362 SECTION IV Pediatric Critical Care Cardiovascular and ADAMTS 13 inhibitors 157,158 In a prospective observa tional study in 9 PICUs, the use of therapeutic plasma exchange in sepsis induced TAMOF[.]
Trang 1and ADAMTS-13 inhibitors.157 , 158 In a prospective
observa-tional study in 9 PICUs, the use of therapeutic plasma exchange
in sepsis-induced TAMOF was associated with a decrease in organ
dysfunction and a 55% lower adjusted relative risk of 28-day
mortality as compared with those not receiving TPE.159 TPE
could potentially have improved sepsis-induced organ
dysfunc-tion by removing inflammatory mediators, reducing
antifibrinol-ytic molecules, replenishing anticoagulant proteins, and restoring
ADAMTS-13 activity to mitigate the dysregulated inflammation,
coagulation, and fibrinolytic pathways of sepsis.159
Summary
Shock is a life-threatening condition that has a myriad of causes
In order to survive shock, recognition and resuscitative efforts
must be achieved early, the etiology elucidated, and ongoing
monitoring and therapy instituted The astute clinician who
rec-ognizes shock, promptly establishes therapy, and continuously
assesses response during treatment offers the child the best chance
for a quality survival.
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