Logo
BROWSE EVIDENCE REPOSITORY

 

Key studies English (22) French All (22)

Key Study: Serum lactate as a screening tool and predictor of outcome in pediatric patients presenting to the emergency department with suspected infection (2013)

Visit

Reed LC, J.; Cummings, A.; Markwell, S.; Wall, J.; Duong, M.

Objective: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. Published: 2013.

Key Study: Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study (2013)

Visit

Nijman RGV, Y.; Thompson, M.; Van Veen, M.; Van Meurs, A. H.; Van Der Lei, J....

Objective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Published: 2013.

Key Study: The utility of early lactate testing in undifferentiated pediatric systemic inflammatory response syndrome (2012)

Visit

Scott HFD, A. J.; Gaieski, D. F.; Marchese, R. F.; Mistry, R. D.

Objective: Failure to recognize shock contributes to inadequate early resuscitation in many children with sepsis. Serum lactate levels are used to identify adult patients with septic shock, but physical examination diagnosis alone is recommended in pediatric sepsis. The authors sought to test the utility of lactate testing in pediatric emergency department (ED) patients with systemic inflammatory response syndrome (SIRS). The hypothesis was that early hyperlactatemia (serum lactate >/= 4.0 mmol/L) would be associated with increased risk of organ dysfunction. Published: 2012.

Key Study: Test characteristics of an automated age- and temperature-adjusted tachycardia alert in pediatric septic shock (2012)

Visit

Cruz ATW, E. A.; Graf, J. M.; Perry, A. M.; Harbin, D. E.; Wuestner, E. R.; P...

Objective: This study aimed to create and analyze the performance of an automated triage tool alerting triage nursing staff and physicians to an abnormal heart rate consistent with septic shock in a pediatric emergency department. Published: 2012.

Key Study: Evaluation of temperature-pulse centile charts in identifying serious bacterial illness: observational cohort study (2011)

Visit

Brent AJL, M.; Ninis, N.; Levin, M.; Macfaul, R.; Thompson, M.

Background: Distinguishing serious bacterial infection (SBI) from milder/self-limiting infections is often difficult. Interpretation of vital signs is confounded by the effect of temperature on pulse and respiratory rate. Temperature-pulse centile charts have been proposed to improve the predictive value of pulse rate in the clinical assessment of children with suspected SBI. OBJECTIVES: To assess the utility of proposed temperature-pulse centile charts in the clinical assessment of children with suspected SBI. Published: 2011.

Key Study: Implementation of goal-directed therapy for children with suspected sepsis in the emergency department (2011)

Visit

Cruz ATP, A. M.; Williams, E. A.; Graf, J. M.; Wuestner, E. R.; Patel, B.

Background: Suboptimal care for children with septic shock includes delayed recognition and inadequate fluid resuscitation. OBJECTIVE: To describe the implementation of an emergency department (ED) protocol for the recognition of septic shock and facilitate adherence to national treatment guidelines. Published: 2011.

Key Study: Red blood cell transfusion thresholds in pediatric patients with sepsis (2011)

Visit

Karam OT, M.; Ducruet, T.; Hume, H. A.; Lacroix, J.; Gauvin, F.

Objective: In children with severe sepsis or septic shock, the optimal red blood cell transfusion threshold is unknown. We analyzed the subgroup of patients with sepsis and transfusion requirements in a pediatric intensive care unit study to determine the impact of a restrictive vs. liberal transfusion strategy on clinical outcome. Published: 2011.

Key Study: An emergency department septic shock protocol and care guideline for children initiated at triage (2011)

Visit

Larsen GYM, N.; Greenberg, R.

Background: Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension. OBJECTIVE: Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized. We hypothesized that septic shock protocol and care guideline would expedite identification of septic shock, increase compliance with recommended therapy, and improve outcomes.

Key Study: Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock: a prospective, observational cohort study (2011)

Visit

Verhoeven JJDB, M.; Hokken-Koelega, A. C.; Hazelzet, J. A.; Joosten, K. F.

Objective: The objective of this study was to investigate the occurrence of hyperglycemia and insulin response in critically ill children with meningococcal disease in the intensive care unit of an academic children's hospital. Published: 2011.

Key Study: Adjunctive corticosteroid therapy in pediatric severe sepsis: observations from the RESOLVE study (2011)

Visit

Zimmerman JJW, M. D.

Objective: To assess whether corticosteroids, used as adjunctive therapy for pediatric severe sepsis, is associated with improved outcomes. Published: 2011.

Key Study: The relationship between body temperature, heart rate and respiratory rate in children (2009)

Visit

Davies PM, I.

Objective: To describe and quantify the effect that increasing body temperature has on heart rate and respiratory rate in children attending a paediatric emergency department (ED). Published: 2009.

