Sepsis and septic shock: progress and future considerations.

ABSTRACT

OBJECTIVE: To define sepsis and septic shock in children, to outline an approach to treatment in the emergency, critical care units and to outline a global sepsis initiative. METHODS: A synopsis of the literature and adaptation of current treatment guidelines for sepsis in children. RESULTS: Sepsis in children can be recognized early using clinical parameters. Prompt, aggressive treatment using ACCM guidelines has resulted in improved outcomes. CONCLUSION: A collaborative approach to the diagnosis and treatment of sepsis by the Emergency Department and Pediatric Intensive Care Unit can lead to improved outcomes of children with sepsis. Treatment based on a model of escalating levels of care and organ support which takes into consideration the resources available in different settings is likely to improve sepsis outcomes globally. The World Federation Sepsis Initiative (www.wfpiccs.org) is intended to promote treatment based on this model.