James L Wynn1, Hector R Wong, Thomas P Shanley, Matthew J Bizzarro, Lisa Saiman, Richard A Polin. 1. 1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Vanderbilt University, Nashville, TN. 2Division of Pediatric Critical Care Medicine, Cincinnati Children's Medical Center, Cincinnati, OH. 3Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 4Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI. 5Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Yale University School of Medicine, New Haven, CT. 6Division of Infectious Diseases, Department of Pediatrics, Columbia University Medical Center, New York, NY. 7Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Columbia University Medical Center, New York, NY.
Abstract
OBJECTIVE: To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. STUDY SELECTION: The review focused primarily on pediatric literature relevant to the topic of interest. CONCLUSIONS: Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.
OBJECTIVE: To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. STUDY SELECTION: The review focused primarily on pediatric literature relevant to the topic of interest. CONCLUSIONS:Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.
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