Upperman Jeffrey S, Sheridan Robert L
Division of Pediatric Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Pediatr Crit Care Med. 2005 May;6(3 Suppl):S108-11. doi: 10.1097/01.PCC.0000161578.11270.39.
The purpose of this review is to review how pediatric trauma may predispose children to sepsis.
The information discussed in this report is derived from a recent literature review of pediatric trauma and related topics and discussion at an international consensus conference on pediatric sepsis.
There is a paucity of evidence on sepsis-related complications in pediatric trauma patients. Severe traumatic brain injury is a leading predisposing factor for sepsis complications. Excluding burn trauma, traumatically injured children without severe head injury rarely succumb to overwhelming sepsis.
Patients with multiple traumatic injuries are frequently admitted to the intensive care unit, and because head injury is the most common ailment, unconscious patients with a combination of injuries that include head injury will regularly require mechanical ventilation and central venous access and are at risk for life-threatening nosocomial infections. Outside of pulmonary contusions, organ-specific causes of infection are infrequent.