Early Recognition and Management of Pediatric Septic Shock: Phoenix Criteria Implementation and Clinical Outcomes
Keywords:
pediatric sepsis; septic shock; Phoenix Sepsis Score; lactate clearance; early resuscitationAbstract
Objective: To evaluate the clinical outcomes of pediatric septic shock management using the newly published 2024 Phoenix Sepsis Criteria and assess lactate clearance as a prognostic marker. Methods: A prospective observational study of 56 children (median age 4.2 years) admitted with sepsis to the Fergana Regional Multidisciplinary Children's Hospital between June 2024 and May 2025. Sepsis was diagnosed using Phoenix Sepsis Score criteria with septic shock defined by cardiovascular dysfunction. Results: Fifty-six patients were enrolled; 48 survived and 8 died (mortality rate 14.3%). Median admission lactate was significantly higher in non-survivors (5.1 mmol/L vs. 3.2 mmol/L, p=0.0001). Lactate clearance at 24 hours >50% was associated with survival; 87.5% of survivors achieved this threshold versus 12.5% of non-survivors. Adherence to fluid resuscitation bundles within the first hour improved outcomes. Conclusion: Early application of Phoenix criteria with serial lactate monitoring enables timely intervention and significantly improves pediatric septic shock survival. Integration of lactate-guided resuscitation into critical care protocols is essential.
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