title: Sepsis, severe sepsis and septic shock in paediatric multiple organ dysfunction syndrome.
abstract: OBJECTIVE
  To determine the association between severity of sepsis with outcome and severity of illness in children with multiple organ dysfunction syndrome (MODS).
  
  
  METHODS
  Four hundred and ninety-five consecutive paediatric intensive care unit (PICU) admissions were analysed. multiple organ dysfunction syndrome was defined as simultaneous dysfunction of >/= 2 organ system and sepsis by the American College of Chest Physicians and Society of Critical Care Medicine Consensus Conference definition.
  
  
  RESULTS
  Eighty-four patients developed MODS. The incidence of sepsis, severe sepsis and septic shock in these patients was 10.7%, 23.8% and 17.9%, respectively. Worsening categories of sepsis were associated with: (1) a higher mean admission Paediatric Risk of Mortality (PRISM II): 36.6 +/- 25.9, 56.8 +/- 32.1 and 73.6 +/- 28.5%, respectively (P = 0. 005), (2) a larger number of organ dysfunctions: mean MODS index of 37%, 46% and 58%, respectively (P = 0.007), and (3) a higher mortality: 22.2%, 65% and 80%, respectively (P = 0.03).
  
  
  CONCLUSIONS
  Presence of sepsis, severe sepsis and septic shock was associated with an increasing severity of illness, increased number of organ dysfunctions and a distinct risk of mortality among critically ill children.
authors.affiliation: Paediatric Intensive Care Unit, University Malaya Medical Center, KualaLumpur, Malaysia. adrian@medicine.med.um.edu.my
authors.forename: A
authors.initials: A
authors.lastname: Goh
authors.forename: L
authors.initials: L
authors.lastname: Lum
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000150:complications / Q000175:diagnosis*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D012772:Shock, Septic / Q000150:complications / Q000175:diagnosis* / Q000401:mortality