Modern Diagnostics of Sepsis and Septic Shock in Children

Yekaterina Y. Bulatova; Nurila A. Maltabarova; Murat B. Zhumabayev; Tatyana A. Li; Marina P. Ivanova

doi:10.29333/ejgm/7879

Full Text (PDF)

Yekaterina Y. Bulatova ¹ ^* , Nurila A. Maltabarova ¹, Murat B. Zhumabayev ¹, Tatyana A. Li ¹, Marina P. Ivanova ¹

More Detail

¹ NJSC “Astana Medical University”, 010000, Nur-Sultan, KAZAKHSTAN^* Corresponding Author

Abstract

Sepsis is still one of the leading causes of child mortality worldwide, despite advances in its diagnosis and treatment. Difficulties in recognizing the transition of a localized infectious-inflammatory process to a generalized one lead to a belated diagnosis and the beginning of therapy. Meanwhile, the earlier treatment is started, the higher the patients’ chances of life. Early diagnosis of sepsis, which corresponds to modern ideas about this condition, is one of the main tasks for both scientists and practitioners. The aim of this review is to study modern recommendations for the diagnosis of sepsis and septic shock in children. The article reflects the epidemiology, etiological features, modern definitions and methods of diagnosis of pediatric sepsis.

Keywords

sepsis in children
pediatric sepsis
septic shock in children
sepsis diagnostics
sepsis recognition
sepsis biomarkers

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, 2020, Volume 17, Issue 5, Article No: em216

https://doi.org/10.29333/ejgm/7879

Publication date: 05 Apr 2020

Article Views: 2640

Article Downloads: 3995

Open Access Disclosures References How to cite this article

Disclosure

Declaration of Conflict of Interest: No conflict of interest is declared by author(s).

