Manejo moderno del shock séptico pediátrico: estrategias hemodinámicas, perfusión tisular y supervivencia

Septic shock is a frequent cause of paediatric morbidity and mortality. The study therefore aimed to analyse recent scientific evidence on the modern management of paediatric septic shock, with emphasis on haemodynamic strategies and tissue perfusion as determinants of survival. A systematic review was conducted in accordance with PRISMA 2020 in PubMed/MEDLINE, Scopus and Web of Science, with a sample of 12 studies published between 2020 and 2026. Balanced solutions reduced acute kidney injury without lowering mortality, the choice between epinephrine and norepinephrine did not change survival, vasopressor administration within the first hour was associated with lower mortality, and microcirculatory incoherence predicted death. It was concluded that resuscitation should be physiology-guided, with prudent fluids and timely vasoactive support.