Optimizing intensive care management in paediatric sepsis.
OBJECTIVE
Paediatric sepsis continues to be a disease with unacceptably high morbidity and mortality, despite huge advances in paediatric intensive care organization and technology. This review examines the epidemiology, pathophysiology and advances in the treatment of paediatric sepsis.


RESULTS
Many studies initially reporting encouraging or positive results on adult patients with sepsis have subsequently been disproved either in further studies on adults or in proof-of-principle studies on children. Publication of treatment guidelines for paediatric sepsis has led to better organization and implementation of care; however, this has yet to translate into demonstrable improvement in outcome. We will examine the major therapeutic advances of recent years and put them into the context of paediatric sepsis, examining why they often have not translated into survival benefit.


CONCLUSIONS
This review aims to evaluate the recent therapeutic advances and potential for further developments in the management of paediatric sepsis in the ICU.
Rooney
Zoe
Z
Department of Paediatrics, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London, UK.
Nadel
Simon
S