References

Dugani S, Kissoon N. Global advocacy needed for sepsis in children. Journal of Infection, 2017:74. https://doi.org/10.1016/s0163-4453(17)30193-7
Schlapbach LJ, Straney L, Alexander J, Maclaren G, Festa M, Schibler A, Slater A. Mortality related to invasive infections, sepsis, and septic shock in critically ill children in Australia and New Zealand, 2002-13: a multicentre retrospective cohort study. The Lancet Infectious Diseases, 2015;15(1):46-54. https://doi.org/10.1016/s1473-3099(14)71003-5
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 Respiratory Medicine, 2018;6(3):223-30. https://doi.org/10.1016/S2213-2600(18)30063-8
Ansermino JM, Wiens MO, Kissoon N. We need smarter trigger tools for diagnosing sepsis in children in Canada. Cmaj, 2018;190(36):E1060-E1061. https://doi.org/10.1503/cmaj.180434 PMid:30201612 PMCid:PMC6131073
Conway EE. Pediatric Sepsis: A Primer for the Pediatrician. Pediatric Annals, 2018;47(7):e292-e299. https://doi.org/10.3928/19382359-20180620-02 PMid:30001444
Agyeman PKA, Schlapbach LJ, Giannoni E, Stocker M, Posfay-Barbe KM, 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. https://doi.org/10.1016/S2352-4642(17)30010-X
Yang J, Zhang S, Zhang J, Dong J, Wu J, Zhang L, et al. Identification of key genes and pathways using bioinformatics analysis in septic shock children. Infection and Drug Resistance, 2018;11:1163-74. https://doi.org/10.2147/IDR.S157269 PMid:30147344 PMCid:PMC6098424
Wong HR. Genetics and genomics in pediatric septic shock. Critical Care Medicine, 2012;40(5):1618-26. https://doi.org/10.1097/CCM.0b013e318246b546 PMid:22511139 PMCid:PMC3329642
Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016;315(8):762-74. https://doi.org/10.1001/jama.2016.0288 PMid:26903335 PMCid:PMC5433435
Bradshaw C, Goodman I, Rosenberg R, Bandera C, Fierman A, Rudy B. Implementation of an inpatient pediatric sepsis identification pathway. Pediatrics, 2016;137(3). https://doi.org/10.1542/peds.2014-4082 PMid:26908676
Ames SG, Davis BS, Angus DC, Carcillo JA, Kahn JM. Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality. Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2018;19(5):390-6. https://doi.org/10.1097/PCC.0000000000001502 PMid:29461429 PMCid:PMC5935525
Mathias B, Mira JC, Larson SD. Pediatric sepsis. Current Opinion in Pediatrics, 2016;28(3):380-7. https://doi.org/10.1097/MOP.0000000000000337 PMid:26983000 PMCid:PMC4913352
Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A. Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. American Journal of Respiratory and Critical Care Medicine, 2015;191(10):1147-57. https://doi.org/10.1164/rccm.201412-2323OC PMid:25734408 PMCid:PMC4451622
Plunkett A, Tong J. Sepsis in children. BMJ, 2015;350(jun09 10):h3017-h3017. https://doi.org/10.1136/bmj.h3017 PMid:26060188
Souza DCde, Brandão MB, Piva JP. From the International Pediatric Sepsis Conference 2005 to the Sepsis-3 Consensus. Revista Brasileira de Terapia Intensiva, 2018;30(1):1-5. https://doi.org/10.5935/0103-507x.20180005
de Souza D, Machado F. Epidemiology of Pediatric Septic Shock. Journal of Pediatric Intensive Care, 2019;08(01):003-10. https://doi.org/10.1055/s-0038-1676634 PMid:31073502 PMCid:PMC6506671
Tan B, Wong JJM, Sultana R, Koh JCJW, Jit M, Mok YH, Lee JH. Global Case-Fatality Rates in Pediatric Severe Sepsis and Septic Shock: A Systematic Review and Meta-analysis. JAMA Pediatrics, 2019, April 1;173:352-61. https://doi.org/10.1001/jamapediatrics.2018.4839 PMid:30742207 PMCid:PMC6450287
The Ministry of Health Care of The Republic of Kazakhstan. The health of the population of the Republic of Kazakhstan and the activities of healthcare organizations in 2017. Statistical Digest. Astana, Republic of Kazakhstan. 2018.
Boeddha NP, Schlapbach LJ, Driessen GJ, Herberg JA, Rivero-Calle I, Cebey-López M. EUCLIDS consortium, on behalf of the E. Mortality and morbidity in community-acquired sepsis in European pediatric intensive care units: a prospective cohort study from the European Childhood Life-threatening Infectious Disease Study (EUCLIDS). Critical Care (London, England), 2018;22(1):143. https://doi.org/10.1186/s13054-018-2052-7 PMid:29855385 PMCid:PMC5984383
Hasan GM, Al-Eyadhy AA, Temsah MHA, Al-Haboob AA, Alkhateeb MA, Al-Sohime F. Feasibility and efficacy of sepsis management guidelines in a pediatric intensive care unit in Saudi Arabia: A quality improvement initiative. International Journal for Quality in Health Care, 2018;30(8):587-93. https://doi.org/10.1093/intqhc/mzy077 PMid:29697828
Prout AJ, Talisa VB, Carcillo JA, Mayr FB, Angus DC, Seymour CW, et al. Children with Chronic Disease Bear the Highest Burden of Pediatric Sepsis. The Journal of Pediatrics, 2018;199:194-199.e1. https://doi.org/10.1016/j.jpeds.2018.03.056 PMid:29753542 PMCid:PMC6063765
