Severe sepsis
Severe sepsis is the final common pathway for many childhood infections, with mortality rates ranging from 6-30%. Part of the initial management of severe sepsis in recent years has been aggressive fluid resuscitation. In 2011, a large, multicentred, randomised trial of fluid resuscitation in Sub-Saharan Africa demonstrated increased mortality from this practice. The impact on developed countries has been unclear. No change to current guidelines has taken place. This survey of senior Emergency Department clinicians sought to clarify if and how fluid resuscitation is currently conducted in Australian and New Zealand Emergency Department with specific reference to fluid resuscitation. The study was distributed electronically to PREDICT site representatives, who disseminated it within their department.
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Publications to date
Long E., Babl F., Dalziel S., Dalton S., Etheridge C., and Duke T., ‘Fluid Resuscitation for Paediatric Sepsis: A Survey of Senior Emergency Physicians in Australia and New Zealand’, Emerg Med Australas, (2015). link
Long E, Duke T, Oakley E, O’Brien A, Sheridan B, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does respiratory variation of inferior vena cava diameter predict fluid responsiveness in spontaneously ventilating children with sepsis. Emerg Med Australas. 2018 Mar 8. doi: 10.1111/1742-6723.12948. [Epub ahead of print] [link]
Long E, Babl FE, Oakley E, Sheridan B, Duke T; Pediatric Research in Emergency Departments International Collaborative (PREDICT). Cardiac Index Changes With Fluid Bolus Therapy in Children With Sepsis-An Observational Study. Pediatr Crit Care Med. 2018 Mar 10. doi: 10.1097/PCC.0000000000001534. [Epub ahead of print] [link].
Long E, Oakley E, Duke T, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Does Respiratory Variation in Inferior Vena Cava Diameter Predict Fluid Responsiveness: A Systematic Review and Meta-Analysis. Shock. 2017 May;47(5):550-559. doi: 10.1097/SHK.0000000000000801. PMID: 28410544 [Link]
Long E., Oakley E., Duke T., Babl FE., On behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT). The Clinical Utility of Respiratory Variation in Inferior Vena Cava Diameter for Predicting Fluid Responsiveness in Spontaneously Ventilating Patients. Shock. 2017 Jul 19. doi:10.1097/SHK.0000000000000951 [Epub ahead of print] PMID: 28727606. [Link]
Long E., Babl FE., Angley E., Duke T.A. Prospective quality improvement study in the emergency department targeting paediatric sepsis. Arch Dis Child. 2016 Oct;101(10):945-50. doi: 10.1136/archdischild-2015-310234. link
Long E, Oakley E., Babl FE, and Duke T, ‘An Observational Study Using Ultrasound to Assess Physiological Changes Following Fluid Bolus Administration in Paediatric Sepsis in the Emergency Department.’, BMC Pediatr, (July 2016). [link]
Long E, and Duke T, ‘Fluid Resuscitation Therapy for Paediatric Sepsis’, J Paediatr Child Health, (2016) 52 (2), 141-46. link
Long E., Babl F., Dalziel S., Dalton S., Etheridge C., and Duke T., ‘Fluid Resuscitation for Paediatric Sepsis: A Survey of Senior Emergency Physicians in Australia and New Zealand’,Emerg Med Australas, (2015) Jun;27(3):245-50. doi: 10.1111/1742-6723.12400. [link]