Paediatric sepsis: old wine in new bottles?

Schlapbach, Luregn J.; Javouhey, Étienne; Jansen, Nicolaas J. G.

doi:10.1007/s00134-017-4800-6

Cited by 11 publications

(7 citation statements)

References 15 publications

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“…Furthermore, their impact on clinical outcomes is unknown (11). In both adults and children, the SIRS criteria have been criticized for their broader inclusion of mild symptoms and lack of specificity (12,13). On the other hand, these definitions may also miss patients with infection and single-organ failure with a high mortality risk (14,15).…”

Section: Pediatric Sepsis Definitionsmentioning

confidence: 99%

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

Patel

McElvania

2019

The Journal of Applied Laboratory Medicine

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Background Sepsis is a leading cause of death for children in the US and worldwide. There is a lack of consensus how sepsis is clinically defined, and sepsis definitions and diagnostic guidelines for the pediatric population have remained unchanged for more than a decade now. Current pediatric definitions are largely based on adult guidelines and expert opinion rather than evidence based on outcomes in the pediatric populations. Without a clear definition of sepsis, it is challenging to evaluate the performance of new laboratory tests on the diagnosis and management of sepsis. Content This review provides an overview of common etiologies of sepsis in pediatric populations, challenges in defining and diagnosing pediatric sepsis, and current laboratory tests used to identify and monitor sepsis. Strengths and limitations of emerging diagnostic strategies will also be discussed. Summary Currently there is no single biomarker that can accurately diagnose or predict sepsis. Current biomarkers such as C-reactive protein and lactate are neither sensitive nor specific for diagnosing sepsis. New biomarkers and rapid pathogen identification assays are much needed. Procalcitonin, although having some limitations, has emerged as a biomarker with demonstrated utility in management of sepsis in adults. Parallel studies analyzing the utility of procalcitonin in pediatric populations are lagging but have shown potential to affect sepsis care in pediatric populations. Multibiomarker approaches and stepwise algorithms show promise in the management of pediatric sepsis. However, a major hurdle is the lack of validated clinical criteria for classification of pediatric sepsis, which is necessary for the development of well-designed studies that can assess the clinical impact of these emerging biomarkers.

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Section: Pediatric Sepsis Definitionsmentioning

confidence: 99%

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

Patel

McElvania

2019

The Journal of Applied Laboratory Medicine

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“…Given the significance of a new universally applicable paediatric SOFA score, Kawasaki et al suggested that the way forward requires worldwide collaboration of paediatric intensivists [16]. A renewed focus on re-evaluating sepsis epidemiology with novel and generalisable sepsis stratification tools is necessary to design efficient trials to improve care for paediatric sepsis [17].…”

Section: Sepsismentioning

confidence: 99%

Focus on paediatrics 2018

Kanthimathinathan

Peters

2018

Intensive Care Med

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“…The use of infection prevention and care bundles has rapidly extended to neonatal care settings and proven effective in reducing adverse clinical outcomes, including HCAI. 8 , 9 , 10 To provide consistency in their formulation and implementation for reducing neonatal HCAI in LMIC, a classification system is needed. The creation of a Classification Framework will also provide common and consistent terminology and definitions for the care bundle element categories.…”

Section: Introductionmentioning

confidence: 99%

Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review

et al. 2022

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Background Health care-associated infections (HCAI) in neonatal units in low-and middle-income countries (LMIC) are a major cause of mortality. This scoping review aimed to synthesise published literature on infection prevention and care bundles addressing neonatal HCAI in LMICs and to construct a Classification Framework for their components (elements).Methods Five electronic databases were searched between January 2001 and July 2020. A mixed-methods approach was applied: qualitative content analysis was used to build a classification framework to categorise bundle elements and the contents of the classification groups were then described quantitatively.Findings 3619 records were screened, with 44 eligible studies identified. The bundle element Classification Framework created involved: (1) Primary prevention, (2) Detection, (3) Case management, and Implementation (3 + I). The 44 studies included 56 care bundles with 295 elements that were then classified. Primary prevention elements (128, 43%) predominated of which 71 (55%) focused on central line catheters and mechanical ventilators. Only 12 elements (4%) were related to detection. A further 75 (25%) elements addressed case management and 66 (88%) of these aimed at outbreak control.Interpretation The 3 + I Classification Framework was a feasible approach to reporting and synthesising research for infection-relevant bundled interventions in neonatal units. A shift towards the use in infection prevention and care bundles of primary prevention elements focused on the neonate and on commonly used hospital devices in LMIC (e.g., self-inflating bags, suctioning equipment) would be valuable to reduce HCAI transmission. Detection elements were a major gap.

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Paediatric sepsis: old wine in new bottles?

Cited by 11 publications

References 15 publications

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

Focus on paediatrics 2018

Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review

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