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Novel Pediatric Sepsis Criteria and Clinical Decision Support Tools

新型儿科败血症标准和临床决策支持工具

基本信息

批准号：
10280004
负责人：
Tellen Bennett
金额：
$ 75.46万
依托单位：
UNIVERSITY OF COLORADO DENVER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2025-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10280004
关键词：
Accident and Emergency department Address Adult Advisory Committees Affect Bangladesh Caring Cessation of life Child Childhood China Clinical Clinical Data Colombia Critical Care Critically ill children Data Databases Development Diagnosis Disease Early Diagnosis Early identification Electronic Health Record Emergency Care Environment Functional disorder Health Priorities Heart Hospital Mortality Human body Immune response Income Infection Inpatients Institution Intensive Care Units International Kidney Life Lung Measurement Measures Medicine Modeling Organ Organ failure Patients Pediatric Hospitals Public Health Publishing Resources Role Science Sepsis Site Societies Specificity System Systemic Inflammatory Response Syndrome Techniques Update Work base clinical care clinical decision support computing resources data resource design effective therapy global health health care availability high risk improved improved outcome innovation inpatient service low and middle-income countries mobile application mortality mortality risk novel pediatric emergency prototype response risk stratification support tools systemic inflammatory response unnecessary treatment

项目摘要

PROJECT SUMMARY/ABSTRACT Pediatric sepsis is a major global public health problem associated with millions of deaths every year. However, the current criteria to diagnose pediatric sepsis are outdated, lack specificity, do not allow early detection and risk stratification in all settings, and are discordant with clinician-based diagnosis. In 2016, the adult Sepsis-3 task force redefined sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection,” emphasizing the pivotal role of organ dysfunction in the pathophysiology of sepsis. Importantly, they used a data-driven approach. The adult Sepsis-3 criteria, however, have been criticized for their limited applicability outside the intensive care unit and in resource-limited settings. The pediatric criteria are still based on the systemic inflammatory response syndrome and unvalidated organ dysfunction criteria. In 2019, the Society of Critical Care Medicine and other major global organizations sponsored the creation of the Pediatric Sepsis Definition Task Force to update the definition and operational criteria for pediatric sepsis. The overall objective of this proposal is to derive and validate novel pediatric sepsis criteria that generalize beyond the ICU and to differently resourced settings. The new criteria will be based on measures of organ dysfunction. However, it remains unknown which organ dysfunction measures are optimal for the new pediatric sepsis criteria. Furthermore, there is currently no pediatric emergency and inpatient database with the granularity and broad representation needed to derive and validate the new sepsis criteria. In this proposal, we will address these critical gaps to advance the science and clinical care of pediatric sepsis. We will extend our prior work and leverage the expertise of our international investigative team to build a large, centralized electronic health record database of pediatric emergency and inpatient care from institutions in both high-income countries and low- and middle-income countries. We will use these rich clinical data to accomplish the following aims: 1) determine the optimal clinical criteria for each pediatric organ dysfunction in differently resourced settings and care environments, 2) develop and validate novel pediatric sepsis criteria, and 3) design, build, and evaluate prototype CDS tools to facilitate use of the new pediatric sepsis criteria. We have assembled an investigative team with a successful track record in the field and will work in partnership with the Pediatric Sepsis Definition Task Force to address this global health priority. We expect the results of this proposal to have a powerful and sustained impact on the science of pediatric sepsis and organ dysfunction and ultimately improve sepsis recognition, accelerate appropriate effective treatment, decrease unnecessary treatment, and improve the outcomes of children with sepsis around the world.

项目总结/文摘