Code sepsis: defining and translating optimal resuscitation and care for children with septic shock

Background: Sepsis is a systemic inflammatory response of the body to a suspected or proven infection. The most serious form of sepsis is called septic shock. The death rate for children with septic shock is unacceptably high (up to 70%). The American College of Critical Care Medicine (ACCM) has Guidelines explaining how to treat septic shock and these are used around the world. Some parts of the guidelines are not supported by high quality evidence but other parts are. Over the next 5 years, I will work towards two important goals to improve the care and outcomes for children with septic shock. Goal 1: Improve understanding of how best to use IV fluid to treat septic shock. Rationale: Fluid is important in the treatment of septic shock, but too much IV fluid is harmful for patients. Patients who don't get enough fluid do poorly too. Plan: We will do a study called a 'randomized controlled trial' where some patients are treated with a strategy that involves 'less fluid' and more medications to help the circulation (blood flow) and other patients will receive 'usual care' which typically involves a lot of fluid. We will assess patients in both groups to determine which strategy leads to the best outcomes. Goal 2: Improving the use of treatments that we know work well. Rationale: Guidelines tell us what is considered the best care for patients, but patients don't always get the best care. Plan: We plan to review the medical charts of a group of children who had septic shock to see how well the treatment they received matches the ACCM guidelines. The next steps will be to determine why some children may not have received the best care, and to develop solutions to fix this. Summary: My research over the next 5 years will inform the ACCM guidelines with new evidence, and help ensure that children with septic shock get the best treatment. Achieving these goals will help to improve survival and outcomes for children with septic shock.

PARKER, Melissa

McMaster University

Canadian Blood Services-CIHR Partnership New Investigator Program

Ontario

$300,000