perinatologyРоссийский вестник перинатологии и педиатрииRossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)1027-40652500-2228Ltd. “The National Academy of Pediatric Science and Innovation”10.21508/1027-4065-2020-65-3-131-137perinatology-1161Research ArticleДИСКУССИЯDISCUSSINСепсис в педиатрической практике – пора договариватьсяPediatric sepsis – time to reach agreementhttps://orcid.org/0000-0003-0798-1625ЛекмановА. У.LekmanovA. U.

Лекманов Андрей Устинович д.м.н., проф., гл. науч. сотр. отдела хирургии детского возраста

450008 Уфа, ул. Ленина, д. 3

aulek@rambler.ruhttps://orcid.org/0000-0002-9016-9461МироновП. И.MironovP. I.

Миронов Петр Иванович – д.м.н., проф. кафедры детской хирургии

450008 Уфа, ул. Ленина, д. 3

Научно-исследовательский институт клинической хирургии ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России; ГБУЗ города Москвы «Детская городская клиническая больница №9 им. Г.Н. Сперанского» ДЗМРоссияPirogov Russian National Research Medical University; Speranskiy Children’s City Clinical Hospital No.9Russian FederationФГБОУ ВО «Башкирский государственный медицинский университет» Минздрава РоссииРоссияBashkir State Medical UniversityRussian Federation202008072020653131137Copyright © Ltd. “The National Academy of Pediatric Science and Innovation”, 20202020Ltd. “The National Academy of Pediatric Science and Innovation”Ltd. “The National Academy of Pediatric Science and Innovation”https://www.ped-perinatology.ru/jour/about/submissions#copyrightNoticehttps://www.ped-perinatology.ru/jour/article/view/1161

Цель: представить эволюцию и современную концепцию сепсиса у детей.

По данным многих авторов, сепсис у детей считается основной причиной смерти от инфекционных заболеваний, причем смертность связана с задержкой диагностики и несоблюдением руководящих принципов терапии. В статье обсуждается эволюция взглядов на сепсис в течение последних 30 лет. Проанализированы изменения дефиниций сепсиса у взрослых от концепций Сепсис-1 к Сепсис-3. В настоящее время сепсис правильнее рассматривать не как прогрессирующее системное воспаление, а как угрожающую жизни органную дисфункцию вследствие дисрегуляции ответа организма на инфекцию. Так как в основе сепсиса лежит единый патобиологический процесс, определения сепсиса должны быть применимы одинаково к взрослым и детям. Однако терминология и интенсивная терапия педиатрического сепсиса находится вне рекомендаций Сепсис-3. В последние 3 года проведены исследования по использованию различных педиатрических шкал для верификации сепсиса и внедрения в педиатрию идеологии Сепсис-3. В настоящее время крайне важен консенсусный и мультидисциплинарный подход педиатров и врачей интенсивной терапии для достижения реальных успехов в ранней диагностике и снижении летальности при сепсисе у детей.

Objective: to present the evolution and modern concept of pediatric sepsis.

According to many authors, pediatric sepsis is considered to be the main cause of death from infectious diseases; and the mortality is associated with a late diagnosis and non-compliance with treatment guidelines. The article discusses the evolution of views on sepsis over the past 30 years. It analyzes the changes of sepsis concepts in adults from Sepsis-1 to Sepsis-3. Currently, sepsis is considered as a life-threatening organ dysfunction due to dysregulation of the body’s response to infection rather than a progressive systemic inflammation. Since sepsis is based on a pathobiological process, its definitions should be applied both to adults and children. However, the terminology and intensive care of pediatric sepsis is beyond the recommendations of Sepsis-3. Over the last 3 years the scientists have studied various pediatric scales to verify sepsis and introduce the Sepsis-3 ideology into pediatrics. Currently, the consensus and multidisciplinary approach of pediatricians and intensive care physicians is extremely important to achieve real success in early diagnosis and reduce mortality in children with sepsis.

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The authors declare that there are no conflicts of interest present.