This Pediatric Systemic Inflammatory Response Syndrome (SIRS) calculator helps the diagnosis of pediatric SIRS and sepsis if infectious cause is present. There is more information on pediatric presentation and how to interpret the diagnosis criteria below the form.
How does this Pediatric Systemic Inflammatory Response Syndrome (SIRS) calculator work?
This health tool provides orientation in the diagnosis of SIRS and if necessary sepsis in pediatric patients. Criteria are similar to that in the case of adult patients; however, there are particularities of age and of result interpretation that arise.
These criteria have been in place for sepsis diagnosis until 2016, now are only used to help clinician establish SIRS because it tends to be highly sensitive.
The criteria used in the Pediatric Systemic Inflammatory Response Syndrome (SIRS) calculator are the following:
■ Temperature less than 36°C (96.8°F) or greater than 38.5°C (101.3°F). Obtained either orally, rectally or from catheter probe.
■ Heart rate above normal for average in the absence of drug, pain stimuli or congenital heart disease. This indicates that the patient might be hemodynamically compromised.
■ Unexplained persistent depression for more than 30 minutes.
■ Respiratory rate above normal for age due to inadequate perfusion or metabolic stress.
■ Need for mechanical ventilation – independent of neuromuscular disease or anesthetic use.
■ White blood cell count elevated or depressed, unrelated to chemotherapy and marking acute phase reaction.
■ Greater than 10% bands plus other immature forms in WBC.
Positive criteria for pediatric SIRS must include abnormal temperature and at least one other of the above presentations.
Left untreated SIRS leads to sepsis and other complications, such as organ dysfunction and organ failure, in the case of both infectious and non infectious causes.
SIRS criteria are non specific and can only provide quick insight on the situation, therefore require clinical interpretation and further investigation.
Pediatric SIRS guidelines
SIRS is defined as the immune response to inflammation of infectious and non infectious cause. Early recognition of SIRS is crucial in ensuring good outcomes. Late stage SIRS include multiple organ dysfunction syndrome, peripheral vasodilatation and circulatory collapse.
Pediatric presentation includes fever as most common symptom, rapid heart beat, labored breathing, cool extremities and reasons to believe the infant or child has been exposed to infectious illnesses or recent immunization.
Diagnosis most commonly relies on blood count, electrolyte parameters, renal and liver function tests, urinalysis, inflammatory markers and acute phase reactants.
The patient’s immune system is the most relevant in determining outcome and reaction to treatment with mortality rates from pediatric sepsis ranging from 9% to 35%.
References
1) Scott HF, Donoghue AJ, Gaieski DF, Marchese RF, Mistry RD. (2012) The utility of early lactate testing in undifferentiated pediatric systemic inflammatory response syndrome. Acad Emerg Med; 19(11):1276-80.
2) Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis. (2005) International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med; 6(1):2-8.
3) Scott HF, Deakyne SJ, Woods JM, Bajaj L. (2015) The prevalence and diagnostic utility of systemic inflammatory response syndrome vital signs in a pediatric emergency department. Acad Emerg Med; 22(4):381-9.
4) Jeffery AD, Mutsch KS, Knapp L. (2014) Knowledge and recognition of SIRS and sepsis among pediatric nurses. Pediatr Nurs; 40(6):271-8.
10 May, 2016