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Published on: June 15, 2019
Insights
Timely diagnosis of pediatric surgical sepsis, using systemic inflammatory response syndrome and PRISM scores, is crucial. Delayed diagnosis, indicated by multiorgan insufficiency, negatively impacts treatment outcomes for children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Sepsis research
Context:
- Sepsis diagnosis in children requires specific criteria.
- Established guidelines like ACCP/SCCM (1991) inform sepsis identification.
- Pediatric surgical sepsis presents unique diagnostic challenges.
Purpose:
- To analyze treatment outcomes for pediatric surgical sepsis.
- To evaluate diagnostic criteria for timely sepsis identification in children.
- To correlate diagnostic timing with patient outcomes.
Summary:
- Analyzed 263 children (3-14 years) with surgical sepsis.
- Utilized modified systemic inflammatory response syndrome (SSIR) criteria and PRISM scores for diagnosis.
- Timely diagnosis defined by persistent SSIR symptoms and PRISM score indicating ≥1.0% lethality within 24 hours of intensive care.
Impact:
- Highlights the importance of early sepsis detection in pediatric surgical patients.
- Identifies specific criteria for timely diagnosis, differentiating it from delayed diagnosis.
- Emphasizes that multiorgan insufficiency syndromes signify delayed sepsis diagnosis and potentially poorer outcomes.
Abstract:
Results of treatment of 263 children with surgical sepsis aged from 3 to 14 years were analyzed. Diagnosis of sepsis was based on recommendations of ACCP/SCCM (1991). For diagnosis of sepsis in children it is recommended to use criteria of syndrome of systemic inflammatory response (SSIR) in M.Parker's modification, scale of assessment of severity state - PRISM, classification of organ insufficiency by L. Doughty et al. Diagnosis of sepsis may be regarded as timely when 3 and more symptoms of SSIR persist in a child with pyoinflammatory disease during 24 hours of intensive care and in PRISM scale severity corresponding to experted lethality > or = 1,0%. When syndromes of multiorgan insufficiency are revealed, diagnosis of sepsis must be regarded as delayed.
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