Ruth A, McCracken CE, Fortenberry JD, Hall M, Simon HK, & Hebbar KB. Pediatric severe sepsis: Current trends and outcomes from the pediatric health information systems database. Pediatric Critical Care Medicine, 2014;15(9):828-38. https://doi.org/10.1097/PCC.0000000000000254 PMid:25226500
Kuo K-C, Yeh Y-C, Chiu I-M, Tang K-S, Su C-M, Huang Y-H. The clinical features and therapy of community-acquired gram negative bacteremia in children less than three years old. Pediatrics & Neonatology. 2019. https://doi.org/10.1016/j.pedneo.2019.05.009 PMid:31257100
Gupta N, Richter R, Robert S, Kong M. Viral Sepsis in Children. Frontiers in Pediatrics, 2018;6:252. https://doi.org/10.3389/fped.2018.00252 PMid:30280095 PMCid:PMC6153324
Donna Mendez RL. Sepsis in children. Pediatrics International, 2000;42(5):528-33. https://doi.org/10.1046/j.1442-200X.2000.01281.x PMid:11059544
Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatric Critical Care Medicine, 2013;14(7):686-93. https://doi.org/10.1097/PCC.0b013e3182917fad PMid:23897242
Seymour CW, Liu VX, Iwashyna TJ, Brunkhorst FM, Rea TD, Scherag A, et al. Assessment of Clinical Criteria for Sepsis: For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, 2016;315(8):762-74. https://doi.org/10.1001/jama.2016.0288 PMid:26903335 PMCid:PMC5433435
Weiss SL, Deutschman CS. Are septic children really just “septic little adults”? Intensive Care Medicine, 2018;44(3):392-4. https://doi.org/10.1007/s00134-017-5041-4 PMid:29356850
Simpson SQ. SIRS in the Time of Sepsis-3. Chest, 2018;153(1):34-8. https://doi.org/10.1016/j.chest.2017.10.006 PMid:29037526
Sankar J, Dhochak N, Kumar K, Singh M, Sankar MJ, Lodha R. Comparison of International Pediatric Sepsis Consensus Conference Versus Sepsis-3 Definitions for Children Presenting with Septic Shock to a Tertiary Care Center in India: A Retrospective Study∗. Pediatric Critical Care Medicine, 2019;20(3):E122-E129. https://doi.org/10.1097/PCC.0000000000001864 PMid:30640887
Wang Y, Lin X, Yue H, Kissoon N, Sun B. Evaluation of systemic inflammatory response syndrome-negative sepsis from a Chinese regional pediatric network 11 Medical and Health Sciences 1103 Clinical Sciences. BMC Pediatrics, 2019;19(1). https://doi.org/10.1186/s12887-018-1364-8 PMid:30621637 PMCid:PMC6325779
Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatric Critical Care Medicine, 2005;6(1). https://doi.org/10.1097/01.PCC.0000149131.72248.E6 PMid:15636651
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Medicine. 2013. https://doi.org/10.1007/s00134-012-2769-8 PMid:23361625
Emr BM, Alcamo AM, Carcillo JA, Aneja RK, Mollen KP. Pediatric Sepsis Update: How Are Children Different? Surgical Infections, 2018;19(2):176-83. https://doi.org/10.1089/sur.2017.316 PMid:29394150
Wheeler DS, Wong HR, Zingarelli B. Pediatric Sepsis - Part I: “Children are not small adults”; The Open Inflammation Journal, 2011;4:4-15. https://doi.org/10.2174/1875041901104010004 PMid:23723956 PMCid:PMC3665507
Wheeler DS. Introduction to Pediatric Sepsis. The Open Inflammation Journal, 2011;4(Suppl 1-M):1-3. https://doi.org/10.2174/1875041901104010001 PMid:25285177 PMCid:PMC4183156
Horeczko T, Green JP. Emergency department presentation of the pediatric systemic inflammatory response syndrome. Pediatric Emergency Care, 2013;29(11):1153-8. https://doi.org/10.1097/PEC.0b013e3182a9e629 PMid:24168885
Zhumabayev M, Maltabarova N, Kokoshko A. A Cerebralstroke and the Problem of Inflammatory Complications. Research Journal of Medical Sciences, 2016;10(5):492-7. https://doi.org/10.36478/rjmsci.2016.492.497
Schlapbach LJ, Straney L, Bellomo R, MacLaren G, Pilcher D. Prognostic accuracy of age-adapted SOFA, SIRS, PELOD-2, and qSOFA for in-hospital mortality among children with suspected infection admitted to the intensive care unit. Intensive Care Medicine, 2018;44(2):179-88. https://doi.org/10.1007/s00134-017-5021-8 PMid:29256116 PMCid:PMC5816088
Schlapbach LJ. Paediatric sepsis. Current Opinion in Infectious Diseases, 2019:1. https://doi.org/10.1097/QCO.0000000000000583 PMid:31335441
Peters C, Murthy S, Brant R, Kissoon N, Görges M. Mortality Risk Using a Pediatric Quick Sequential (Sepsis-Related) Organ Failure Assessment Varies With Vital Sign Thresholds. Pediatric Critical Care Medicine, 2018;19(8):e394-e402. https://doi.org/10.1097/PCC.0000000000001598 PMid:29939978
Morin L, Ray S, Wilson C, Remy S, Benissa MR, Jansen NJG, et al. Refractory septic shock in children: a European Society of Paediatric and Neonatal Intensive Care definition. Intensive Care Medicine, 2016;42(12):1948-57. https://doi.org/10.1007/s00134-016-4574-2 PMid:27709263 PMCid:PMC5106490
Hofer N, Zacharias E, Müller W, Resch B. An update on the use of C-reactive protein in early-Onset neonatal sepsis: Current insights and new tasks. Neonatology, 2012;102:25-36. https://doi.org/10.1159/000336629 PMid:22507868
