Sepsis in children: A narrative review

Abstract

Sepsis, a systemic inflammatory response to infection, is a significant global child health concern with rising incidences and high mortality rates. The study describes how the main protective measure against sepsis is immunization, demonstrating its effectiveness against many pediatric infections. The disease's rapid progression necessitates swift recognition and initiation of treatment, primarily using antibiotics. However, the etiology of sepsis in children varies and is influenced by age, comorbidity, and geographical location, with an increasing prevalence of multi-drug-resistant organisms complicating antimicrobial selection. Risk factors like immunosuppressive treatments, malnutrition, alcoholism, and diseases compromising immune status increase susceptibility to sepsis. Moreover, the likelihood is further exacerbated by invasive procedures, hospital stay length, and underlying chronic diseases. Sepsis pathophysiology encompasses significant cardiovascular disturbances, from a localized infection to mild systemic infection, to septic shock. Elevated lactate in patients, traditionally believed to reflect tissue hypoxia, also appears to be driven by aerobic glycolysis triggered by increased adrenergic tone. Profound endothelial changes during sepsis, including leukocyte adhesion increase, shift to a procoagulant state, vasodilation, and barrier function loss, lead to widespread tissue edema. The article concludes by underscoring the urgency of thorough research to improve understanding and develop more effective interventions against sepsis.