SCCM Resource Library-Treating Pediatric Septic Shock With a Witch's Brew of Potions

Video Transcription

Video Summary

This video features three speakers who discuss the potential use of different medications in the treatment of pediatric septic shock. Dr. Bridget Blowey discusses thiamine (vitamin B1) and its impact on carbohydrate metabolism and energy production. She explains that thiamine deficiency is relatively common in pediatric septic shock patients and that thiamine administration could potentially have a positive impact on lactate levels and overall outcomes. However, more research is needed to fully understand the benefits and risks of thiamine administration in this population.<br /><br />Dr. Nelson Sanchez-Pinto discusses the use of vitamin C in pediatric septic shock. He explains that vitamin C has pleiotropic effects that could be beneficial in the treatment of sepsis, including reducing oxidative stress and enhancing the production of catecholamines. While there is limited evidence in pediatric patients specifically, some studies suggest that vitamin C administration may improve outcomes in sepsis patients with ARDS. However, further research is needed to identify specific patient populations that could benefit from vitamin C therapy.<br /><br />Dr. Tom Moran discusses the potential use of methylene blue in pediatric septic shock. Methylene blue works by inhibiting the action of nitric oxide, which can cause vasodilation and contribute to hypotension in septic shock patients. Although there is limited evidence in pediatric patients, some studies suggest that methylene blue can increase mean arterial pressure and decrease vasopressor requirements. However, more research is needed to determine the appropriate dosing and patient populations that would benefit from methylene blue therapy.<br /><br />Overall, while there is some evidence to support the use of thiamine, vitamin C, and methylene blue in pediatric septic shock, more research is needed to fully understand their effectiveness and determine the best approach for their use in this population.

Asset Subtitle

Pediatrics, Sepsis, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Review pharmacology and the role of thiamine to reverse refractory pediatric septic shock with elevated lactate levels
Describe the novel application of methylene blue in vasopressor-refractory pediatric septic shock
Discuss the role and benefits of vitamin C in the treatment of pediatric septic shock

Will You Be Mine, Thine Thiamine?
Bridget L. Blowey

Don't Forget to Take Your Vitamin C for Pediatric Septic Shock!
L. Nelson Sanchez-Pinto

Getting Rid of the Blues with Methylene Blue

Thomas J. Moran

Meta Tag

Content Type Presentation

Knowledge Area Pediatrics

Knowledge Area Sepsis

Knowledge Level Advanced

Membership Level Select

Tag Shock

Tag Monitoring

Year 2021

Keywords

medications

pediatric septic shock

thiamine

vitamin C

methylene blue

outcomes

oxidative stress

arterial pressure

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