BackgroundThe identification of sepsis in children varies depending on the definition used. Our purpose was to compare clinical data and outcome of atypical sepsis, manifested as having sepsis but not fulfilling the criteria of systemic inflammatory response syndrome (SIRS-negative sepsis, SNS), in children based on the modified Angus criteria with those of sepsis (S) and severe sepsis (SS) based on the international consensus criteria.MethodsPediatric departments in 11 regional city and county referral hospitals with emergency and intensive care settings in Huai'an serving for 843,000 children participated in a parallel multicenter prospective survey. Clinical data registry was used to recruit those who fulfilled the diagnostic criteria for pediatric sepsis from all admissions (n=27,836) from 28days to 15years old, from September 1, 2010 to August 31, 2011.ResultsA total of 1606 children met the criteria for pediatric sepsis and were divided into three groups: S, (n=1377), SS (n=153, including 32 septic shock), based on the consensus definition criteria, and SNS (n=76) based on the modified Angus criteria. Most deaths (38/54, 70.3%) occurred within three days of admission. The SNS mainly occurred in infants and was associated with cardiopulmonary and neurologic dysfunction without satisfying the SIRS criteria.ConclusionsSNS differed from SS in that it predominantly affected infants and manifested with cardiopulmonary and neurologic dysfunction. There were no laboratory variables which were useful in identification of SNS, or predicting response to therapy or outcome.
[1]Fudan Univ, Childrens Hosp, Dept Pediat, 399 Wanyuan Rd, Shanghai 201102, Peoples R China;
[2]Fudan Univ, Childrens Hosp, Dept Pediat Crit Care, 399 Wanyuan Rd, Shanghai 201102, Peoples R China;
[3]Huaian Women & Childrens Hosp, Dept Pediat, Huaian 223002, Jiangsu, Peoples R China;
[4]Huaian Women & Childrens Hosp, Dept Pediat Crit Care, Huaian 223002, Jiangsu, Peoples R China;
[5]Univ British Columbia, Dept Pediat, Vancouver, BC, Canada;
[6]BC Childrens Hosp, Vancouver, BC, Canada
(8.0+极速模式)