Martinez R, Rode H. Role of procalcitonin in paediatric burn wound sepsis. South African Medical Journal, 2018;108(10):793-4. https://doi.org/10.7196/SAMJ.2018.v108i10.13515 PMid:30421701
Tanır Basaranoglu S, Karadag-Oncel E, Aykac K, Ozsurekci Y, Aycan AE, Cengiz AB, et al. Presepsin: A new marker of catheter related blood stream infections in pediatric patients. Journal of Infection and Chemotherapy, 2018;24(1):25-30. https://doi.org/10.1016/j.jiac.2017.08.012 PMid:28919353
El Gendy FM, El-Mekkawy MS, Saleh NY, Habib MSEdin, Younis FE. Clinical study of Presepsin and Pentraxin3 in critically ill children. Journal of Critical Care, 2018;47:36-40. https://doi.org/10.1016/j.jcrc.2018.06.004 PMid:29886065
Yoon SH, Kim EH, Kim HY, Ahn JG. Presepsin as a diagnostic marker of sepsis in children and adolescents: A systemic review and meta-analysis. BMC Infectious Diseases, 2019;19(1). https://doi.org/10.1186/s12879-019-4397-1 PMid:31470804 PMCid:PMC6717384
Weidhase L, Wellhöfer D, Schulze G, Kaiser T, Drogies T, Wurst U, Petros S. Is Interleukin-6 a better predictor of successful antibiotic therapy than procalcitonin and C-reactive protein? A single center study in critically ill adults. BMC Infectious Diseases, 2019;19(1):150. https://doi.org/10.1186/s12879-019-3800-2 PMid:30760225 PMCid:PMC6375140
Casserly B, Phillips GS, Schorr C, Dellinger RP, Townsend SR, Osborn TM, et al. Lactate measurements in sepsis-induced tissue hypoperfusion: results from the Surviving Sepsis Campaign database. Critical Care Medicine, 2015;43(3):567-73. https://doi.org/10.1097/CCM.0000000000000742 PMid:25479113
Schuh AM, Leger KJ, Summers C, Uspal NG. Lactic Acidosis in a Critically Ill Patient: Not Always Sepsis. Pediatric Emergency Care, 2018;34(9):e165-e167. https://doi.org/10.1097/PEC.0000000000001603 PMid:30180106
Jacobs L, Berrens Z, Stenson EK, Zackoff MW, Danziger LA, Lahni P, Wong HR. The Pediatric Sepsis Biomarker Risk Model (PERSEVERE) Biomarkers Predict Clinical Deterioration and Mortality in Immunocompromised Children Evaluated for Infection. Scientific Reports, 2019;9(1). https://doi.org/10.1038/s41598-018-36743-z PMid:30675002 PMCid:PMC6344559
Wong HR, Cvijanovich NZ, Anas N, Allen GL, Thomas NJ, Bigham MT, et al. Improved risk stratification in pediatric septic shock using both protein and mRNA Biomarkers: Persevere-XP. American Journal of Respiratory and Critical Care Med, 2017;196(4):494-501. https://doi.org/10.1164/rccm.201701-0066OC PMid:28324661 PMCid:PMC5564676
Wong HR, Cvijanovich NZ, Anas N, Allen GL, Thomas NJ, et al. Pediatric Sepsis Biomarker Risk Model-II: Redefining the Pediatric Sepsis Biomarker Risk Model with Septic Shock Phenotype. Critical Care Medicine, 2016;44(11):2010-7. https://doi.org/10.1097/CCM.0000000000001852 PMid:27513537 PMCid:PMC5201138
Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to predict sepsis in children. Pakistan Journal of Medical Sciences, 2018;34(4):918-22. https://doi.org/10.12669/pjms.344.14547
Gupta S, Alam A. Shock Index-A Useful Noninvasive Marker Associated With Age-Specific Early Mortality in Children With Severe Sepsis and Septic Shock: Age-Specific Shock Index Cut-Offs. Journal of Intensive Care Medicine, 2018:885066618802779. https://doi.org/10.1177/0885066618802779 PMid:30278814
Sharma A, Sikka M, Gomber S, Sharma S. Plasma Fibrinogen and D-dimer in Children With Sepsis: A Single-Center Experience. Iranian Journal of Pathology, 2018;13(2):272-5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/30697298 PMid:30697298 PMCid:PMC6339482
Piva JP, Garcia PCR, Da Rocha TS. Hypofibrinogenemia and pediatric sepsis: Another piece of the puzzle! Pediatric Critical Care Medicine, 2018;19(5):491-2. https://doi.org/10.1097/PCC.0000000000001514 PMid:29727417
A. Cabrita J, Pinheiro I, Menezes Falcão L. Rethinking the concept of sepsis and septic shock. European Journal of Internal Medicine, 2018, August 1;54:1-5. https://doi.org/10.1016/j.ejim.2018.06.002 PMid:29921471
Excellence C. Sepsis: recognition, diagnosis and early management: © NICE (2017) Sepsis: recognition, diagnosis and early management. BJU International, 2018;121(4):497-514. https://doi.org/10.1111/bju.14179 PMid:29603898
Hébert A, Boucher M-P, Guimont C, Weiss M. Effect of measuring vital signs on recognition and treatment of septic children. Paediatrics & Child Health, 2017;22(1):13-6. https://doi.org/10.1093/pch/pxw003 PMid:29483789 PMCid:PMC5819837
Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Medicine, 2019;7:205031211983504. https://doi.org/10.1177/2050312119835043 PMid:30915218 PMCid:PMC6429642
Li TA, Maltabarova NA, Kussaev YM, Yermekov JM. Bronchopulmonary Dysplasia at Children. Annals of Tropical Medicine & Public Health-Special Issue, 2018;17:62-8.

