SIRS o no SIRS: ¿es esa la infección? Una revisión crítica de los criterios de definición de sepsis

Jaramillo-Bustamante, Juan Camilo; Piñeres-Olave, Byron Enrique; González‐Dambrauskas, Sebastián

doi:10.24875/bmhim.20000202

Cited by 10 publications

(10 citation statements)

References 58 publications

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“…Tan et al 3 reported that sepsis-related mortality rate is 19% in high-income countries whereas it is as high as 32% in low-income countries. These rates show that sepsis is undoubtedly a socioeconomic disease 4,70–72 and urgent measures are necessary to adapt management guidelines for their use in all these scenarios 51 . Indeed, in resource-poor settings, the use of vasoactive agents through a PVL in PSS is justifiable as it is cost effective and found to be safe without serious adverse effects if experienced and continuous nursing care may be provided.…”

Section: Discussionmentioning

confidence: 99%

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

et al. 2020

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Objective: Mortality in pediatric septic shock remains unacceptably high.Delays in vasopressor administration have been associated with an increased risk of mortality. Current treatment guidelines suggest the use of a peripheral vascular line (PVL) for inotropic administration in fluid-refractory septic shock when a central vascular line is not already in place. The aim of this study was to report local adverse effects associated with inotropic drug administration through a PVL at a pediatric emergency department setting in the first hour of treatment of septic shock.Methods: A prospective, descriptive, observational cohort study of patients with septic shock requiring PVL inotropic administration was conducted at the pediatric emergency department of a tertiary care pediatric hospital. For the infusion and postplacement care of the PVL for vasoactive drugs, an institutional nursing protocol was used.Results: We included 49 patients; 51% had an underlying disease.Eighty-four percent of the children included had a clinical "cold shock." The most frequently used vasoactive drug was epinephrine (72%). One patient presented with local complications.Conclusions: At our center, infusion of vasoactive drugs through a PVL was shown to be safe and allowed for adherence to the current guidelines for pediatric septic shock.

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Section: Discussionmentioning

confidence: 99%

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

et al. 2020

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“…The recommendation for applying them should be in accordance with the diagnostic impression, the patient's physical examination, the PAS, and the physician's judgment [18,24]. The use of ultrasound for this condition worldwide has revealed that it has a relatively high sensitivity and specificity (90% and 95%, respectively) [25]. However, even though it represents a reproducible and nonionizing diagnostic aid, especially for the age group in question, it is limited by the fact that it is an operator-dependent test, and its sensitivity and specificity are linked to the radiologist's experience.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of acute appendicitis in patients younger than age 4: a descriptive study

et al. 2022

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Background Acute appendicitis is an infrequent pathology in children under 4 years of age, and its diagnosis is a clinical challenge that can lead to late detection. The intention of this study is to describe the clinical and surgical findings and to explore factors and outcomes associated with appendiceal perforation in patients under 4 years of age with histologically confirmed acute appendicitis. Cross-sectional study of historical data is on patients with a pathologic diagnosis of appendicitis. Clinical, surgical, and pathological variables were described. The relationship between the presence of perforation and associated factors and outcomes was explored using odds ratios (OR) and 95% confidence intervals. Results Seventy-five patients were found between 2013 and 2019. Seventy-four cases presented with pain on palpation, 56 (75%) with signs of peritoneal irritation, and 70 (93%) with sepsis on admission to the emergency room. An ultrasound was done on 57 patients (76%), and only 26 (45%) were suggestive of appendicitis. Forty-one (55%) cases were operated on by open surgery and 34 (45%) by laparoscopy. In 61 (81%), they were perforated, and 48 (64%) presented peritonitis. Perforation was associated with increased hospital days (OR = 2.54 [1.60−4.03]), days of antibiotics (OR = 4.40 [2.09−9.25]), and admission to intensive care (OR = 9.65 [1.18−78.57]). Conclusions Abdominal pain reported by parents, pain on abdominal palpation, and clinical criteria of sepsis on admission to the emergency room are common features. Acute appendicitis complicated by perforation leads to high morbidity due to longer antibiotic treatment, hospitalization days, admission to PICU, and postoperative ileus.

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“…En el 2016, la Campaña de Sobrevivir a la Sepsis no especifica las definiciones para población pediátrica y desaparece el concepto de sepsis grave 6,7,11,12 . En 2020, la Campaña de Sobrevivir a la Sepsis reconoce la falta de definiciones específicas de sepsis y shock séptico en Pediatría, pero mantiene la definición de sepsis asociada a fallo orgánico y shock séptico asociado a insuficiencia circulatoria aguda 6,7,13 .…”

Section: Definiciones En Pediatríaunclassified

“…La definición de sepsis y shock séptico en Pediatría no es del todo clara, pero ha sido modifica a través del tiempo y adaptada a los nuevos avances médicos [2][3][4]6,11,12 . El fallo orgánico puede ser cuantificado mediante diversas escalas, pero actualmente se emplea la escala SOFA o qSOFA, pero estas no son especificas en pacientes pediátricos, siendo empleada la escala pSOFA, aunque esta aún no está validada por el consenso Sepsis-3, ya que no se ha establecido su sensibilidad y especificidad más que en pacientes críticos 6 .…”

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Manejo De Sepsis Y Shock Séptico en Pediatría

Crespo¹,

Puente²,

Flores³

et al. 2023

Infectología Clínica

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El reconocimiento temprano de un cuadro séptico debe ser uno de los principales objetivos en el momento de la atención de un paciente pediátrico, la instauración del tratamiento temprano representa la oportunidad para obtener una mayor posibilidad de supervivencia. Aunque aún existen pocos estudios en el manejo específico en la población infantil, la detección e intervención debe adaptarse a la edad, la gravedad y en el presunto origen infeccioso siendo individualizado el tratamiento. La siguiente revisión permite profundizar en los conocimientos básicos sobre la sepsis y el shock séptico en pediatría con la finalidad de promover una detección temprana y así destacar las medidas efectivas para un adecuado manejo.

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SIRS o no SIRS: ¿es esa la infección? Una revisión crítica de los criterios de definición de sepsis

Cited by 10 publications

References 58 publications

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

Use of Inotropics by Peripheral Vascular Line in the First Hour of Treatment of Pediatric Septic Shock: Experience at an Emergency Department

Outcomes of acute appendicitis in patients younger than age 4: a descriptive study

Manejo De Sepsis Y Shock Séptico en Pediatría

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