Dissertation/ Thesis
Epinephrine use in pediatric septic shock: a retrospective, single center study on 117 patients ; Place de l’adrénaline dans le choc septique pédiatrique : une étude rétrospective, monocentrique sur 117 patients
| العنوان: | Epinephrine use in pediatric septic shock: a retrospective, single center study on 117 patients ; Place de l’adrénaline dans le choc septique pédiatrique : une étude rétrospective, monocentrique sur 117 patients |
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| المؤلفون: | Starck, Julie |
| المساهمون: | Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Laurent Dupic |
| المصدر: | https://dumas.ccsd.cnrs.fr/dumas-01221689 ; Médecine humaine et pathologie. 2015. |
| بيانات النشر: | HAL CCSD |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Réanimation pédiatrique, Choc septique, Adrénaline, Mortalité, MESH: Epinephrine, MESH: Shock, Septic, MESH: Mortality, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | Introduction: Septic shock remains a major health issue. International pediatric therapeutic guidelines do exist. However, as for epinephrine use, they are only based on adult or neonatal references. Our study constitutes the first specifically pediatric work on epinephrine use in septic shock.Patients and methods: Retrospective, single center, observational study of children (newborn excluded) treated for septic shock in our ward between 2009 and 2013. Definition of two groups with and without epinephrine use. Description of each group (sociodemographic, clinical and biological data, epinephrine modality of prescription, patients’ outcome), and comparison between the two groups in uni and multivariate analysis.Results: Patients treated with epinephrine (n=49) are clinically and biologically more severe at the onset of the septic shock, than patients treated without (n=68). Our delay before initiating epinephrine is four times longer than the one given in the recommendations. Above all, patients treated with epinephrine have a higher mortality rate (63,3 versus 16,2%) in uni and multivariate analysis after adjustment on the initial gravity, with a potential association between the maximum epinephrine dose used and death.Conclusion: Isn’t a better initial monitoring of our patients necessary to determine their hemodynamic profile at best and prescribe the most appropriate drug? Would an earlier initiation of epinephrine have a beneficial effect on the mortality rate of these patients? Would alternative therapeutics such as the ECMO be beneficial beyond a given maximum dose of epinephrine? ; Introduction : Le choc septique reste un problème majeur de santé publique. Des recommandations thérapeutiques internationales pédiatriques existent. L’utilisation de l’adrénaline dans celles-ci ne repose que sur des références adultes ou néonatales. Notre objectif est de décrire la place de l’adrénaline sur une première cohorte de patients spécifiquement pédiatrique.Patients et méthodes : Étude rétrospective, monocentrique, ... |
| نوع الوثيقة: | master thesis |
| اللغة: | French |
| Relation: | dumas-01221689; https://dumas.ccsd.cnrs.fr/dumas-01221689; https://dumas.ccsd.cnrs.fr/dumas-01221689/document; https://dumas.ccsd.cnrs.fr/dumas-01221689/file/ThExe_STARCK_Julie_DUMAS.pdf |
| الاتاحة: | https://dumas.ccsd.cnrs.fr/dumas-01221689 https://dumas.ccsd.cnrs.fr/dumas-01221689/document https://dumas.ccsd.cnrs.fr/dumas-01221689/file/ThExe_STARCK_Julie_DUMAS.pdf |
| Rights: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.E02BD869 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |