[Management of the first hour of the pediatric septic shock patient].

Background: The pediatric septic shock mortality in Tunisia remains high (50%) and was markedly higher than in western countries (10%). The decrease in septic shock mortality has been obtained with the advent of the early goal directed therapy.

Aim: The aim of this paper is to propose to the first line practitioners in Tunisia, during the first hour after establishing the diagnosis of septic shock practical clinical guidelines based on earlier consensus recommendations.

Methods: Literature review.

Results: Septic shock must be rapidly suspected and early recognized. Adequate oxygenation and prompt correction of hemodynamic derangements has been shown to improve outcome through aggressive volume resuscitation, early empiric antibiotherapy and early initiation of vasopressor agents. Frequent reassessment has been emphasized to ensure appropriate management. This treatment must take into consideration the resources available in our area. We can reasonably hope to decrease mortality of patients with septic shock if the first line physicians keep in mind specific therapeutic goals.