Improving sepsis diagnosis in children

Tuesday 20 February 2018

Mater Researches are investigating the diagnosis process for sepsis in children, a major disease that can lead to severe illness and remains one of the leading causes of mortality in children.

Associate Professor Luregn Schlapbach explained that the key problem of diagnosis is that sepsis initially often presents similarly to common respiratory infections like pneumonia and other initially mild infections.

“In view of the past difficulties in diagnosing sepsis reliably, a taskforce of adult critical care physicians and sepsis experts revised the definition of sepsis in adults in 2016,” said A/Prof Schlapbach.

“The new sepsis definition, so called Sepsis-3 definitions, defines sepsis as dysregulated host response to infection resulting in organ dysfunction.

“Essentially, this means that sepsis is when a body’s reaction to infection becomes so overwhelming that it causes one or several organs to shut down, which can lead to death in the worst cases.

“Usually our immune defense protects our body from infections. However in the case of sepsis, the combination of infection with the response to infection can cause harm to our body”.

A/Prof Schlapbach said that the new definition had not been properly tested and applied to cases of sepsis in children, who are the age group exposed to the highest sepsis burden.

“The Paediatric Critical Care Research Group at Mater Research, The University of Queensland, and Lady Cilento Children’s Hospital has been working with national and international experts to assess how best to translate new adult sepsis definitions to children.”

In two recent studies led by A/Prof Schlapbach, published in Intensive Care Medicine, and a recent editorial published in JAMA Pediatrics, researchers identified the best scoring systems and a set of rapidly available clinical parameters to improve correct diagnosis of sepsis.

“Based on a multicentre cohort study of more than 2500 patients, our findings support the need to revise paediatric sepsis definitions.

“Adapting Sepsis-3 to age-specific criteria performs better than the previous Sepsis-2-based criteria for this age-group.”

A/Prof Schlapbach said the revision of definitions would lead to more reliable capturing of sepsis in children.

“Sepsis has been recognized as a priority in health, and several states are in the process of launching initiatives to improve sepsis treatment. Studies suggest the incidence of sepsis in adults and children is increasing but we are unsure if this is a true increase or if it relates to clinicians diagnosing sepsis more often,” he said.

"In order to assess the effectiveness of these initiatives, robust measuring of sepsis through reliable diagnosis is required.”