Prevention Is the Prescription for Reducing Pediatric Sepsis

As a pediatrician, I've seen the impact of pediatric sepsis firsthand — it's an aggressive and unrelenting adversary that knows neither geographic nor demographic bounds. Sepsis is also harder to identify in children than in adults, which makes it especially crucial to find early and treat aggressively. But what exactly is pediatric sepsis and what can we do to prevent, recognize and treat it?

Pediatric sepsis happens when an infection gets so severe that it leads to life-threatening problems. Importantly, that means virtually any infection — viral, bacterial or otherwise — can ultimately lead to sepsis if its progression isn’t stopped by a child’s own immune system or by appropriate treatment. Over 75,000 children with sepsis are admitted to hospitals in the U.S. every year with the global impact estimated at 25 million. While many of those children recover, sepsis takes the lives of more kids annually than cancer and the mortality rate for its most severe form (septic shock) can reach over 40%.

Step one in reducing the burden of pediatric sepsis is preventing it, and one of the best ways to prevent sepsis is by staying up-to-date on childhood vaccines. My generation of pediatricians has been spared treating countless patients with conditions like Haemophilus bacterial epiglottitis and meningococcal meningitis thanks to nearly universal childhood vaccination. But these bacteria still live in our environment, and children who are unvaccinated or too young to be able to receive a vaccine remain at risk of developing severe infection and ultimately sepsis.

Step two is to spot early-warning signs of sepsis as quickly as possible. Remember the signs of severe infection (like changes in temperature, heart rate, mental alertness and skin color) look different in children of different ages. I’ve seen premature infants with sepsis — including my own niece — whose only symptoms were dips in heart rate, breathing rate and oxygen saturation. Parents and caregivers should talk to their child's primary care provider about what to look out for at different ages.

Finally, remember that while not all children with infections require intensive treatment, they do need careful observation to ensure they are improving. Early diagnosis and appropriate treatment can go a long way toward preventing an infection from deteriorating into sepsis. When a child shows signs of an infection, parents and caregivers should seek early guidance from their medical professionals on management. And if things get worse, seek care quickly. Once sepsis sets in minutes matter — treatment may include rapid infusion of intravenous fluids, antimicrobials, medications for blood pressure support and more, and the earlier that treatment begins the better chance it has to work.

This pediatric sepsis awareness week hospitals across America will treat thousands of children with sepsis. While we stand ready 24/7/365 to serve our communities, I know that I speak for all of them when I say, the more we do together to prevent pediatric sepsis the better.

Chris DeRienzo, M.D., is AHA’s Senior Vice President and Chief Physician Executive. As part of his work to develop strategies and resources that improve health outcomes in support of the mission of the nation’s hospitals and health systems, he co-leads AHA’s Patient Safety Initiative, a collaborative, data-driven effort that gives hospitals and health systems a strong voice in the national conversation around health care safety, centering the views of clinicians, and telling the hospital and health system patient safety story.