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Review
. 2023;11(2):29-39.
doi: 10.1007/s40124-023-00286-3. Epub 2023 May 9.

Pediatric Sepsis: a Summary of Current Definitions and Management Recommendations

Mariana Miranda  1 , Simon Nadel  2
Affiliations
Review

Pediatric Sepsis: a Summary of Current Definitions and Management Recommendations

Mariana Miranda et al. Curr Pediatr Rep. 2023.

Abstract

Purpose of review: Pediatric sepsis remains an important cause of morbidity and mortality in children. This review will summarize the main aspects of the definition, the current evidence base for interventions discuss some controversial themes and point towards possible areas of improvement.

Recent findings: Controversy remains regarding the accurate definition, resuscitation fluid volume and type, choice of vasoactive/inotropic agents, and antibiotic depending upon specific infection risks. Many adjunctive therapies have been suggested with theoretical benefits, although definitive recommendations are not yet supported by data. We describe best practice recommendations based on international guidelines, a review of primary literature, and a discussion of ongoing clinical trials and the nuances of therapeutic choices.

Summary: Early diagnosis and timely intervention with antibiotics, fluid resuscitation, and vasoactive medications are the most important interventions in sepsis. The implementation of protocols, resource-adjusted sepsis bundles, and advanced technologies will have an impact on reducing sepsis mortality.

Keywords: Antibiotic management; Fluid resuscitation; Pediatric intensive care unit; Pediatric sepsis; Septic shock.

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Conflict of interest statement

Conflict of InterestThe authors declare no competing interests.

References

    1. Weiss SL, Peters MJ, Alhazzani W, Agus MSD, Flori HR, Inwald DP, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Pediatr Crit Care Med. 2020;21(2):e52–e106. doi: 10.1097/PCC.0000000000002198. - DOI - PubMed
    1. Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. Lancet Respir Med. 2018;6(3):223–230. doi: 10.1016/S2213-2600(18)30063-8. - DOI - PubMed
    1. Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200–211. doi: 10.1016/S0140-6736(19)32989-7. - DOI - PMC - PubMed
    1. Cinel I, Dellinger RP. Advances in pathogenesis and management of sepsis. Curr Opin Infect Dis. 2007;20(4):345–352. doi: 10.1097/QCO.0b013e32818be70a. - DOI - PubMed
    1. Workman JK, Ames SG, Reeder RW, Korgenski EK, Masotti SM, Bratton SL, et al. Treatment of pediatric septic shock with the surviving sepsis campaign guidelines and PICU patient outcomes. Pediatr Crit Care Med. 2016;17(10):e451–e458. doi: 10.1097/PCC.0000000000000906. - DOI - PubMed

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