Pediatric Sepsis Definition-A Systematic Review Protocol by the Pediatric Sepsis Definition Taskforce.
Pediatric Sepsis Definition-A Systematic Review Protocol by the Pediatric Sepsis Definition Taskforce.
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DOI：
10.1097/cce.0000000000000123
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发表时间：
2020-06-01
影响因子：
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通讯作者：
Sorce, Lauren R
中科院分区：
文献类型：
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作者：
Menon, Kusum;Schlapbach, Luregn J;Sorce, Lauren R
目的：脓毒症是全球儿童发病率和死亡率的主要原因。然而，有证据表明，在临床实践、编码和研究中，“败血症”一词的使用存在重大不准确之处。目前和以前的脓毒症定义是根据专家共识制定的，但用于识别脓毒症儿童的具体标准尚未得到严格评估。因此，作为重症医学学会儿童脓毒症定义工作组的一部分，我们将进行系统综述，以综合有关个体因素、临床标准或疾病严重程度评分的证据，这些证据可能用于识别患有感染的儿童，这些儿童患有或处于脓毒症相关器官功能障碍的高风险，并将这些因素、标准分开。这些评分可以用来识别患有败血症的儿童，这些儿童进展到多器官功能障碍或死亡的风险很高。资料来源：我们将通过搜索以下数据库来确定符合条件的研究：MEDLINE、Embase和Cochrane中央对照试验注册库。研究选择：我们将纳入2004年1月1日至2020年3月16日期间发表的所有随机试验和队列研究。数据提取：数据提取将包括与研究特征、人群特征、临床标准和结果相关的信息。数据综合：我们将计算预测败血症的每个标准的敏感性和特异性，并在数据允许的情况下进行荟萃分析。我们还将提供总体医院死亡率的汇总估计。结论：本综述中确定感染患者发生败血症相关器官功能障碍和/或进展为多器官功能障碍或死亡的高风险的潜在危险因素、临床标准和疾病严重程度评分将用于儿科败血症定义工作组的下一步工作。
OBJECTIVES: Sepsis is responsible for a substantial proportion of global childhood morbidity and mortality. However, evidence demonstrates major inaccuracies in the use of the term "sepsis" in clinical practice, coding, and research. Current and previous definitions of sepsis have been developed using expert consensus but the specific criteria used to identify children with sepsis have not been rigorously evaluated. Therefore, as part of the Society of Critical Care Medicine's Pediatric Sepsis Definition Taskforce, we will conduct a systematic review to synthesize evidence on individual factors, clinical criteria, or illness severity scores that may be used to identify children with infection who have or are at high risk of developing sepsis-associated organ dysfunction and separately those factors, criteria, and scores that may be used to identify children with sepsis who are at high risk of progressing to multiple organ dysfunction or death.DATA SOURCES: We will identify eligible studies by searching the following databases: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials.STUDY SELECTION: We will include all randomized trials and cohort studies published between January 1, 2004, and March 16, 2020.DATA EXTRACTION: Data extraction will include information related to study characteristics, population characteristics, clinical criteria, and outcomes.DATA SYNTHESIS: We will calculate sensitivity and specificity of each criterion for predicting sepsis and conduct a meta-analysis if the data allow. We will also provide pooled estimates of overall hospital mortality.CONCLUSIONS: The potential risk factors, clinical criteria, and illness severity scores from this review which identify patients with infection who are at high risk of developing sepsis-associated organ dysfunction and/or progressing to multiple organ dysfunction or death will be used to inform the next steps of the Pediatric Sepsis Definition Taskforce.