Key Study: How well do vital signs identify children with serious infections in paediatric emergency care? (2009)

Visit

Thompson MC, N.; Harnden, A.; Mayon-White, R.; Perera, R.; Mant, D.

Objective: To determine whether vital signs identify children with serious infections, and to compare their diagnostic value with that of the Manchester triage score (MTS) and National Institute for Health and Clinical Excellence (NICE) traffic light system of clinical risk factors. Published: 2009.

Key Study: Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit (2009)

Visit

Inwald DPT, R. C.; Peters, M. J.; Nadel, S.

Objective: To audit current UK practice of the management of severe sepsis in children against the 2002 American College of Critical Care Medicine/Pediatric Advanced Life Support (ACCM-PALS) guideline. Published: 2009.

Key Study: Vasopressin in pediatric vasodilatory shock: a multicenter randomized controlled trial (2009)

Visit

Choong KB, D.; Fraser, D. D.; Gaboury, I.; Hutchison, J. S.; Joffe, A. R.; Li...

Rationale: Vasopressin has been proposed as a potent vasoactive agent in the treatment of vasodilatory shock in adults and children. The objective of this trial was to evaluate the efficacy and safety of vasopressin as an adjunctive agent in pediatric vasodilatory shock. Published: 2009.

Key Study: Hydrocortisone therapy for patients with septic shock (2008)

Visit

Sprung CLA, D.; Keh, D.; Moreno, R.; Singer, M.; Freivogel, K.; Weiss, Y. G.;...

Background: Hydrocortisone is widely used in patients with septic shock even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin. Published: 2008.

Key Study: Serum lactate as a predictor of mortality in patients with infection (2007)

Visit

Trzeciak SD, R. P.; Chansky, M. E.; Arnold, R. C.; Schorr, C.; Milcarek, B.; ...

Objective: To determine the utility of an initial serum lactate measurement for identifying high risk of death in patients with infection. DESIGN AND SETTING: Post-hoc analysis of a prospectively compiled registry in an urban academic hospital. Published: 2007.

Key Study: Rapid fluid resuscitation in pediatrics: testing the American College of Critical Care Medicine guideline (2007)

Visit

Stoner MJG, D. G.; Cohen, D. M.; Fernandez, S. A.; Hall, M. W.

Objective: The 2002 American College of Critical Care Medicine (ACCM) guidelines for the resuscitation of pediatric septic shock suggest that 20 mL/kg of bolus intravenous fluid be given within 5 minutes. Of 3 commonly used, inexpensive methods of fluid delivery, we hypothesized that only use of a manual push-pull system will permit guideline adherence. Published: 2007.

Key Study: Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock (2005)

Visit

Upadhyay MS, S.; Murlidharan, J.; Kaur, N.; Majumdar, S.

Objective: To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. Published: 2005.

Key Study: International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics (2005)

Visit

Goldstein BG, B.; Randolph, A.

Objective: Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population. Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children. An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children. Published: 2005.

Key Study: Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome (2003)

Visit

Han YYC, J. A.; Dragotta, M. A.; Bills, D. M.; Watson, R. S.; Westerman, M. E...

Objective: Experimental and clinical studies of septic shock support the concept that early resuscitation with fluid and inotropic therapies improves survival in a time-dependent manner. The new American College of Critical Care Medicine-Pediatric Advanced Life Support (ACCM-PALS) Guidelines for hemodynamic support of newborns and children in septic shock recommend this therapeutic approach. The objective of this study was to determine whether early septic shock reversal and use of resuscitation practice consistent with the new ACCM-PALS Guidelines by community physicians is associated with improved outcome. Published: 2003.

Key Study: Early goal-directed therapy in the treatment of severe sepsis and septic shock (2001)

Visit

Rivers EN, B.; Havstad, S.; Ressler, J.; Muzzin, A.; Knoblich, B.; Peterson, ...

Background: Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit. Published: 2001.

Key Study: Role of early fluid resuscitation in pediatric septic shock (1991)

Visit

Carcillo JaD, A. L.; Zaritsky, A.

Objective: To examine the association of the volume of fluid administered at 1 and 6 hours after presentation, with survival and the occurrence of the adult respiratory distress syndrome, cardiogenic pulmonary edema, and persistent hypovolemia during the resuscitation of children with septic shock. Published: 1991.

Key Study: Serum lactate as a screening tool and predictor of outcome in pediatric patients presenting to the emergency department with suspected infection (2013)

Visit

Reed LC, J.; Cummings, A.; Markwell, S.; Wall, J.; Duong, M.

Objective: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. Published: 2013.

Key Study: Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study (2013)

Visit

Nijman RGV, Y.; Thompson, M.; Van Veen, M.; Van Meurs, A. H.; Van Der Lei, J....

