The Cardiovascular
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Pediatric SIRS, Sepsis, and Septic Shock Criteria

Age-based paediatric SIRS and sepsis classification.

Pediatric SIRS, Sepsis, and Septic Shock Criteria
Age group
Sets the age-specific vital-sign and leukocyte thresholds.
Core temperature
°C
Heart rate
bpm
Respiratory rate
/min
Leukocyte count
x10^3/mm^3
Suspected or proven infection
Acute non-cardiovascular organ dysfunction
Respiratory, renal, neurological, haematological or hepatic dysfunction.
Cardiovascular dysfunction despite fluid bolus
Hypotension, need for vasoactive drug, or hypoperfusion after >=40 mL/kg isotonic fluid.
Complete the fields above to see the result.

When to use

  • Classifying a child along the SIRS -> sepsis -> severe sepsis -> septic shock continuum using age-adjusted vital signs.

Formula

SIRS = >=2 of: abnormal temperature (>38.5 or <36 C), age-abnormal heart rate, age-abnormal respiratory rate, or abnormal leukocyte count - with at least one being temperature or leukocyte count. Sepsis = SIRS + infection. Severe sepsis = sepsis + organ dysfunction. Septic shock = sepsis + cardiovascular dysfunction.

Pearls and pitfalls

  • For infants <1 year, bradycardia also counts as an abnormal heart-rate criterion.
  • The 2024 Phoenix criteria have since redefined paediatric sepsis around organ dysfunction rather than SIRS.

References

  1. Goldstein B, Giroir B, Randolph A. International pediatric sepsis consensus conference. Pediatr Crit Care Med. 2005;6(1):2-8.