International Consensus Criteria for Pediatric Sepsis and Septic Shock

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Public health

Background:

• Sepsis is a major global child mortality cause.
• Existing pediatric sepsis criteria (2005) are outdated and lack predictive accuracy.
• The Sepsis-3 definition excluded children, necessitating updated pediatric-specific guidelines.

Purpose of the Study:

• To develop and validate updated criteria for identifying sepsis and septic shock in children.
• To establish a more accurate and clinically relevant definition for pediatric sepsis.

Main Methods:

• Convened an international pediatric expert task force (Society of Critical Care Medicine).
• Utilized a modified Delphi consensus process informed by international surveys.
• Analyzed a large dataset (>3 million EHR encounters) for developing and validating the Phoenix Sepsis Score.

Main Results:

• The Phoenix Sepsis Score (≥2) identifies children with suspected infection and life-threatening organ dysfunction.
• Children meeting Phoenix criteria had significantly higher in-hospital mortality (7.1% higher-resource, 28.5% lower-resource settings).
• Septic shock in children is defined by sepsis with cardiovascular dysfunction (e.g., hypotension, high lactate, vasopressors).

Conclusions:

• The Phoenix sepsis criteria offer a validated, evidence-based approach for pediatric sepsis and septic shock.
• Implementation of the Phoenix Sepsis Score can enhance clinical care, epidemiological studies, and research globally.
• These criteria represent a significant advancement in managing pediatric sepsis worldwide.