Sepsis is a leading cause of death in hospitalized children, killing almost 5,000 children annually in the U.S., more than cancer. As many as 40,000 children are hospitalized annually for sepsis, one of the most expensive conditions to treat. That makes it a significant challenge for children’s hospitals, which see 65 percent of the children with sepsis.
What is pediatric sepsis?
Sepsis – often called blood poisoning – is the immune system overreacting to an infection of any kind. It can spread rapidly in children’s small bodies. Children with compromised immune systems, like hematology and oncology patients, are particularly susceptible to sepsis. All three stages of sepsis infection—sepsis, severe sepsis, and septic shock—can result in disability or death.
How does sepsis impact children when it happens?
The window for diagnosis and effective intervention in children is very short, from 1-4 hours. Every hour delay in treatment increases mortality by nearly 8 percent. If undetected, sepsis can rapidly escalate to severe sepsis and septic shock, causing extensive and irreversible body system damage. Early treatment drastically improves patient outcomes.
- Morality rates are high — nearly 5,000 die from sepsis and related complications each year
- 75 percent of septic patients are admitted to an intensive care unit after a sepsis diagnosis
- Half of sepsis survivors are readmitted for additional care after surviving sepsis
- 38 percent of sepsis survivors will sustain a lifelong disability as a result of sepsis
What makes it so difficult to diagnose and treat?
Sepsis can affect anyone, anywhere – even outside a hospital. Pediatric experts estimate about 55 percent of patients develop sepsis before they get to the hospital. Once they arrive, it’s difficult to recognize for many reasons.
- The symptoms – like fever or disorientation – can mimic a number of other common illnesses
- Few pediatric patients present with the same – or same number of – symptoms. There is no one indicator for sepsis.
- Sepsis has a low awareness; providers and families may not even consider it as a possibility.
- There are no specific tests that point to sepsis; instead, diagnosis requires a series of steps proven to be effective
- There’s variation in approaches to identify and treat sepsis
The role of children’s hospitals in sepsis
Children’s hospitals treat a large percentage of children with sepsis, including inpatients and patients referred from ambulatory care settings. They also provide specialized care for many children with compromised immune systems, which puts patients at increased risk. It’s critical that children’s hospitals have the right protocols in place to detect the condition early and provide timely treatment.
Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med 2009.
Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008.
Nursing considerations to complement the Surviving Sepsis Campaign guidelines. Crit Care Med 2011; 39.
Pediatr Crit Care Med. 2013 Sep;14(7):686-93
Pediatr Crit Care Med 2014; 15:798–805 / Pediatr Crit Care Med 2014; 15:828–838
AJRCCM SPROUT/PALISI (In Press). 03-March-2015