New Criteria for Sepsis in Children Based on Organ Failure

The Society of Critical Care Medicine (SCCM) tasked a broad international panel of experts with creating and verifying new data-based criteria for sepsis in children, including clinician-scientists from Ann & Robert H. Lurie Children’s Hospital in Chicago.

Sepsis is a huge public health burden, killing more than 3.3 million children worldwide each year. The new pediatric sepsis criteria, known as the Phoenix criteria, are based on the current adult criteria, which describe sepsis as a severe response to infection involving organ failure rather than the previous focus on systemic inflammation.

The revised pediatric sepsis criteria and their development are described in two publications published in JAMA on January 21, 2024, and unveiled concurrently at the SCCM Critical Care Congress in Phoenix, Arizona.

Primary author of one of the papers L. Nelson Sanchez-Pinto, MD, MBI who co-led the data group of the SCCM task force with Tellen D. Bennett, MD, MS, at the University of Colorado said, “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 health care encounters from 10 hospitals around the world, including in low-resource settings”.

“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’s Feinberg School of Medicine and a Warren and Eloise Batts Research Scholar at Lurie Children’s Hospital.

Lauren Sorce, Ph.D., RN, CPNP-AC/PC, FCCM, FAAN, Founders’ Board Nurse Scientist and Associate Director of Nursing Research at Lurie Children’s, and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine, was part of the SCCM leadership team that put together the pediatric sepsis task force.

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

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