Published in January 2024, the International Consensus Criteria for Pediatric Sepsis and Septic Shock uses the Phoenix  score to identify pediatric patients <18 years at risk of life threatening organ dysfunction and define sepsis (Suspected infection and Phoenix Sepsis Score ≥2points)  and septic shock (Sepsis with ≥1 cardiovascular point(s).

Previously, spectrum Defined by the International Consensus Conference on Pediatric Sepsis and Organ Dysfunction:

Latest definitions for adult sepsis (JAMA 2016, Sepsis-3):


Clinical Presentation


Vasoactive Inotropic Score


Late death in Pediatric Sepsis, from Czaja et al, Pediatrics 2009


1) J.A. Lorente, J.C. Marshall: Neutralization of tumor necrosis factor in preclinical models of sepsis. Shock. 1 (Suppl 24):107-119 2005

2) P.Y. Bochud, M. Bonten, O. Marchetti, T. Calandra: Antimicrobial therapy for patients with severe sepsis and septic shock: an evidence-based review. Crit Care Med. 32 (Suppl 11):S495-512 2004

3) ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, Barnato AE, WeissfeldLA, Pike F, Terndrup T, Wang HE, Hou PC, LoVecchio F, Filbin MR, Shapiro NI, Angus DC. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014 May 1;370(18):1683-93. doi: 10.1056/NEJMoa1401602. Epub 2014 Mar 18.

4) ARISE Investigators; ANZICS Clinical Trials Group, Peake SL, Delaney A, Bailey M, Bellomo R, Cameron PA, Cooper DJ, Higgins AM, Holdgate A, Howe BD, Webb SA, Williams P. Goal-directed resuscitation for patients with early septic shock. N Engl J Med. 2014 Oct 16;371(16):1496-506.

5) Holst LB, Haase N, Wetterslev J, Wernerman J, Guttormsen AB, Karlsson S,Johansson PI, Aneman A, Vang ML, Winding R, Nebrich L, Nibro HL, Rasmussen BS, Lauridsen JR, Nielsen JS, Oldner A, Pettilä V, Cronhjort MB, Andersen LH, Pedersen UG, Reiter N, Wiis J, White JO, Russell L, Thornberg KJ, Hjortrup PB, Müller RG, Møller MH, Steensen M, Tjäder I, Kilsand K, Odeberg-Wernerman S, Sjøbø B, Bundgaard H, Thyø MA, Lodahl D, Mærkedahl R, Albeck C, Illum D, Kruse M, Winkel P, Perner A; TRISS Trial Group; Scandinavian Critical Care Trials Group. Lower versus higher hemoglobin threshold for transfusion in septic shock. N Engl J Med. 2014 Oct 9;371(15):1381-91.

6) Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb;41(2):580-637.

7) R.S. Watson, J.A. Carcillo: Scope and epidemiology of pediatric sepsis. Pediatr Crit Care Med. 6 (Suppl 3):S3-52005

8) R.S. Hotchkiss, I.E. Karl: The pathophysiology and treatment of sepsis. N Engl J Med. 348 (2):138-150 200312519925

9) R.S. Hotchkiss, C.M. Coopersmith, J.E. McDunn, T.A.Ferguson: The sepsis seesaw: tilting toward immunosuppression. Nat Med. 15 (5):496-497 2009 19424209

10) S. Nadel, B. Goldstein, M.D. Williams, et al.:Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial.Lancet. 369 (9564):836-843 2007

11) J.A. Carcillo, A.L. Davis, A. Zaritsky: Role of early fluid resuscitation in pediatric septic shock. Jama. 266(9):1242-1245 1991

12) H.R. Wong, N. Cvijanovich, G.L. Allen, et al.: Genomic expression profiling across the pediatric systemic inflammatory response syndrome, sepsis, and septic shock spectrum. Crit Care Med. 37 (5):1558-1566 2009

13) E. Rivers, B. Nguyen, S. Havstad: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 345 (19):1368-1377 2001

14) D. Vlasselaers, I. Milants, L. Desmet, et al.: Intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study. Lancet. 373(9663):547-556 2009 19176240

15) C.L. Sprung, D. Annane, D. Keh, et al.: Hydrocortisone therapy for patients with septic shock. N Engl J Med. 358(2):111-124 2008

16) Sterling SA, Miller WR, Pryor J, Puskarich MA, Jones AE. The Impact of Timing of Antibiotics on Outcomes in Severe Sepsis and Septic Shock: A Systematic Review and Meta-Analysis. Crit Care Med. 2015 Sep;43(9):1907-15.

17) Ventura AM, Shieh HH, Bousso A, Góes PF, Fernandes Ide C, de Souza DC, PauloRL, Chagas F, Gilio AE. Double-Blind Prospective Randomized Controlled Trial ofDopamine Versus Epinephrine as First-Line Vasoactive Drugs in Pediatric SepticShock. Crit Care Med. 2015 Nov;43(11):2292-302.

18) Singer M, Deutschman CS, Seymour C, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287.