Effectiveness of provider strategies for the early recognition of clinical deterioration due to sepsis in pediatric patients: a systematic review protocol

Patton, Lindsey; Young, Virginia

doi:10.11124/jbisrir-2016-003237

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…Lack of reporting and the fact that sepsis mimics or interacts with many other disorders make estimating the burden of sepsis difficult. However, in industrialized countries, the overall mortality rate of children with severe sepsis and septic shock is estimated between 2 and 10%, whereas mortality in developing countries is reported as high as 50% [2].…”

Section: Introductionmentioning

confidence: 99%

Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

Algebaly¹,

Fouad²,

Elkholy³

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Sepsis is a major challenge in emergency departments and intensive care units (ICUs). Sepsis also mimics or interacts with many other disorders causing high mortality and morbidity. There is no accurate biomarker or test to diagnose or predict sepsis. The treatment of sepsis is often based on the clinician’s experience. AIM: We conducted this study to analyze the serum level of presepsin in pediatric critical patients with SIRS, sepsis, severe sepsis, and septic shock. METHODS: The study included 58 children, 32 septic pediatric patients admitted to the Pediatric ICU (PICU) of Cairo University Teaching Hospital and 26 healthy children who served as a control group. The aim was to estimate the diagnostic accuracy of presepsin in predicting sepsis in PICU. We classified the patients into systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock according to the international consensus conference criteria. RESULTS: In our study, we detected a positive correlation between C-reactive protein and presepsin levels at day 1 and day 3 of admission and a negative correlation between hemoglobin and presepsin levels at day 1. However, we found no difference in the serum presepsin between the children who had sepsis and the healthy ones (at day 1 [p = 0.430) and at day 3 [p = 0.845]). We also found that serum levels of presepsin were not significantly increased with the increasing severity of sepsis despite the higher median values with increasing sepsis severity. CONCLUSIONS: It was noted that presepsin levels increased in anemic critical patients, whereas presepsin had no role in differentiating the septic critical patients from healthy children. However, its level increased with increasing severity of sepsis grade.

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Section: Introductionmentioning

confidence: 99%

Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

Algebaly¹,

Fouad²,

Elkholy³

et al. 2020

Open Access Maced J Med Sci

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“…While one identified protocol aims to capture strategies for early recognition of paediatric sepsis from clinical deterioration, the focus of the review is general strategy effectiveness and does not explicitly include engineering databases, which would describe technical design aspects. 38 Purpose of the study Given the limitations of recent literature reviews and the lack of reviews focused on paediatric sepsis, it is necessary to synthesise the current research describing the development and evaluation of automated sepsis prediction technologies for this underrepresented age cohort. The scoping review defined by this protocol will identify and summarise the existing literature on the design characteristics, performance and integration of automated Open access sepsis prediction technologies in paediatric contexts.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Many systematic and scoping reviews have been rigorous in their search strategy but similar to the identified narrative reviews, report on screening tools and technologies for adult patients while excluding children23 24 27 32–35 and the engineering disciplines 18 22 36–38. Currently published protocols plan to exclude data-driven algorithms37 or only include literature on the application of machine learning,39 which may not capture all research on certain relevant technologies.…”

Section: Introductionmentioning

confidence: 99%

“…We have not identified any systematic or scoping reviews that comprehensively scope the literature on digital paediatric sepsis prediction technology. While one identified protocol aims to capture strategies for early recognition of paediatric sepsis from clinical deterioration, the focus of the review is general strategy effectiveness and does not explicitly include engineering databases, which would describe technical design aspects 38…”

Section: Introductionmentioning

confidence: 99%

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Automated digital technologies for supporting sepsis prediction in children: a scoping review protocol

et al. 2022

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IntroductionWhile there have been several literature reviews on the performance of digital sepsis prediction technologies and clinical decision-support algorithms for adults, there remains a knowledge gap in examining the development of automated technologies for sepsis prediction in children. This scoping review will critically analyse the current evidence on the design and performance of automated digital technologies to predict paediatric sepsis, to advance their development and integration within clinical settings.Methods and analysisThis scoping review will follow Arksey and O’Malley’s framework, conducted between February and December 2022. We will further develop the protocol using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. We plan to search the following databases: Association of Computing Machinery (ACM) Digital Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Google Scholar, Institute of Electric and Electronic Engineers (IEEE), PubMed, Scopus and Web of Science. Studies will be included on children >90 days postnatal to <21 years old, predicted to have or be at risk of developing sepsis by a digitalised model or algorithm designed for a clinical setting. Two independent reviewers will complete the abstract and full-text screening and the data extraction. Thematic analysis will be used to develop overarching concepts and present the narrative findings with quantitative results and descriptive statistics displayed in data tables.Ethics and disseminationEthics approval for this scoping review study of the available literature is not required. We anticipate that the scoping review will identify the current evidence and design characteristics of digital prediction technologies for the timely and accurate prediction of paediatric sepsis and factors influencing clinical integration. We plan to disseminate the preliminary findings from this review at national and international research conferences in global and digital health, gathering critical feedback from multidisciplinary stakeholders.Scoping review registrationhttps://osf.io/veqha/?view_only=f560d4892d7c459ea4cff6dcdfacb086

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Assessment of clinical outcome of children with sepsis outside the intensive care unit

Zallocco¹,

Osimani²,

Carloni³

et al. 2018

Eur J Pediatr

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In 2016, in order to identify adult patients with sepsis who are likely to have poor outcomes, the Third International Consensus Definitions Task Force introduced a new bedside index, called the quick Sepsis-related Organ Failure Assessment (qSOFA) score. However, these new criteria have not been validated in the pediatric population. In this study, we sought to assess the qSOFA score for children with sepsis, who are being treated outside the pediatric intensive care units. The qSOFA criteria were revised and applied to a study population of 89 pediatric patients with sepsis, admitted in a pediatric tertiary referral center from 2006 to 2016. The analysis of prognostic performance of qSOFA score for the prediction of severe sepsis showed a sensitivity of 46% (95% CI, 27-67%), a specificity of 74% (95% CI, 62-85%), a positive predictive value of 43% (95% CI, 34-52%), and a negative predictive value of 77% (95% CI, 71-82%). The area under ROC curve for qSOFA score ≥ 2 was 0.602 (95% CI 0.492-0.705).Conclusion: The qSOFA score showed a low accuracy to identify children in the pediatric ward at risk for severe sepsis. Clinical tools are needed to facilitate the diagnosis of impending organ dysfunction in pediatric infection outside of the ICU. What is Known: • One of the major challenges for clinicians is to identify and recognize children with sepsis and impending organ dysfunction, in the emergency and in the pediatric department. • In 2016, members of the Sepsis-3 task force proposed qSOFA, an empirically derived score using simple clinical criteria, to assist clinicians in identifying adult patients with sepsis at risk for poor outcome. What is New: • qSOFA demonstrated insufficient clinical value to be recommended as a screening tool for pediatric sepsis outside ICU. • D-dimer level and blood glucose may be useful biomarkers to identify children at risk for severe sepsis.

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Effectiveness of provider strategies for the early recognition of clinical deterioration due to sepsis in pediatric patients: a systematic review protocol

Cited by 3 publications

References 24 publications

Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

Automated digital technologies for supporting sepsis prediction in children: a scoping review protocol

Assessment of clinical outcome of children with sepsis outside the intensive care unit

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