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World Federation of Pediatric Intensive Care and Critical Care Societies: Global Sepsis Initiative
Niranjan Kissoon1, Joseph A Carcillo, Victor Espinosa
1University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada. nkissoon@cw.bc.ca
Insights
The Global Pediatric Sepsis Initiative aims to reduce childhood sepsis deaths through quality improvement programs. Compliance with resuscitation and intensive care unit management bundles significantly reduces mortality in developing and industrialized nations.
Area of Science:
- Pediatric critical care medicine
- Global public health
- Quality improvement science
Background:
- Sepsis causes 60-80% of childhood deaths annually, according to WHO estimates.
- Effective interventions exist for both resource-scarce and resource-abundant settings.
- The World Federation of Pediatric Intensive Care and Critical Care Societies launched the Global Pediatric Sepsis Initiative to enhance care quality for children with sepsis.
Purpose of the Study:
- To announce the Global Pediatric Sepsis Initiative.
- To justify the inclusion of specific care bundles.
- To present preliminary data and encourage broader participation.
Main Methods:
- A web-based education, demonstration, and toolkit (pyramid bundles/checklist) was developed.
- The initiative categorizes settings into four resource levels (A-D) based on child mortality rates and industrialization.
- Customized administrative and clinical recommendations are provided for each resource category.
Main Results:
- Data from 361 children across four categories were collected in the vanguard phase.
- Quality assurance reports were distributed to 23 international centers.
- Compliance with resuscitation and intensive care unit management bundles was associated with significant mortality reduction in categories C and D.
Conclusions:
- The Global Pediatric Sepsis Initiative is now accessible online.
- Reducing pediatric mortality and morbidity requires continuous recruitment of international centers.
- Participation is crucial for improving global child healthcare quality annually.
Background:
According to World Health Organization estimates, sepsis accounts for 60%-80% of lost lives per year in childhood. Measures appropriate for resource-scarce and resource-abundant settings alike can reduce sepsis deaths. In this regard, the World Federation of Pediatric Intensive Care and Critical Care Societies Board of Directors announces the Global Pediatric Sepsis Initiative, a quality improvement program designed to improve quality of care for children with sepsis.
Objectives:
To announce the global sepsis initiative; to justify some of the bundles that are included; and to show some preliminary data and encourage participation.
Methods:
The Global Pediatric Sepsis Initiative is developed as a Web-based education, demonstration, and pyramid bundles/checklist tool (http://www.pediatricsepsis.org or http://www.wfpiccs.org). Four health resource categories are included. Category A involves a nonindustrialized setting with mortality rate <5 yrs and >30 of 1,000 children. Category B involves a nonindustrialized setting with mortality rate <5 yrs and <30 of 1,000 children. Category C involves a developing industrialized nation. In category D, developed industrialized nation are determined and separate accompanying administrative and clinical parameters bundles or checklist quality improvement recommendations are provided, requiring greater resources and tasks as resource allocation increased from groups A to D, respectively.
Results:
In the vanguard phase, data for 361 children (category A, n = 34; category B, n = 12; category C, n = 84; category D, n = 231) were successfully entered, and quality-assurance reports were sent to the 23 participating international centers. Analysis of bundles for categories C and D showed that reduction in mortality was associated with compliance with the resuscitation (odds ratio, 0.369; 95% confidence interval, 0.188-0.724; p < .0004) and intensive care unit management (odds ratio, 0.277; 95% confidence interval, 0.096-0.80) bundles.
Conclusions:
The World Federation of Pediatric Intensive Care and Critical Care Societies Global Pediatric Sepsis Initiative is online. Success in reducing pediatric mortality and morbidity, evaluated yearly as a measure of global child health care quality improvement, requires ongoing active recruitment of international participant centers. Please join us at http://www.pediatricsepsis.org or http://www.wfpiccs.org.
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