Can the Pediatric Logistic Organ Dysfunction-2 Score on Day 1 Be Used in Clinical Criteria for Sepsis in Children?*

Leclerc, Francis; Duhamel, Alain; Deken, Valérie; Grandbastien, Bruno; Leteurtre, Stéphane

doi:10.1097/pcc.0000000000001182

Cited by 60 publications

(62 citation statements)

References 23 publications

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“…Schlapbach et al demonstrated that PELOD-2 ≥ 8 best discriminated for both mortality and the composite outcome, while data on alternative pSOFA cut-points were not provided. This finding mirrors a prior study by Leclerc et al who also reported that PELOD-2 ≥ 8 best discriminated mortality in children with suspected infection [9]. Schlapbach et al reasoned that higher pSOFA/PELOD-2 thresholds would select for patients with multiple organ dysfunction syndrome but exclude children with single or more subtle organ dysfunction.…”

supporting

confidence: 78%

Are septic children really just “septic little adults”?

Weiss

Deutschman

2018

Intensive Care Med

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supporting

confidence: 78%

Are septic children really just “septic little adults”?

Weiss

Deutschman

2018

Intensive Care Med

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“…Their median PELOD-2 score was significantly higher in the group who died than those who lived (died : survived = 13 : 3; P=0.0001). 20 We found that PELOD-2 score ≥ 8 lower prognostic value compared to other mortality predictors. Although it was not the best predictor of mortality, PELOD-2 score ≥ 8 was better than severe sepsis criteria based on diagnostic parameters.…”

Section: Discussionmentioning

confidence: 61%

“…The initial PELOD-2 validation study found that PELOD-2 scores were significantly higher in non-survivors compared to survivors [mean 14.9 (SD 6.1) vs. mean 4.2 (SD 3.2), respectively, P <0.0001]. 20 The study showed failure of three organ systems and a mean PELOD-2 score of 7.5 predicted a mortality rate of 7.1%. Whereas failure of three organ systems and mean PELOD-2 score of 11.5 predicted a mortality rate of 30.5%.…”

Section: Discussionmentioning

confidence: 86%

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Wulandari¹,

Pudjiastuti²,

Martuti³

2019

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Background Sepsis is one of the main causes of death in infants and children. Currently, it is defined as a life-threatening organ dysfunction, caused by an inflammatory response of infection. Several organ dysfunction assessment methods are available, but they are not uniformly used. Objective To compare the accuracy of three mortality predictor tools: severe sepsis criteria, pediatric logistic organ dysfunction (PELOD)-2, and pediatric sequential organ failure assessment (pSOFA), in critically ill children with sepsis. Methods This prospective cohort study was conducted in the pediatric intensive care unit (PICU) and pediatric high care unit (HCU) of dr. Moewardi Hospital, Surakarta, Central of Java. All patients who met the systemic inflammatory response syndrome (SIRS) criteria were included in our study. The exclusion criteria were congenital anomalies of heart or kidney, malignancy, or hematological abnormalities. The data were taken from laboratory and physical examinations by the physicians on duty. The outcome assessed was mortality. Results Of 30 subjects, the mean age was 22.22 (SD 29.36) months; the most common infection source was the respiratory tract, followed by gastrointestinal tract and central nervous system. Most subjects were treated in the PICU and had a mean length of stay of 8.70 (SD 11.91) days. Severe sepsis and PELOD-2 were not significant predictors of death. However, pSOFA score was a statistically significant predictor of mortality, with odds ratio 10.11 (95%CI 1.054 to 97.002; P=0.039). Conclusion Pediatric SOFA (pSOFA) is a better predictor of mortality compared to PELOD-2 and SIRS-severe sepsis. A pSOFA score ≥ 2 increases the risk of mortality by 10.11-fold.

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“…The new scoring criteria were developed and validated using a large cohort of >1 million adult patients (17). Although Sepsis-3 definitions were not validated separately for pediatric populations, recent studies have demonstrated the feasibility of developing pediatric SOFA (pSOFA) and Pediatric Logistic Organ Dysfunction-2 (PELOD-2) scores for use in pediatric patients (18,19). A fundamental challenge in creating consensus definitions for the pediatric populations is the degree of age stratification required for various organ dysfunction and laboratory parameters.…”

Section: Pediatric Sepsis Definitionsmentioning

confidence: 99%

“…A fundamental challenge in creating consensus definitions for the pediatric populations is the degree of age stratification required for various organ dysfunction and laboratory parameters. Further studies validating the utility of the pSOFA and PELOD-2 scores in pediatric populations are in motion, and it is hoped they will pave the way for the much-needed update in pediatric consensus definitions (19,20). Definitions for sepsis have important implications in assessing the impact of novel diagnostic tools on patient outcomes.…”

Section: Pediatric Sepsis Definitionsmentioning

confidence: 99%

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

Patel

McElvania

2019

The Journal of Applied Laboratory Medicine

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Background Sepsis is a leading cause of death for children in the US and worldwide. There is a lack of consensus how sepsis is clinically defined, and sepsis definitions and diagnostic guidelines for the pediatric population have remained unchanged for more than a decade now. Current pediatric definitions are largely based on adult guidelines and expert opinion rather than evidence based on outcomes in the pediatric populations. Without a clear definition of sepsis, it is challenging to evaluate the performance of new laboratory tests on the diagnosis and management of sepsis. Content This review provides an overview of common etiologies of sepsis in pediatric populations, challenges in defining and diagnosing pediatric sepsis, and current laboratory tests used to identify and monitor sepsis. Strengths and limitations of emerging diagnostic strategies will also be discussed. Summary Currently there is no single biomarker that can accurately diagnose or predict sepsis. Current biomarkers such as C-reactive protein and lactate are neither sensitive nor specific for diagnosing sepsis. New biomarkers and rapid pathogen identification assays are much needed. Procalcitonin, although having some limitations, has emerged as a biomarker with demonstrated utility in management of sepsis in adults. Parallel studies analyzing the utility of procalcitonin in pediatric populations are lagging but have shown potential to affect sepsis care in pediatric populations. Multibiomarker approaches and stepwise algorithms show promise in the management of pediatric sepsis. However, a major hurdle is the lack of validated clinical criteria for classification of pediatric sepsis, which is necessary for the development of well-designed studies that can assess the clinical impact of these emerging biomarkers.

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Can the Pediatric Logistic Organ Dysfunction-2 Score on Day 1 Be Used in Clinical Criteria for Sepsis in Children?*

Cited by 60 publications

References 23 publications

Are septic children really just “septic little adults”?

Are septic children really just “septic little adults”?

Severe sepsis criteria, PELOD-2, and pSOFA as predictors of mortality in critically ill children with sepsis

Diagnostic Challenges and Laboratory Considerations for Pediatric Sepsis

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