International Consensus Criteria for Pediatric Sepsis and Septic Shock
Rattachement africain : au, ch, us, Afrique du Sud, ca, Kenya, it, gb, bd, br, co, in, jp, fr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Importance: Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children. Objective: To update and evaluate criteria for sepsis and septic shock in children. Evidence Review: The Society of Critical Care Medicine (SCCM) convened a task force of 35 pediatric experts in critical care, emergency medicine, infectious diseases, general pediatrics, nursing, public health, and neonatology from 6 continents. Using evidence from an international survey, systematic review and meta-analysis, and a new organ dysfunction score developed based on more than 3 million electronic health record encounters from 10 sites on 4 continents, a modified Delphi consensus process was employed to develop criteria. Findings: Based on survey data, most pediatric clinicians used sepsis to refer to infection with life-threatening organ dysfunction, which differed from prior pediatric sepsis criteria that used systemic inflammatory response syndrome (SIRS) criteria, which have poor predictive properties, and included the redundant term, severe sepsis. The SCCM task force recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. Children with a Phoenix Sepsis Score of at least 2 points had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings, more than 8 times that of children with suspected infection not meeting these criteria. Mortality was higher in children who had organ dysfunction in at least 1 of 4-respiratory, cardiovascular, coagulation, and/or neurological-organ systems that was not the primary site of infection. Septic shock was defined as children with sepsis who had cardiovascular dysfunction, indicated by at least 1 cardiovascular point in the Phoenix Sepsis Score, which included severe hypotension for age, blood lactate exceeding 5 mmol/L, or need for vasoactive medication. Children with septic shock had an in-hospital mortality rate of 10.8% and 33.5% in higher- and lower-resource settings, respectively. Conclusions and Relevance: The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force using a large international database and survey, systematic review and meta-analysis, and modified Delphi consensus approach. A Phoenix Sepsis Score of at least 2 identified potentially life-threatening organ dysfunction in children younger than 18 years with infection, and its use has the potential to improve clinical care, epidemiological assessment, and research in pediatric sepsis and septic shock around the world.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- International Consensus Criteria for Pediatric Sepsis and Septic Shock
- Date Crossref
- 27/02/2024
- Éditeur
- American Medical Association (AMA)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The University of Queensland Child Health Research Centre pays non établi dans la noticeUniversité ou école supérieure
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University of Zurich pays non établi dans la noticeUniversité ou école supérieure
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University Children's Hospital Zurich Department of Intensive Care and Neonatology pays non établi dans la noticeÉtablissement de santé
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Seattle Children's Hospital pays non établi dans la noticeÉtablissement de santé
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University of Washington Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Northwestern University Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Lurie Children's Hospital pays non établi dans la noticeÉtablissement de santé
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University of Cape Town University of Cape Town, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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Red Cross War Memorial Children's Hospital Department of Paediatrics and Child Health Cape Town, Afrique du Sud (code pays fourni par la source)Établissement de santé
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University of Ottawa pays non établi dans la noticeUniversité ou école supérieure
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Children's Hospital of Eastern Ontario Department of Pediatrics pays non établi dans la noticeÉtablissement de santé
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Nationwide Children's Hospital Division of Critical Care Medicine pays non établi dans la noticeÉtablissement de santé
Child Health Research Centre — The University of Queensland, University of Zurich et Department of Intensive Care and Neonatology — University Children's Hospital Zurich, avec 9 autres affiliations. Pays d’affiliation : Afrique du Sud, Kenya.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.