ABSTRACT Objective To describe the clinical characteristics and
treatment of
children with
sepsis, severe sepsis, and
septic shock at a pediatric
emergency department of a
public hospital.
Methods A retrospective,
observational study. The
medical records of
patients included in the
hospital Pediatric
Sepsis Protocol and
patients with discharge
ICD-10 A41.9 (
sepsis, unspecified), R57 (
shock) and A39 (
meningococcal meningitis) were evaluated. Results A total of 399
patients were included. The
prevalence of
sepsis, severe sepsis, and
septic shock at the
emergency room were 0.41%, 0.14% and 0.014%, respectively. The median age was 21.5 months for
sepsis, 12 months for
severe sepsis, and 20.5 months for
septic shock.
Sepsis, severe sepsis, and
septic shock were more often associated with
respiratory diseases. The
Respiratory Syncytial Virus was the most common agent. The median
time to
antibiotic and fluid
administration was 3 hours in
patients with
sepsis and
severe sepsis. In
patients with
septic shock, the median times to administer
antibiotics, fluid and vasoactive
drugs were 2 hours, 2.5 hours and 6 hours, respectively. The median length of
hospital stay for
patients with
sepsis, severe sepsis and
septic shock were 3 days, 4 days and 1 day, respectively. The overall
mortality was 2%. Conclusion
Sepsis had a low
prevalence.
Early diagnosis and recognition are a challenge for the
emergency care pediatrician, the first place of admission.