New criteria for sepsis in children based on organ dysfunction

(Press-News.org) Clinician-scientists from Ann & Robert H. Lurie Children’s Hospital of Chicago were among a diverse, international group of experts tasked by the Society of Critical Care Medicine (SCCM) with developing and validating new data-based criteria for sepsis in children. Sepsis is a major public heath burden, claiming the lives of over 3.3 million children worldwide every year. The new pediatric sepsis criteria – called the Phoenix criteria – follow the paradigm shift in the recent adult criteria that define sepsis as severe response to infection involving organ dysfunction, as opposed to an earlier focus on systemic inflammation. The new pediatric sepsis criteria and their development are presented in two papers published in JAMA on January 21, 2024, and concurrently announced at the SCCM Critical Care Congress in Phoenix, Arizona.

“The last pediatric sepsis criteria were developed nearly 20 years ago and were based on expert opinion, whereas the new criteria we derived are based on data from electronic health records and analysis of more than 3 million pediatric healthcare encounters from 10 hospitals around the world, including in low-resource settings,” said lead author of one of the papers L. Nelson Sanchez-Pinto, MD, MBI, critical care physician at Lurie Children’s who co-led the data group of the SCCM task force with Tellen D. Bennett, MD, MS, at the University of Colorado. “We used a machine learning approach to narrow down elements that were most effective in identifying children at high risk of dying from organ dysfunction in the setting of an infection. The criteria we developed rely on four systems – cardiovascular, respiratory, neurological and coagulation. These criteria are better than the old ones at identifying children with infections at higher risk of poor outcomes and are globally applicable, including in low-resource settings.”

Dr. Sanchez-Pinto is an Associate Professor of Pediatrics and Preventive Medicine at Northwestern University Feinberg School of Medicine, as well as Warren and Eloise Batts Research Scholar at Lurie Children’s. His data-driven work to derive the new sepsis criteria was funded by the National Institutes of Health (NIH).

The SCCM leadership team that assembled the task force on pediatric sepsis included Lauren Sorce, PhD, RN, CPNP-AC/PC, FCCM, FAAN, Founders’ Board Nurse Scientist and Associate Director of Nursing Research at Lurie Children’s, as well as Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. Dr. Sorce has since been named President of SCCM.

The pediatric sepsis task force also included Elizabeth Alpern, MD, MSCE, Division Head of Emergency Medicine at Lurie Children’s and Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute, which is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is a nonprofit organization committed to providing access to exceptional care for every child. It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine.

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