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Sepsis bei Kindern

Pediatric sepsis

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Zusammenfassung

Die Sepsis stellt die Pädiatrie weiterhin vor große Herausforderungen. Obwohl die Mortalität der Sepsis im Kindesalter deutlich niedriger als bei erwachsenen Patienten ist, verursacht sie einen signifikanten Anteil der Sterberate bei Kindern. Die zunehmende Intensivierung der Therapie in der Neonatologie und der pädiatrischen Intensivmedizin, der höhere Anteil von Patienten mit schweren chronischen Vorerkrankungen in der Kinderintensivmedizin und die mittlerweile beträchtliche Anzahl von Kindern mit angeborener, erworbener oder therapeutisch induzierter Inkompetenz des Immunsystems halten die Sepsisinzidenz auf hohem Niveau. Hinzu kommt die steigende Zahl von Sepsen, die durch hochresistente Erreger induziert werden. Der gerade bei Kindern häufig fulminante Verlauf erfordert das sehr rasche Erkennen des kritisch kranken Sepsispatienten und den Beginn der sofortigen effektiven Therapie, um die Morbidität und die Mortalität signifikant zu senken. Hier sind noch große Anstrengungen notwendig, um die Therapie dahingehend wesentlich zu verbessern.

Abstract

Sepsis in childhood is still a challenging diagnosis. Although the mortality of sepsis is much lower in children compared to adults, it remains one of the main causes of death in childhood. Increasing intensification of therapy in the field of neonatology and pediatric intensive care, the high proportion of patients with severe chronic pre-existing diseases in pediatric intensive care as well as the constantly growing number of children with inborn, acquired or therapy-induced incompetence of the immune system keeps the incidence of pediatric sepsis at a high level. In addition, there are an increasing number of cases of sepsis induced by highly resistant pathogens. One of the hallmarks of treatment success in pediatric sepsis is the early recognition of critically ill patients and the immediate initiation of effective treatment in order to significantly reduce the morbidity and mortality. To achieve these goals also in primary care settings, much effort is required in future years.

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Authors and Affiliations

  1. Abteilung pädiatrische Kardiologie und Intensivmedizin, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    M. Sasse &  K. Seidemann

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  1. M. Sasse
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  2. K. Seidemann
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Correspondence to M. Sasse.

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Interessenkonflikt

M. Sasse gibt an, von der Fa. Shire Vortragshonorare zu erhalten. K. Seidemann gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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G. Hansen, Hannover

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Sasse, M., Seidemann, K. Sepsis bei Kindern. Monatsschr Kinderheilkd 166, 41–47 (2018). https://doi.org/10.1007/s00112-017-0416-8

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