Multiprofessional Critical Care Review: Pediatric (2023)-Pathophysiology of Pediatric Sepsis

Video Transcription

Video Summary

In this lecture, Dr. Scott Weiss discusses the pathophysiology of pediatric sepsis. Sepsis is a spectrum of pathophysiologic response to infection that involves increased inflammation, abnormal perfusion, and organ dysfunction. It is a syndrome that involves an underlying infection, and its diagnosis is based on nonspecific clinical and laboratory parameters. The immune system plays a crucial role in sepsis, with both the innate and adaptive immune responses being activated. Various cytokines and chemokines are released, leading to systemic inflammation. Coagulation abnormalities also occur in sepsis, with a procoagulant state leading to microvascular thrombosis and altered microcirculation. The endothelium becomes activated and dysfunctional, leading to increased vascular permeability and further loss of organ function. Macrovascular dysfunction, or shock, can present as either warm or cold shock, depending on the balance between cardiac output and systemic vascular resistance. Microcirculatory dysfunction can occur even in the presence of restored macrocirculation, leading to relative ischemia in certain tissues. Lastly, dysfunction of the mitochondria can lead to a decrease in aerobic ATP production and an increase in reactive oxygen species. The pathophysiology of sepsis is complex and involves multiple interconnected systems. Different phenotypes of sepsis, such as thrombocytopenia-associated multiple organ dysfunction syndrome (TAMOF) , immunoparalysis and hyperferritinemic sepsis, have distinct pathophysiological mechanisms and may require targeted therapies. Overall, understanding the pathophysiology of pediatric sepsis is crucial for early recognition and management of the condition.

Keywords

pediatric sepsis

pathophysiology

infection

inflammation

organ dysfunction

immune system

cytokines

chemokines

coagulation abnormalities

endothelium dysfunction

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.