Pediatric Sepsis: Evolving Diagnostic Criteria, Organ Dysfunction Complications, and Evidence-Based Management
Keywords:
pediatric sepsis, Phoenix Sepsis Score, organ dysfunction, septic shock, fluid resuscitation, PICS-p, biomarkersAbstract
Background: Sepsis remains a principal cause of pediatric morbidity and mortality globally, accounting for more than 3 million childhood deaths annually. The 2024 Phoenix Sepsis Criteria represent a paradigm shift from SIRS-based definitions toward organ dysfunction-centered assessment, improving diagnostic accuracy and prognostic stratification. Objective: This review synthesizes current evidence on the epidemiology, pathophysiology, complications, and management of pediatric sepsis, contrasting historical and contemporary approaches. Methods: A narrative review of publications from PubMed, EMBASE, and Cochrane Library (2000–2025) was conducted. Results: Evidence supports POCUS-guided, titrated fluid resuscitation; early broad-spectrum antibiotics within one hour; norepinephrine as first-line vasopressor; and structured post-discharge surveillance for post-intensive care syndrome in pediatrics (PICS-p). Conclusion: Integrating the Phoenix Score into clinical practice alongside personalized resuscitation protocols and long-term follow-up will meaningfully reduce sepsis-associated mortality and long-term functional impairment.
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