Abstract
Sepsis is an important cause of morbidity and mortality both in neonates and children. Septic episodes caused by bacteria may rapidly progress from mild to severe illness with shock and multiorgan failure. Early recognition of bacterial infection and initiation of appropriate antimicrobial treatment decreases morbidity and mortality [1]. However, other non-bacterial pathologies like burns, trauma, major surgery, reperfusion after ischemia or Addisonian crisis can elicit a systemic inflammatory response syndrome (SIRS) clinically similar to bacterial sepsis [2]. Careful evaluation of history and clinical circumstances helps but does not resolve the inaccuracy of presumptive diagnosis. Despite maximized efforts to isolate bacteria, about half of the septic episodes in adult [3] and pediatric patients [4] remain culture-negative.
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References
Kreger BE, Craven DE, McCabe WR (1980) Gram-negative bacteremia. IV. Re-evaluation of clinical features and treatment in 612 patients. Am J Med 68:344–355.
Bone RC (1992) Toward an epidemiology and natural history of SIRS (systemic inflammatory response syndrome) Jama 268:3452–3455.
Rangel-Frausto MS, Pittet D, Costigan M, Hwang T, Davis CS, Wenzel RP (1995) The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. Jama 273:117–123.
Fischer JE, Fischer JC, Printzen G, Nadal D, Schmid E, Fanconi S (1996) Endogenous gran- ulocyte-colony stimulating factor in the early diagnosis of sepsis, (in preparation).
Thijs L, Hack C (1995) Time course of cytokine levels in sepsis. Intensive Care Med 21:S258-S263.
Besedovsky H, Del Rey A (1996) Immune-Neuro-Endocrine Interactions: Facts and Hypotheses. Endocrine Rev 17:1–39.
Parrillo J (1993) Pathogenetic mechanisms of septic shock. New Eng J Med 328:1471- 1477.
Ward P (1991) Mechanisms of endothelial cell killing by H202 or products of activated neutrophiles. Am J Med 91:3C-89S-94S.
Weiss J (1989) Tissue destruction by neutrophiles. N Engl J Med 320:365–376.
Fisher CJ, Jr., Slotman GJ, Opal SM, et al (1994) Initial evaluation of human recombinant interleukin-1 receptor antagonist in the treatment of sepsis syndrome: a randomized, open-label, placebo-controlled multicenter trial. Crit Care Med 22:12–21.
Bone R, Fischer CJ, Clemmer T, et al (1987) A controlled clinical trial of high-dose methyl-prednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317:653- 658.
Natanson C, Hoffman WD, Suffredini AF, Eichacker PQ, Danner RL (1994) Selected treatment strategies for septic shock based on proposed mechanisms of pathogenesis. Ann Intern Med 120:771–783.
Fanaroff AA, Korones SB, Wright LL, et al (1994) A controlled trial of intravenous immune globulin to reduce nosocomial infections in very-low-birth-weight infants. N Engl J Med 330:1107–1113.
Hayden W (1994) Sepsis terminology in pediatrics. J Pediatrics 124:657–658.
Bone RC, Balk RA, Cerra FB, et al (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 101:1644–1655.
Saez Llorens X, McCracken GH, Jr. (1993) Sepsis syndrome and septic shock in pediatrics: current concepts of terminology, pathophysiology, and management. J Pediatr 123:497–508.
Kuhns DB, Alvord WG, Gallin JI (1995) Increased circulating cytokines, cytokine antagonists, and E-selectin after intravenous administration of endotoxin in humans. J Infect Dis 171:145–152
Dale D, Liles W, Summer W, Nelson S (1995) Review: Granulocyte Colony-Stimulating Factor-Role and Relationships in Infectious Diseases. J Infect Dis 172:1061–1075.
Walley K (1995) Ventricular dysfunction during sepsis. In Vincent J (ed) 1995 Yearbook of intensive care and emergency medicine. Springer, Berlin, Heidelberg, pp 505–517.
Salvo I, de Cian W, Musicco M, et al (1995) The Italian SEPSIS study: preliminary results on the incidence and evolution of SIRS, sepis, severe sepsis and septic shock. Intensive Care Med 21:S244-S249.
Le Gall J, Lemeshov S (1995) SAPS II and MPM II models for early severe sepsis. In Sib- bald W, Vincent J (ed) Clinical trials for the treatment of sepsis. Springer, Berlin Heidelberg, pp 13–34.
Vincent J (1995) The “at risk” patient population. Sibbald W, Vincent J (ed) Clinical trials for the treatment of sepsis. Springer, Berlin Heidelberg, pp 13–34.
Escobar G, Fischer A, De Kun L, Kremers R, Armstrong M (1995) Score for neonatal acute physiology: validation in three Kaiser Permanente neonatal intensive care units. Pediatrics 98:918–922.
Eidelman L, Sprung C (1994) Why have new effective therapies for sepsis not been developed. Crit Care 22:1330–1334.
Richardson DK, Gray JE, McCormick MC, Workman K, Goldmann DA (1993) Score for Neonatal Acute Physiology: a physiologic severity index for neonatal intensive care. Pediatrics 91:617–623.
Pollack M, Ruttimann U, Getson P (1988) Pediatric risk of mortality (PRISM) score. Crit Care 16:1110–1116.
Gessler P, Kirchmann N, Kientsch ER, Haas N, Lasch P, Kachel W (1993) Serum concentrations of granulocyte colony-stimulating factor in healthy term and preterm neonates and in those with various diseases including bacterial infections. Blood 82:3177–3182.
Eichacker P (1995) Neutrophile directed therapies in sepsis, 24th Annual Meeting of the International Society for Experimental Hematology. Düsseldorf.
Baraff LJ, Bass JW, Fleisher GR, et al (1993) Practice guideline for the management of infants and children 0 to 36 months of age with fever without source. Ann Emerg Med 22:1198–1210.
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Fischer, J., Fanconi, S. (1996). Systemic Inflammatory Response Syndrome (SIRS) in Pediatric Patients. In: Tibboel, D., van der Voort, E. (eds) Intensive Care in Childhood. Update in Intensive Care and Emergency Medicine, vol 25. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80227-0_20
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DOI: https://doi.org/10.1007/978-3-642-80227-0_20
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