A STUDY OF OPTIMUM DURATION OF ADMINISTRATION OF FIRST FLUID BOLUS IN PEDIATRIC SEPTIC SHOCK

Abstract

IntroductionSepsis, a syndrome caused by infection, is a significant public health concern. According to the World Health Organization, infectious diseases account for more than 60% of mortality among children under the age of five worldwide. Sepsis is a potentially catastrophic multiorgan failure caused by the body's dysregulated reaction to an infectious infection. Despite various efforts, severe sepsis and septic shock continue to be the leading cause of death from infection in children. It is projected that infectious illnesses killed more than 4 million children under the age of five in 2013, with severe sepsis and septic shock accounting for the great majority of those deaths. At Alexandria University's Pediatric Intensive Care Unit (PICU), 42% of patients with septic shock died.Current guidelines advocate aggressive fluid resuscitation of up to 60 mL/kg boluses of 20 mL/kg each over 5–10 minutes to achieve the desired heart rate and blood pressure. Researchers have begun questioning the basics of fluid resuscitation including the need for and duration of administration of boluses. Different studies have reported varying duration of administration of the three boluses ranged from 60 to 90 minutes. there is paucity of evidence on the optimal duration of administration of fluid boluses in the first hour of fluid resuscitation.