Evaluation of systemic inflammatory response syndrome-negative sepsis from a Chinese regional pediatric network.
Infection
Outcome
Pediatrics
Sepsis
Systemic inflammatory response syndrome
Therapy
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
08 01 2019
08 01 2019
Historique:
received:
28
05
2018
accepted:
04
12
2018
entrez:
10
1
2019
pubmed:
10
1
2019
medline:
20
2
2020
Statut:
epublish
Résumé
The identification of sepsis in children varies depending on the definition used. Our purpose was to compare clinical data and outcome of atypical sepsis, manifested as having sepsis but not fulfilling the criteria of systemic inflammatory response syndrome (SIRS-negative sepsis, SNS), in children based on the modified Angus criteria with those of sepsis (S) and severe sepsis (SS) based on the international consensus criteria. Pediatric departments in 11 regional city and county referral hospitals with emergency and intensive care settings in Huai'an serving for 843,000 children participated in a parallel multicenter prospective survey. Clinical data registry was used to recruit those who fulfilled the diagnostic criteria for pediatric sepsis from all admissions (n = 27,836) from 28 days to 15 years old, from September 1, 2010 to August 31, 2011. A total of 1606 children met the criteria for pediatric sepsis and were divided into three groups: S, (n = 1377), SS (n = 153, including 32 septic shock), based on the consensus definition criteria, and SNS (n = 76) based on the modified Angus criteria. Most deaths (38/54, 70.3%) occurred within three days of admission. The SNS mainly occurred in infants and was associated with cardiopulmonary and neurologic dysfunction without satisfying the SIRS criteria. SNS differed from SS in that it predominantly affected infants and manifested with cardiopulmonary and neurologic dysfunction. There were no laboratory variables which were useful in identification of SNS, or predicting response to therapy or outcome.
Sections du résumé
BACKGROUND
The identification of sepsis in children varies depending on the definition used. Our purpose was to compare clinical data and outcome of atypical sepsis, manifested as having sepsis but not fulfilling the criteria of systemic inflammatory response syndrome (SIRS-negative sepsis, SNS), in children based on the modified Angus criteria with those of sepsis (S) and severe sepsis (SS) based on the international consensus criteria.
METHODS
Pediatric departments in 11 regional city and county referral hospitals with emergency and intensive care settings in Huai'an serving for 843,000 children participated in a parallel multicenter prospective survey. Clinical data registry was used to recruit those who fulfilled the diagnostic criteria for pediatric sepsis from all admissions (n = 27,836) from 28 days to 15 years old, from September 1, 2010 to August 31, 2011.
RESULTS
A total of 1606 children met the criteria for pediatric sepsis and were divided into three groups: S, (n = 1377), SS (n = 153, including 32 septic shock), based on the consensus definition criteria, and SNS (n = 76) based on the modified Angus criteria. Most deaths (38/54, 70.3%) occurred within three days of admission. The SNS mainly occurred in infants and was associated with cardiopulmonary and neurologic dysfunction without satisfying the SIRS criteria.
CONCLUSIONS
SNS differed from SS in that it predominantly affected infants and manifested with cardiopulmonary and neurologic dysfunction. There were no laboratory variables which were useful in identification of SNS, or predicting response to therapy or outcome.
Identifiants
pubmed: 30621637
doi: 10.1186/s12887-018-1364-8
pii: 10.1186/s12887-018-1364-8
pmc: PMC6325779
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
11Investigateurs
Bo Sun
(B)
Yuanyuan Wang
(Y)
Hongni Yue
(H)
Xiaofei Lin
(X)
Bing Li
(B)
Chunlin Yu
(C)
Xiaochun Yang
(X)
Chunming Shan
(C)
Yujin Fan
(Y)
Maotian Dong
(M)
Li Hao
(L)
Yixing Zhang
(Y)
Wenlong Lin
(W)
Xiaofeng Zuo
(X)
Tingting Yin
(T)
Ping Su
(P)
Yongbo Heng
(Y)
Jinzhong Xu
(J)
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