Scientific article
by Matthew P . Malone , MD 1 ; Abdallah Dalabih , MD 1 ; Ronald C . Sanders Jr ., MD , MS 1 ; Michael H . Stroud , MD 1
1
Section of Critical Care Medicine , Department of Pediatrics , UAMS
Pediatric Sepsis : Update on Recognition and Management from the Surviving Sepsis Campaign
Abstract
Sepsis in children is increasingly common and is associated with high morbidity and mortality . In February 2020 , international critical care experts published the first edition of “ Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children .” Definitions were simplified to decrease confusion for clinical providers , and individual centers were encouraged to establish septic shock recognition and resuscitation “ bundles ,” enabling timely triage and management of pediatric sepsis . Key features include : immediate IV / IO access , antibiotic administration within one hour , obtaining blood cultures , prompt fluid resuscitation with emphasis on frequent reassessment , and early initiation of inotropes .
Introduction
The International Society of Critical Care Medicine convened this year to provide updates on several subjects , including the revised Surviving Sepsis Campaign ( SSC ) guidelines for adults and children . A panel of 49 experts and 12 international organizations reviewed the most recent literature and shared their experience and expertise to establish the latest guidelines for pediatric septic shock and sepsis-associated organ dysfunction in children . 1 Intended users of these guidelines are health professionals caring for children in a hospital , emergency department , or other acute-care settings .
Sepsis remains a health concern for children , with more than 1.2 million annual cases worldwide . Mortality of sepsis in children varies depending upon associated risk factors , severity of illness , and geographic location of the patient , ranging from 4-50 %. 1 Given the rural nature of much of Arkansas , the majority of patients with sepsis initially present to our frontline health care providers in urgent-visit centers , primary care offices , and emergency departments . Thus , this update is pertinent to all practitioners caring for children in Arkansas .
Background
Sepsis is a significant problem in the U . S . and accounts for over 40,000 deaths
Figure 1 . Initial Resuscitation Algorithm for Children . ( Source : Surviving Sepsis Campaign . www . sccm . org / SurvivingSepsisCampaign / Guidelines / Pediatric- Patients )
226 • The Journal of the Arkansas Medical Society www . ArkMed . org