Differences in sepsis between children and adults: Literature analysis

Evelina Bučionytė1, Austėja Bernotaitė1, Viltė Fominskytė1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania 

Abstract: Despite medical progress, sepsis remains one of the leading causes of death in children. The main challenge for medical staff is early diagnosis and treatment of sepsis to avoid fatal outcomes. Children sepsis is different from adult sepsis, so it is important to know the differences in diagnostic, clinical, and treatment options to help provide the most effective care. Aim: To highlight the main differences between children and adult sepsis. Method: The review of literature was conducted using the “Medline” (PubMed) and, “UpToDate” medical databases, selecting publications investigating adult and children sepsis, their differences and similarities. Conclusions:  Childhood sepsis is diagnosed based on Systemic inflammatory response syndrome (SIRS) criteria, while adult sepsis is diagnosed using the qSOFA and SOFA scores. In adults, sepsis may include hypotension and lactic acidosis, and in children, these symptoms are rare. The clinical manifestation of septic shock is also different – adults mostly experience warm shock, whereas children are more likely to experience cold shock. Fluid therapy is better tolerated by children, therefore intensive infusion therapy (up to 60 ml / kg) is administered.  For adults it is important to titrate fluids according to central venous pressure (CVP).
Keywords: children sepsis, adult sepsis, systemic inflammatory response syndrome, severe sepsis, septic shock.