Septic shock in newborn infants [Choque séptico en neonatos.]

Systemic bacterial infections continue to be a main cause of death in newborns at neonatal intensive care units (NICU), worldwide. Bacteria causing neonatal septicemia are mainly the gram-negative, which possess endotoxin and are responsible for endotoxic shock. However, gram-positive bacteria are also able to induce septic shock, especially in immunocompromised hosts, like the newborns. Diagnosis and treatment of neonatal septic shock are quite difficult. Furthermore, there is not sufficient knowledge about its real frequency in Latin-american countries. The hyperdynamic phase of septic shock in newborns can be short and the hypodynamic phase is rapidly established, which increases the mortality. Since few years ago, some important aspects of physiopathology in septic shock have been studied and, at the same time that our knowledge about immunologic soluble mediators is increasing, new therapeutic modalities have been discovered. Such is the case of the therapeutic potentialities of cytokines, receptor antagonists and monoclonal antibodies, which is very encouraging at the present time