Pediatric sepsis

Abstract

Purpose of Review Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72,000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis. Recent Findings The definition of pediatric sepsis is currently in a state of evolution and there is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated. Summary Current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become commonplace.

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

“…1). In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) 4 were introduced. Although the Sepsis-3 task force acknowledged the need for pediatric-specific definitions, these new definitions currently apply only to adult populations (3).…”

“…Risk of death increases with increasing sepsis severity (4). In 1966, the mortality rate for pediatric septic shock was 97% (5).…”

“…Multiple "-omics" approaches have also been applied for discovery of novel prognostic and diagnostic markers (4,29). Wong ....................................................................................................... multiplex mRNA quantification platform of 100 genes that could accurately classify patients with septic shock and potentially identify patients who will benefit from corticosteroid therapies (68).…”

Development and Validation of an Automated Sepsis Risk Assessment System

“…The 1.5‐fold expansion of the infant ICU in the study hospital in September 2013 may have also contributed to these findings. Considering that infant and pediatric sepsis accounted for 40–65% of the total sepsis prevalence, and the clinical features of sepsis in infant and pediatric patients are different from those in adult patients (Mathias, Mira, & Larson, ; Sepanski et al, ), whether the Auto‐SepRAS would predict sepsis risk with accuracy in all ages should be determined. However, Auto‐SepRAS had moderate predictive ability for both the pediatric and adolescent group and and the adult group.…”

Modern Diagnostics of Sepsis and Septic Shock in Children

“…It should be noted that in this article we did not aim to consider the features of sepsis in newborns, since sepsis in this age group differs significantly from sepsis in children older than the neonatal period and adults and requires separate consideration (12).…”