TY - JOUR
T1 - Latin American Consensus on the Management of Sepsis in Children
T2 - Sociedad Latinoamericana de Cuidados Intensivos Pediátricos [Latin American Pediatric Intensive Care Society] (SLACIP) Task Force: Executive Summary
AU - Fernández-Sarmiento, Jaime
AU - De Souza, Daniela Carla
AU - Martinez, Anacaona
AU - Nieto, Victor
AU - López-Herce, Jesús
AU - Soares Lanziotti, Vanessa
AU - Arias López, María del Pilar
AU - De Carvalho, Werther Brunow
AU - Oliveira, Claudio F.
AU - Jaramillo-Bustamante, Juan Camilo
AU - Díaz, Franco
AU - Yock-Corrales, Adriana
AU - Ruvinsky, Silvina
AU - Munaico, Manuel
AU - Pavlicich, Viviana
AU - Iramain, Ricardo
AU - Márquez, Marta Patricia
AU - González, Gustavo
AU - Yunge, Mauricio
AU - Tonial, Cristian
AU - Cruces, Pablo
AU - Palacio, Gladys
AU - Grela, Carolina
AU - Slöcker-Barrio, Maria
AU - Campos-Miño, Santiago
AU - González-Dambrauskas, Sebastian
AU - Sánchez-Pinto, Nelson L.
AU - Celiny García, Pedro
AU - Jabornisky, Roberto
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2022/6
Y1 - 2022/6
N2 - Objective: The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. Design: A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working in Latin American countries. The experts were organized into 10 nominal groups, each coordinated by a member. Methods: A formal consensus was formed based on the modified Delphi method, combining the opinions of nominal groups of experts with the interpretation of available scientific evidence, in a systematic process of consolidating a body of recommendations. The systematic search was performed by a specialized librarian and included specific algorithms for the Cochrane Specialized Register, PubMed, Lilacs, and Scopus, as well as for OpenGrey databases for grey literature. The GRADEpro GDT guide was used to classify each of the selected articles. Special emphasis was placed on search engines that included original research conducted in LMICs. Studies in English, Spanish, and Portuguese were covered. Through virtual meetings held between February 2020 and February 2021, the entire group of experts reviewed the recommendations and suggestions. Result: At the end of the 12 months of work, the consensus provided 62 recommendations for the diagnosis and treatment of pediatric sepsis in LMICs. Overall, 60 were strong recommendations, although 56 of these had a low level of evidence. Conclusions: These are the first consensus recommendations for the diagnosis and management of pediatric sepsis focused on LMICs, more specifically in Latin American countries. The consensus shows that, in these regions, where the burden of pediatric sepsis is greater than in high-income countries, there is little high-level evidence. Despite the limitations, this consensus is an important step forward for the diagnosis and treatment of pediatric sepsis in Latin America.
AB - Objective: The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. Design: A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working in Latin American countries. The experts were organized into 10 nominal groups, each coordinated by a member. Methods: A formal consensus was formed based on the modified Delphi method, combining the opinions of nominal groups of experts with the interpretation of available scientific evidence, in a systematic process of consolidating a body of recommendations. The systematic search was performed by a specialized librarian and included specific algorithms for the Cochrane Specialized Register, PubMed, Lilacs, and Scopus, as well as for OpenGrey databases for grey literature. The GRADEpro GDT guide was used to classify each of the selected articles. Special emphasis was placed on search engines that included original research conducted in LMICs. Studies in English, Spanish, and Portuguese were covered. Through virtual meetings held between February 2020 and February 2021, the entire group of experts reviewed the recommendations and suggestions. Result: At the end of the 12 months of work, the consensus provided 62 recommendations for the diagnosis and treatment of pediatric sepsis in LMICs. Overall, 60 were strong recommendations, although 56 of these had a low level of evidence. Conclusions: These are the first consensus recommendations for the diagnosis and management of pediatric sepsis focused on LMICs, more specifically in Latin American countries. The consensus shows that, in these regions, where the burden of pediatric sepsis is greater than in high-income countries, there is little high-level evidence. Despite the limitations, this consensus is an important step forward for the diagnosis and treatment of pediatric sepsis in Latin America.
KW - bolus
KW - bundle
KW - children
KW - consensus
KW - fluid therapy
KW - pediatrics
KW - sepsis
KW - septic shock
KW - vasopressor agents
UR - http://www.scopus.com/inward/record.url?scp=85120458837&partnerID=8YFLogxK
U2 - 10.1177/08850666211054444
DO - 10.1177/08850666211054444
M3 - Article
C2 - 34812664
AN - SCOPUS:85120458837
SN - 0885-0666
VL - 37
SP - 753
EP - 763
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 6
ER -