Strategies for early identification and management of sepsis in children
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20242279Keywords:
Pediatric sepsis, Early identification, Management, Antimicrobial therapy, Vasoactive agentsAbstract
Pediatric sepsis continues to be a major public health concern, leading to considerable morbidity and mortality despite progress in medical treatments. This review explores methods for the prompt detection and management of sepsis in children, highlighting the importance of early recognition and intervention. Diagnosing sepsis in children is difficult because of its non-specific symptoms and the diverse ways it presents in different age groups. Key strategies include enhancing parental education, improving pre-hospital recognition by emergency medical services (EMS), and leveraging the pivotal role of nurses in emergency settings. Effective management involves prompt administration of antimicrobials, appropriate use of vasoactive agents, and comprehensive post-sepsis care to improve long-term outcomes. Advanced diagnostic tools and rapid, reliable biomarkers are crucial for early detection. Additionally, antimicrobial stewardship programs and public health campaigns play a vital role in reducing sepsis incidence. By focusing on these strategies, healthcare providers can significantly improve the early identification and management of sepsis in children, enhancing survival rates and long-term quality of life for pediatric sepsis survivors.
Metrics
References
Miranda M, Nadel S. Pediatric sepsis: a summary of current definitions and management recommendations. Curr Pediatr Rep. 2023;11(2):29-39.
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):e52-106.
Fleischmann-Struzek C, Goldfarb DM, Schlattmann P, Schlapbach LJ, Reinhart K, Kissoon N. The global burden of paediatric and neonatal sepsis: a systematic review. The Lancet Resp Med. 2018;6(3):223-30.
Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200-11.
Agyeman PKA, Schlapbach LJ, Giannoni E, Stocker M, Posfay-Barbe KM, Heininger U, et al. Epidemiology of blood culture-proven bacterial sepsis in children in Switzerland: a population-based cohort study. The Lancet Child Adolescent Health. 2017;1(2):124-33.
Schlapbach LJ, Chiletti R, Straney L, Festa M, Alexander D, Butt W, et al. Defining benefit threshold for extracorporeal membrane oxygenation in children with sepsis—a binational multicenter cohort study. Crit Care. 2019;23(1):429.
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):e451-8.
Tan B, Wong JJ-M, Sultana R, Koh JCJW, Jit M, Mok YH, et al. Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis. JAMA Pediatr. 2019;173(4):352-62.
Peshimam N, Nadel S. Sepsis in children: state-of-the-art treatment. T Ther Adv Infect Dis. 2021;8:20499361211055332.
Kannikeswaran N, Mahajan P. Pediatric Sepsis: New Strategies for Reducing Sepsis Related Mortality. Indian Pediatr. 2023;60(12):981-4.
Harley A, Schlapbach LJ, Johnston AN, Massey D. Challenges in the recognition and management of paediatric sepsis—The journey. Australas Emerg Care. 2022;25(1):23-9.
Harley A, Latour JM, Schlapbach LJ. The role of parental concerns in the recognition of sepsis in children: a literature review. Front Pediatr. 2019;7:161.
Schlapbach LJ, MacLaren G, Festa M, Alexander J, Erickson S, Beca J, et al. Prediction of pediatric sepsis mortality within 1 h of intensive care admission. Intensive Care Med. 2017;43:1085-96.
Kleinpell R, Blot S, Boulanger C, Fulbrook P, Blackwood B. International critical care nursing considerations and quality indicators for the 2017 surviving sepsis campaign guidelines. Intens Care Med. 2019;45:1663-6.
Harley A, Johnston A, Denny K, Keijzers G, Crilly J, Massey D. Emergency nurses’ knowledge and understanding of their role in recognising and responding to patients with sepsis: A qualitative study. Int Emerg Nurs. 2019;43:106-12.
Schlapbach LJ, Weiss SL, Wolf J. Reducing collateral damage from mandates for time to antibiotics in pediatric sepsis—primum non nocere. JAMA Pediatr. 2019;173(5):409-10.
Godbout EJ, Pakyz AL, Markley JD, Noda AJ, Stevens MP. Pediatric antimicrobial stewardship: state of the art. Curr Infect Dis Rep. 2018;20:1-13.
Lampin M, Rousseaux J, Botte A, Sadik A, Cremer R, Leclerc F. Noradrenaline use for septic shock in children: doses, routes of administration and complications. Acta Paediatrica. 2012;101(9):e426-30.
Rygård SL, Butler E, Granholm A, Møller MH, Cohen J, Finfer S, et al. Low-dose corticosteroids for adult patients with septic shock: a systematic review with meta-analysis and trial sequential analysis. Intens Care Med. 2018;44:1003-16.
Venkatesh B, Finfer S, Cohen J, Rajbhandari D, Arabi Y, Bellomo R, et al. Adjunctive glucocorticoid therapy in patients with septic shock. N Engl J Med. 2018;378(9):797-808.
Maitland K, Kiguli S, Opoka RO, Engoru C, Olupot-Olupot P, Akech SO, et al. Mortality after fluid bolus in African children with severe infection. N Engl J Med. 2011;364(26):2483-95.
Inwald DP, Canter R, Woolfall K, O'Hara CB, Mouncey PR, Zenasni Z, et al. Restricted fluid bolus volume in early septic shock: results of the Fluids in Shock pilot trial. Arch Dis Childhood. 2019;104(5):426-31.
Emrath ET, Fortenberry JD, Travers C, McCracken CE, Hebbar KB. Resuscitation with balanced fluids is associated with improved survival in pediatric severe sepsis. Crit Care Med. 2017;45(7):1177-83.
Semler MW, Self WH, Wanderer JP. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018;378(9):829-39.
Abadesso C, Nunes P, Silvestre C, Matias E, Loureiro H, Almeida H. Non-invasive ventilation in acute respiratory failure in children. Pediatr Rep. 2012;4(2):e16.
Chen L, Li T, Fang F, Zhang Y, Faramand A. Tight glycemic control in critically ill pediatric patients: a systematic review and meta-analysis. Crit Care. 2018;22:1-11.
Muszynski JA, Guzzetta NA, Hall MW, Macrae D, Valentine SL, Bateman ST, et al. Recommendations on RBC transfusions for critically ill children with nonhemorrhagic shock from the pediatric critical care transfusion and anemia expertise initiative. Pediatr Crit Care Med. 2018;19(9S):S121-6.
Merritt C, Menon K, Agus MS, Choong K, McNally D, O'Hearn K, et al. Beyond survival: Pediatric critical care interventional trial outcome measure preferences of families and healthcare professionals. Pediatr Crit Care Med. 2018;19(2):e105-11.
Downloads
Published
How to Cite
Issue
Section
