New criteria for diagnosis of pediatric sepsis
The diagnosis of pediatric sepsis will abandon the so-called SIRS criteria in favor of a simple organ-failure score. An international consensus society of pediatric critical care medicine recommended the so-called Phoenix-4 criteria for organ dysfunction, which score one point each for life-threatening dysfunction of the respiratory, cardiovascular, coagulation, or neurologic systems. A score of 2 or higher on the Phoenix-4 in a child with suspected or confirmed infection would diagnose sepsis.
The model was validated using electronic medical record data including 3.6 million pediatric hospital encounters, and was chosen for simplicity over the more burdensome Phoenix-8 criteria (which include kidney and other organ failures).
Prompting the change: SIRS criteria are even less specific in children than adults. Children’s normal-range vital signs vary widely by age, and kids’ frequent viral infections commonly cause fevers, tachycardia and tachypnea. Reliance on SIRS in children has resul…
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