SEPSIS IN CHILDREN: A GENERAL VIEW AT THE MAIN DIAGNOSTIC CRITERIA OF SEPSIS / SEPTIC SHOCK
This literature review presents current data on the clinical and laboratory diagnostics of sepsis and septic shock in children. Particular attention is paid to the early risk factors of sepsis in young children with high body temperature, based on clinical signs such as changes in skin color, motor activity (behavior), respiratory system, blood circulation, and hydration. There is presented the system of “Traffic light system for identifying risk of serious disease” developed by the National Institute for health and Care Excellence of the UK, which includes three levels of risk assessment: green - low risk, orange - moderate, red - high risk of sepsis. The change of normal indicators of vital functions of the body in children should alert the doctor in relation to the possible start of the septic process. With ineffective therapy and unfavorable course of sepsis, the multi-organ failure usually develops. This article provides clear criteria for organ dysfunction, taking into account their clinical and laboratory manifestations, reflects the main clinical criteria of “warm” and “cold” shock. The minimum amount of laboratory tests to be performed in case of suspected sepsis is indicated. In the presence of medical indications, the list of additional laboratory and instrumental measures in the progression of the disease is increased. On the base of the analysis of literature, it is concluded that sepsis should be considered as a situation, in which the time factor is extremely important, because the disease can very quickly progress to organ failure, shock and death. Thus, the rapid and early detection of this disease is mandatory. however, there is still much debate about how to identify these patients and what criteria are the most predictably important for the development of sepsis and septic shock in children.