Sepsis in Children

Sepsis remains one of the leading causes of morbidity and mortality in children despite improved understanding of the pathophysiology, which has led to better clinical management and survival. Recent studies have identified several areas that clinicians must address in order to continue to impact the morbidity and mortality associated with sepsis.

Listen to our expert discuss pediatric sepsis

In today’s episode, we talk with Halden Scott, MD, about the presentation, management and follow-up care of pediatric patients with sepsis.

Dr. Scott is an Associate Professor of Pediatrics and Emergency Medicine at the University of Colorado School of Medicine and a pediatric emergency medicine physician at Children’s Hospital Colorado.

In this episode, our expert discusses:

• The evolving definition of sepsis and the concept of organ dysfunction
• Definitions of clinical, cardiovascular, respiratory and renal organ dysfunction
• Heart rate as an indicator for sepsis and the use of lab tests for diagnosis
• Reasons why sepsis continues to be a leading cause of morbidity and mortality in children
• The relationships between strep and staph infections and sepsis in healthy patients
• The “bundle” concept and what we conclusively know it should include
• Acquiring a blood culture prior to antibiotics and the role of a lactate lab
• Procalcitonin as a marker for bacterial infection and its use in the diagnosis of sepsis
• Age differentiation in terms of prevalence, treatment and preferred antibiotics
• How the referring pediatrician should think about approaching a potential sepsis patient
• Outcomes of sepsis treatment pathways and how the mortality rate has dropped
• Approaches to regulating the immune response and what to consider for follow-up treatment
• The importance of checking organ dysfunction labs and considering other diagnoses

Resources mentioned in today's episode:

• The Children’s Hospital Association Improving Pediatric Sepsis Outcomes Collaborative
• Children’s Hospital Colorado Pathways: Emergency Department Sepsis Pathway
• Most recent pediatric sepsis guidelines
• Articles that Dr. Scott referred to in the podcast about the role of lactate in sepsis, and the problems with SIRS criteria for sepsis screening:
  • Association Between Early Lactate Levels and 30-Day Mortality in Clinically Suspected Sepsis in Children
  • Lactate Clearance and Normalization and Prolonged Organ Dysfunction in Pediatric Sepsis
  • The Prevalence and Diagnostic Utility of Systemic Inflammatory Response Syndrome Vital Signs in a Pediatric Emergency Department

Treatment of sepsis at Children’s Colorado

The Emergency Department at Children’s Colorado treats minor conditions but also deals with much more serious injuries and illnesses such as sepsis. As a Level 1 Regional Pediatric Trauma Center, we provide the highest level of complex care for injured children, 24 hours a day, 365 days a year.