Criteria for Pediatric Sepsis

^aSite of the corresponding author and or location of research ethics approval using the World Bank Classification of 2019–2020.
^bSecondary analysis of a randomized controlled trial.
^cTwo settings were unspecified and one included all hospital locations. In addition, some studies included more than one specified study location resulting in a total of more than 81 study locations.

ACCM = American College of Critical Care Medicine, ACCP = American College of Chest Physicians, SCCM = Society of Critical Care Medicine.
^aValues for age groups from eligible articles were included in category that provided the closest approximation to the classification used in the article. Articles could have patients from more than one age group resulting in totals being > 100%.
^b1. Bone RC, et al: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992; 101:1644–1655. 2. Levy et al (22). 3. Carcillo JA, et al: Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med 2002; 30:1365–1378. 4. Goldstein et al (3). 5. Brierley J, et al: Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med 2009; 37:666–688. 6. Singer M, et al: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801–810.
^cThree papers referred to hospital guidelines and one defined sepsis as tachycardia plus hypothermia (35.0°C) or hyperthermia (38.5°C), or abnormal WBC count plus poor peripheral perfusion (mean arterial pressure 50 mm Hg and/or absent peripheral pulses or capillary refilling time 3 s) in the absence of clinical dehydration.
^dOne paper used Carrol ED, et al: The role of RANTES in meningococcal disease. J Infect Dis 2000; 182:363–366 and one referenced Abraham E, et al: Consensus conference definitions for sepsis, septic shock, acute lung injury, and acute respiratory distress syndrome: Time for a re-evaluation. Crit Care Med 2000; 28:232–235.

LOC = level of consciousness, PELOD = pediatric logistic organ dysfunction, PIM = Pediatric Index of Mortality, PRISM = Pediatric Risk of Mortality.
^aNumbers reported are totals for those with and without the listed outcome for each parameter for continuous variables. For categorical variables, the numbers shown are the number with the parameter over the total with or without the outcome of interest.
^bPooled estimate is for the odds ratio for categorical variables and the mean difference for continuous variables.
^cThe mean values of nonsurvivors versus survivors are provided for all continuous variables.
^dThe study by Thakkar et al (23) reported on two nonoverlapping cohorts of medical and surgical patients that were, therefore, analyzed separately and counted as two studies.

Authors and Disclosures

Kusum Menon, MD, MSc¹, Luregn J. Schlapbach, MD, FCICM, PhD², Samuel Akech, MBChB, MMED, DPhil³, Andrew Argent, MBBCh, MD(Paeds)⁴, Paolo Biban, MD⁵, Enitan D. Carrol, MBChB, MD⁶, Kathleen Chiotos, MD, MSCE⁷, Mohammod Jobayer Chisti, MBBS,, MMed, PhD⁸, Idris V. R. Evans, MD, MSc⁹, David P. Inwald, MB BChir, PhD¹⁰, Paul Ishimine, MD¹¹, Niranjan Kissoon, MD¹², Rakesh Lodha, MD¹³, Simon Nadel, MRCP¹⁴, Cláudio Flauzino Oliveira, MD¹⁵, Mark Peters, MBChB, PhD¹⁶, Benham Sadeghirad, PharmD, MPH,, PhD¹⁷, Halden F. Scott, MD, MSCS¹⁸, Daniela C. de Souza, MD¹⁹, Pierre Tissieres, MD, DSc²⁰, R. Scott Watson, MD, MPH²¹, Matthew O. Wiens, PharmD, PhD^22,23, James L. Wynn, MD²⁴, Jerry J. Zimmerman, MD, PhD²¹ and Lauren R. Sorce, RN, PhD²⁵ for the Pediatric Sepsis Definition Taskforce of the Society of Critical Care Medicine

1 Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
2 Pediatric and Neonatal ICU, University Children's Hospital Zurich, Zurich, Switzerland, and Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia.
3 KEMRI Wellcome Trust Research Program, Nairobi, Kenya.
4 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa.
5 Department of Paediatrics, Verona University Hospital, Verona, Italy.
6 Department of Clinical Infection Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Liverpool, United Kingdom.
7 Children's Hospital of Philadelphia, Philadelphia, PA.
8 International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
9 Department of Critical Care Medicine, University of Pittsburgh School of Medicine, and The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Pittsburgh, PA.
10 Paediatric Intensive Care Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
11 Departments of Emergency Medicine and Pediatrics, University of California San Diego School of Medicine, La Jolla, CA.
12 Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, BC, Canada.
13 All India Institute of Medical Sciences, Delhi, India.
14 St. Mary's Hospital, Imperial College Healthcare NHS Trust, and Imperial College London, London, United Kingdom.
15 Associação de Medicina Intensiva Brasileira, São Paulo, Brazil.
16 University College London Great Ormond Street Institute of Child Health, London, United Kingdom.
17 Departments of Anesthesia and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
18 Departments of Pediatrics and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
19 Departments of Pediatrics, Hospital Sírio-Libanês and Hospital Universitário da Universidade de São Paulo, São Paolo, Brazil.
20 Pediatric Intensive Care, AP-HP Paris Saclay University, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
21 Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.
22 University of British Columbia, Vancouver, BC, Canada.
23 Mbarara University of Science and Technology, Mbarara, Uganda.
24 Department of Pediatrics, University of Florida, Gainesville, FL.
25 Ann & Robert H. Lurie Children's Hospital and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Lurie Children's Pediatric Research & Evidence Synthesis Center (PRECIISE): A JBI Affiliated Group, Chicago, IL.

Address requests for reprints to
Kusum Menon, MD, MSc, Rm 3446, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada. E-mail: menon@cheo.on.ca

Dr. Menon has a Canadian Institutes of Health Research grant for the study of corticosteroids in pediatric septic shock. Dr. Menon's institution received funding from Crowdsourcing; he disclosed that he is a principal investigator on an international trial on Steroids in Pediatric Sepsis Shock. Drs. Menon and Watson received funding from Society of Critical Care Medicine. Dr. Argent received funding from the World Federation of Pediatric Intensive and Critical Care Societies as a part of the process of working with the Pediatric Sepsis Definitions working group. Dr. Biban received funding from Chiesi and Getinge. Dr. Nadel received funding from Abbvie. Dr. Sadeghirad received funding from the Pre-Interventional Preventative Risk Assessment AG, Mitacs Canada, and Accelerate internship in partnership with Nestlé Canada. Dr. Scott's institution received funding from the Agency for Healthcare Research and Quality (AHRQ K08HS025696); he received support for article research from the AHRQ. Dr. Tissieres received funding from Sedana, Inotrem, and Baxter. Dr. Wynn received funding from the National Institutes of Health (NIH) (R01GM128452; R01HD089939, R01HD097081, R43EB029863). Dr. Zimmerman's institution received funding from the NIH, the National Institute of Child Health and Human Development, and Immunexpress; he received funding from Elsevier Publishing. The remaining authors have disclosed that they do not have any potential conflicts of interest.