When coding pediatric sepsis, we at FairCode adhere to published clinical criteria. Here we quote SIRS International Consensus Conference on Pediatric Sepsis.

Sepsis

SIRS in the presence of suspected or proven infection.

SIRS International Consensus Conference on Pediatric Sepsis (≥ 2 of the following):

  • Core temperature of >38.5°C or <36°C (101.3°F or < 96.8°F)
  • Tachycardia,
  • HR > 2 SD above normal for age
  • For children < 1 year of age, bradycardia HR <10th percentile for age
  • Respiratory Rate > 2 SD above normal for age or mechanical ventilation
  • WBC count elevated or depressed for age, or >10 percent Bands

Severe Sepsis: (Dysfunction of ≥ 2 organs)

Cardiovascular

  • Hypotension, or vasopressors
  • Or ≥ 2 of the following: metabolic acidosis, oliguria, prolonged capillary refill or elevated arterial lactate

Respiratory

  • PaO2/FiO2 <300
  • PaCO2 >65 torr or 20 mmHg over baseline PaCO2
  • Greater than 50% FiO2 to maintain SpO2 greater than or equal to 92%
  • Mechanical ventilation

Neurologic

  • Glasgow coma score ≤11
  • Acute change in mental status

Hematologic

  • Platelet count <80,000/microL or a decline of 50 percent
  • DIC

Renal

  • Serum creatinine ≥2 times upper limit of normal for age* or twofold increase in baseline creatinine
  • Infants 0.2-0.4 mg/dL
  • eGFR (ml/min/1.73m2) = [ht (cm) x k] / SCr (mg/dL)
  • k=0.55 unless adolescent male, then k = 0.7

Hepatic

  • Total bilirubin ≥4 mg/dL (except in newborns) or (ALT) >2 times upper limit of normal for age

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