Objective: To derive, cross validate, and externally validate a clinical prediction model that assesses the risks of different serious bacterial infections in children with fever at the emergency department. Published: 2013.

Key Study: The utility of early lactate testing in undifferentiated pediatric systemic inflammatory response syndrome (2012)

Visit

Scott HFD, A. J.; Gaieski, D. F.; Marchese, R. F.; Mistry, R. D.

Objective: Failure to recognize shock contributes to inadequate early resuscitation in many children with sepsis. Serum lactate levels are used to identify adult patients with septic shock, but physical examination diagnosis alone is recommended in pediatric sepsis. The authors sought to test the utility of lactate testing in pediatric emergency department (ED) patients with systemic inflammatory response syndrome (SIRS). The hypothesis was that early hyperlactatemia (serum lactate >/= 4.0 mmol/L) would be associated with increased risk of organ dysfunction. Published: 2012.

Key Study: Test characteristics of an automated age- and temperature-adjusted tachycardia alert in pediatric septic shock (2012)

Visit

Cruz ATW, E. A.; Graf, J. M.; Perry, A. M.; Harbin, D. E.; Wuestner, E. R.; P...

Objective: This study aimed to create and analyze the performance of an automated triage tool alerting triage nursing staff and physicians to an abnormal heart rate consistent with septic shock in a pediatric emergency department. Published: 2012.

Key Study: Evaluation of temperature-pulse centile charts in identifying serious bacterial illness: observational cohort study (2011)

Visit

Brent AJL, M.; Ninis, N.; Levin, M.; Macfaul, R.; Thompson, M.

Background: Distinguishing serious bacterial infection (SBI) from milder/self-limiting infections is often difficult. Interpretation of vital signs is confounded by the effect of temperature on pulse and respiratory rate. Temperature-pulse centile charts have been proposed to improve the predictive value of pulse rate in the clinical assessment of children with suspected SBI. OBJECTIVES: To assess the utility of proposed temperature-pulse centile charts in the clinical assessment of children with suspected SBI. Published: 2011.

Key Study: Implementation of goal-directed therapy for children with suspected sepsis in the emergency department (2011)

Visit

Cruz ATP, A. M.; Williams, E. A.; Graf, J. M.; Wuestner, E. R.; Patel, B.

Background: Suboptimal care for children with septic shock includes delayed recognition and inadequate fluid resuscitation. OBJECTIVE: To describe the implementation of an emergency department (ED) protocol for the recognition of septic shock and facilitate adherence to national treatment guidelines. Published: 2011.

Key Study: Red blood cell transfusion thresholds in pediatric patients with sepsis (2011)

Visit

Karam OT, M.; Ducruet, T.; Hume, H. A.; Lacroix, J.; Gauvin, F.

Objective: In children with severe sepsis or septic shock, the optimal red blood cell transfusion threshold is unknown. We analyzed the subgroup of patients with sepsis and transfusion requirements in a pediatric intensive care unit study to determine the impact of a restrictive vs. liberal transfusion strategy on clinical outcome. Published: 2011.

Key Study: An emergency department septic shock protocol and care guideline for children initiated at triage (2011)

Visit

Larsen GYM, N.; Greenberg, R.

Background: Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension. OBJECTIVE: Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized. We hypothesized that septic shock protocol and care guideline would expedite identification of septic shock, increase compliance with recommended therapy, and improve outcomes.

Key Study: Pathophysiological aspects of hyperglycemia in children with meningococcal sepsis and septic shock: a prospective, observational cohort study (2011)

Visit

Verhoeven JJDB, M.; Hokken-Koelega, A. C.; Hazelzet, J. A.; Joosten, K. F.

Objective: The objective of this study was to investigate the occurrence of hyperglycemia and insulin response in critically ill children with meningococcal disease in the intensive care unit of an academic children's hospital. Published: 2011.

Key Study: Adjunctive corticosteroid therapy in pediatric severe sepsis: observations from the RESOLVE study (2011)

Visit

Zimmerman JJW, M. D.

Objective: To assess whether corticosteroids, used as adjunctive therapy for pediatric severe sepsis, is associated with improved outcomes. Published: 2011.

Key Study: The relationship between body temperature, heart rate and respiratory rate in children (2009)

Visit

Davies PM, I.

Objective: To describe and quantify the effect that increasing body temperature has on heart rate and respiratory rate in children attending a paediatric emergency department (ED). Published: 2009.

Key Study: How well do vital signs identify children with serious infections in paediatric emergency care? (2009)

Visit

Thompson MC, N.; Harnden, A.; Mayon-White, R.; Perera, R.; Mant, D.

Objective: To determine whether vital signs identify children with serious infections, and to compare their diagnostic value with that of the Manchester triage score (MTS) and National Institute for Health and Clinical Excellence (NICE) traffic light system of clinical risk factors. Published: 2009.

