro
authors: A
authors: Donoso F
authors: Área de Cuidados Críticos, Hospital Padre Hurtado, Hospital Padre Hurtado.
authors: Pablo
authors: P
authors: Cruces R
authors: Área de Cuidados Críticos, Hospital Padre Hurtado, Hospital Padre Hurtado.
authors: Franco
authors: F
authors: Díaz R
mesh_terms: D002648:Child; D023281:Genomics; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000209:etiology* / Q000235:genetics; D007362:Intensive Care Units; D012772:Shock, Septic / Q000235:genetics / Q000276:immunology* / Q000628:therapy*