Operationalizing Appropriate Sepsis Definitions in Children Worldwide: Considerations for the Pediatric Sepsis Definition Taskforce

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art_CARROL_Operationalizing_Appropriate_Sepsis_Definitions_in_Children_Worldwide_Considerations_2023.PDF (1.11 MB)
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
CARROL, Enitan D.
RANJIT, Suchitra
MENON, Kusum D.
BENNETT, Tellen D.
SANCHEZ-PINTO, L. Nelson J.
ZIMMERMAN, Jerry J. C.
SORCE, Lauren R. G.
RANDOLPH, Adrienne G.
ISHIMINE, Paul
Citação
PEDIATRIC CRITICAL CARE MEDICINE, v.24, n.6, p.E263-E271, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Sepsis is a leading cause of global mortality in children, yet definitions for pediatric sepsis are outdated and lack global applicability and validity. In adults, the Sepsis-3 Definition Taskforce queried databases from high-income countries to develop and validate the criteria. The merit of this definition has been widely acknowledged; however, important considerations about less-resourced and more diverse settings pose challenges to its use globally. To improve applicability and relevance globally, the Pediatric Sepsis Definition Taskforce sought to develop a conceptual framework and rationale of the critical aspects and context-specific factors that must be considered for the optimal operationalization of future pediatric sepsis definitions. It is important to address challenges in developing a set of pediatric sepsis criteria which capture manifestations of illnesses with vastly different etiologies and underlying mechanisms. Ideal criteria need to be unambiguous, and capable of adapting to the different contexts in which children with suspected infections are present around the globe. Additionally, criteria need to facilitate early recognition and timely escalation of treatment to prevent progression and limit life-threatening organ dysfunction. To address these challenges, locally adaptable solutions are required, which permit individualized care based on available resources and the pretest probability of sepsis. This should facilitate affordable diagnostics which support risk stratification and prediction of likely treatment responses, and solutions for locally relevant outcome measures. For this purpose, global collaborative databases need to be established, using minimum variable datasets from routinely collected data. In summary, a ""Think globally, act locally"" approach is required.
Palavras-chave
biology, criteria, global, pediatric, sepsis
URI
https://observatorio.fm.usp.br/handle/OPI/55011
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Coleções
Artigos e Materiais de Revistas Científicas - HU