{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:08:57Z","timestamp":1793149737302,"version":"4.5.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sepsis is the leading cause of mortality in children worldwide. There is a paucity of data on the criteria used to define sepsis and septic shock and predict mortality. Schlapbach et al. published Phoenix criteria to define sepsis in JAMA in 2024. Previously, paediatricians have used systemic inflammatory response syndrome (SIRS) criteria, but these criteria lack sensitivity and specificity. This group recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and\/or neurological systems. Though included in the 8-point criteria, important criteria like renal and liver are missing from the main criteria. We remain worried about the way these criteria got excluded from the main criteria. Therefore, in this brief report, whilst commending the authors for this stelar task, we highlight the main pitfalls in these criteria especially the renal, neurologic, and liver criteria. These criteria have been shown to be independently associated with outcomes, and we recommend that in the future iterations of the criteria, renal and liver criteria should be defined according to latest definitions and the task force consider utilizing latest criteria for each organ system involved within the formulated criteria.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>:\u00a0In conclusion, Phoenix criteria are a step in the right direction to define life-threatening organ dysfunction in sepsis, but clinicians need to be mindful that diagnosis\/treatment of less severe sepsis should not be delayed if these criteria are not met. Therefore, local early detection and management tools for sepsis should be followed.\n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td align=\"left\" colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 There has always been a quest for a definition for pediatric sepsis. There are limitations to the previous pediatric sepsis criteria which were published in 2005 by the International Pediatric Sepsis Consensus Conference (IPSCC). IPSCC defines sepsis as a suspected or confirmed infection in the presence of systemic inflammatory response syndrome (SIRS). These new Phoenix Pediatric Sepsis (PPS) criteria for sepsis and septic shock are intended to identify children with life-threatening organ dysfunction due to infection, and the score was developed based on a very large pediatric dataset.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td align=\"left\" colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 Though the intention of Phoenix criteria is to help identify children with life threatening organ dysfunction, unfortunately the crietria will miss signs of early sepis. In this manuscript, we point out some of the drawbacks of these criteria which need to be borne in mind while applying these criteria.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-024-05767-1","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T03:30:51Z","timestamp":1726025451000},"page":"5033-5035","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Phoenix criteria for sepsis: are these enough to guide a clinician?"],"prefix":"10.1007","volume":"183","author":[{"given":"Isadora","family":"Rodriguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Deep","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"issue":"8","key":"5767_CR1","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1001\/jama.0196","volume":"331","author":"LN Sanchez-Pinto","year":"2024","unstructured":"Sanchez-Pinto LN, Bennett TD, DeWitt PE et al (2024) (2024) Development and validation of the Phoenix criteria for pediatric sepsis and septic shock. JAMA 331(8):675\u2013686. https:\/\/doi.org\/10.1001\/jama.0196","journal-title":"JAMA"},{"issue":"8","key":"5767_CR2","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1001\/jama.2024.0179","volume":"331","author":"LJ Schlapbach","year":"2024","unstructured":"Schlapbach LJ, Watson RS, Sorce LR et al (2024) International consensus criteria for pediatric sepsis and septic shock. JAMA 331(8):665\u2013674. https:\/\/doi.org\/10.1001\/jama.2024.0179","journal-title":"JAMA"},{"key":"5767_CR3","doi-asserted-by":"publisher","unstructured":"Alcamo, Alicia M; Weiss, Scott L.; Fitzgerald, Julie C, Kirschen, Matthew P.; Loftis, Laura L. MD3; Tang, Swee Fong MD4; Thomas, Neal J. MD1,5; Nadkarni, Vinay M. MD1; Nett, Sholeen T. MD, PhD6; for the Sepsis Prevalence, Outcomes and Therapies (SPROUT) Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network.\u00a0outcomes associated with timing of neurologic dysfunction onset relative to pediatric sepsis recognition*. Pediatric Critical Care Medicine 23(8):p 593\u2013605, August 2022. | https:\/\/doi.org\/10.1097\/PCC.000000000000297","DOI":"10.1097\/PCC.000000000000297"},{"key":"5767_CR4","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.838746","volume":"13","author":"Y Chen","year":"2022","unstructured":"Chen Y, Hu Y, Li X, Chen P, Wang C, Wang J, Wu J, Sun Y, Zheng G, Lu Y, Guo Y (2022) Clinical features and factors associated with sepsis-associated encephalopathy in children: retrospective single-center clinical study. Front Neurol 13:838746. https:\/\/doi.org\/10.3389\/fneur.2022.838746","journal-title":"Front Neurol"},{"issue":"1","key":"5767_CR5","doi-asserted-by":"publisher","first-page":"10673","DOI":"10.1038\/s41598-022-14853-z","volume":"12","author":"BES de Ara\u00fajo","year":"2022","unstructured":"de Ara\u00fajo BES, da Silva Fontana R, de Magalh\u00e3es-Barbosa MC, Lima-Setta F, Paravidino VB, Riveiro PM, Pulcheri LB, Dos Santos Sal\u00fa M, Genu\u00edno-Oliveira MB, Robaina JR, da Cunha AJLA, Cruz FF, Rocco PRM, Bozza FA, de Castro-Faria-Neto HC, Prata-Barbosa A (2022) Clinical features, electroencephalogram, and biomarkers in pediatric sepsis-associated encephalopathy. Sci Rep 12(1):10673. https:\/\/doi.org\/10.1038\/s41598-022-14853-z","journal-title":"Sci Rep"},{"issue":"1","key":"5767_CR6","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s10020-023-00621-wZarbock","volume":"29","author":"JS Dumbuya","year":"2023","unstructured":"Dumbuya JS, Li S, Liang L, Zeng Q (2023) Paediatric sepsis-associated encephalopathy (SAE): a comprehensive review. Molecular medicine (Cambridge, Mas) 29(1):27. https:\/\/doi.org\/10.1186\/s10020-023-00621-wZarbock","journal-title":"Molecular medicine (Cambridge, Mas)"},{"key":"5767_CR7","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1038\/s41581-023-00683-3","volume":"19","author":"A Zarbock","year":"2023","unstructured":"Zarbock A, Nadim MK, Pickkers P et al (2023) Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup. 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