How to cite this article

Vancouver

Bulatova YY, Maltabarova NA, Zhumabayev MB, Li TA, Ivanova MP. Modern Diagnostics of Sepsis and Septic Shock in Children. ELECTRON J GEN MED. 2020;17(5):em216. https://doi.org/10.29333/ejgm/7879

APA

Bulatova, Y. Y., Maltabarova, N. A., Zhumabayev, M. B., Li, T. A., & Ivanova, M. P. (2020). Modern Diagnostics of Sepsis and Septic Shock in Children. Electronic Journal of General Medicine, 17(5), em216. https://doi.org/10.29333/ejgm/7879

AMA

Bulatova YY, Maltabarova NA, Zhumabayev MB, Li TA, Ivanova MP. Modern Diagnostics of Sepsis and Septic Shock in Children. ELECTRON J GEN MED. 2020;17(5), em216. https://doi.org/10.29333/ejgm/7879

Chicago

Bulatova, Yekaterina Y., Nurila A. Maltabarova, Murat B. Zhumabayev, Tatyana A. Li, and Marina P. Ivanova. "Modern Diagnostics of Sepsis and Septic Shock in Children". Electronic Journal of General Medicine 2020 17 no. 5 (2020): em216. https://doi.org/10.29333/ejgm/7879

Harvard

Bulatova, Y. Y., Maltabarova, N. A., Zhumabayev, M. B., Li, T. A., and Ivanova, M. P. (2020). Modern Diagnostics of Sepsis and Septic Shock in Children. Electronic Journal of General Medicine, 17(5), em216. https://doi.org/10.29333/ejgm/7879

MLA

Bulatova, Yekaterina Y. et al. "Modern Diagnostics of Sepsis and Septic Shock in Children". Electronic Journal of General Medicine, vol. 17, no. 5, 2020, em216. https://doi.org/10.29333/ejgm/7879