Key Study: Emergency management of children with severe sepsis in the United Kingdom: the results of the Paediatric Intensive Care Society sepsis audit (2009)

Visit

Inwald DPT, R. C.; Peters, M. J.; Nadel, S.

Objective: To audit current UK practice of the management of severe sepsis in children against the 2002 American College of Critical Care Medicine/Pediatric Advanced Life Support (ACCM-PALS) guideline. Published: 2009.

Key Study: Vasopressin in pediatric vasodilatory shock: a multicenter randomized controlled trial (2009)

Visit

Choong KB, D.; Fraser, D. D.; Gaboury, I.; Hutchison, J. S.; Joffe, A. R.; Li...

Rationale: Vasopressin has been proposed as a potent vasoactive agent in the treatment of vasodilatory shock in adults and children. The objective of this trial was to evaluate the efficacy and safety of vasopressin as an adjunctive agent in pediatric vasodilatory shock. Published: 2009.

Key Study: Hydrocortisone therapy for patients with septic shock (2008)

Visit

Sprung CLA, D.; Keh, D.; Moreno, R.; Singer, M.; Freivogel, K.; Weiss, Y. G.;...

Background: Hydrocortisone is widely used in patients with septic shock even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin. Published: 2008.

Key Study: Serum lactate as a predictor of mortality in patients with infection (2007)

Visit

Trzeciak SD, R. P.; Chansky, M. E.; Arnold, R. C.; Schorr, C.; Milcarek, B.; ...

Objective: To determine the utility of an initial serum lactate measurement for identifying high risk of death in patients with infection. DESIGN AND SETTING: Post-hoc analysis of a prospectively compiled registry in an urban academic hospital. Published: 2007.

Key Study: Rapid fluid resuscitation in pediatrics: testing the American College of Critical Care Medicine guideline (2007)

Visit

Stoner MJG, D. G.; Cohen, D. M.; Fernandez, S. A.; Hall, M. W.

Objective: The 2002 American College of Critical Care Medicine (ACCM) guidelines for the resuscitation of pediatric septic shock suggest that 20 mL/kg of bolus intravenous fluid be given within 5 minutes. Of 3 commonly used, inexpensive methods of fluid delivery, we hypothesized that only use of a manual push-pull system will permit guideline adherence. Published: 2007.

Key Study: Randomized evaluation of fluid resuscitation with crystalloid (saline) and colloid (polymer from degraded gelatin in saline) in pediatric septic shock (2005)

Visit

Upadhyay MS, S.; Murlidharan, J.; Kaur, N.; Majumdar, S.

Objective: To compare the efficacy of crystalloid (Normal saline) and colloid (polymer from degraded Gelatin in saline Haemaccel) intravenous fluid in restoration of circulating volume in children with septic shock. Published: 2005.

Key Study: International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics (2005)

Visit

Goldstein BG, B.; Randolph, A.

Objective: Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population. Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children. An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children. Published: 2005.

Key Study: Early reversal of pediatric-neonatal septic shock by community physicians is associated with improved outcome (2003)

Visit

Han YYC, J. A.; Dragotta, M. A.; Bills, D. M.; Watson, R. S.; Westerman, M. E...

Objective: Experimental and clinical studies of septic shock support the concept that early resuscitation with fluid and inotropic therapies improves survival in a time-dependent manner. The new American College of Critical Care Medicine-Pediatric Advanced Life Support (ACCM-PALS) Guidelines for hemodynamic support of newborns and children in septic shock recommend this therapeutic approach. The objective of this study was to determine whether early septic shock reversal and use of resuscitation practice consistent with the new ACCM-PALS Guidelines by community physicians is associated with improved outcome. Published: 2003.

Key Study: Early goal-directed therapy in the treatment of severe sepsis and septic shock (2001)

Visit

Rivers EN, B.; Havstad, S.; Ressler, J.; Muzzin, A.; Knoblich, B.; Peterson, ...

Background: Goal-directed therapy has been used for severe sepsis and septic shock in the intensive care unit. This approach involves adjustments of cardiac preload, afterload, and contractility to balance oxygen delivery with oxygen demand. The purpose of this study was to evaluate the efficacy of early goal-directed therapy before admission to the intensive care unit. Published: 2001.

Key Study: Role of early fluid resuscitation in pediatric septic shock (1991)

Visit

Carcillo JaD, A. L.; Zaritsky, A.

Objective: To examine the association of the volume of fluid administered at 1 and 6 hours after presentation, with survival and the occurrence of the adult respiratory distress syndrome, cardiogenic pulmonary edema, and persistent hypovolemia during the resuscitation of children with septic shock. Published: 1991.