paediatrics anaesthesia-icu infectious-disease

Phoenix Sepsis Score (Paediatric Sepsis Criteria)

International consensus criteria for sepsis and septic shock in children under 18 (SCCM Pediatric Sepsis Definition Task Force, 2024). Phoenix score = respiratory (0–3) + cardiovascular (0–6) + coagulation (0–2) + neurological (0–2). Sepsis = suspected infection with a score ≥ 2; septic shock = sepsis with ≥ 1 cardiovascular point. Replaces the 2005 IPSCC (SIRS-based) criteria.

Respiratory*

Worst value in the first 24 h. SpO₂:FiO₂ is valid only when SpO₂ ≤ 97%.

Vasoactive medications*

Any systemic dose of dobutamine, dopamine, epinephrine, milrinone, norepinephrine or vasopressin.

Lactate (arterial or venous)*

Mean arterial pressure for age*

Coagulation — platelets < 100 × 10⁹/L, INR > 1.3, D-dimer > 2 mg/L FEU, fibrinogen < 1.0 g/L*

Neurological*

Score interpretation

Phoenix Score < 2 — Sepsis Criteria Not Met 0–1

With suspected infection, a Phoenix score below 2 does not meet the sepsis criteria.

→ Treat the infection per local guidance; keep observing and re-score if the child deteriorates.

Phoenix Score ≥ 2 — Sepsis if Infection Is Suspected 2–13

Phoenix sepsis (in-hospital mortality 7.1% in higher-resource settings). Septic shock = sepsis with ≥ 1 cardiovascular point (any vasoactive, lactate ≥ 5 mmol/L or low MAP for age; mortality 10.8%).

→ Activate the paediatric sepsis pathway: antimicrobials within 1 hour, fluid resuscitation and vasoactive support per a paediatric sepsis guideline (doses from a children's formulary), source control and PICU referral.

Interpretation bands for the Phoenix Sepsis. Apply clinical judgement and local guidance.

References

Schlapbach LJ, Watson RS, Sorce LR, et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024;331(8):665–674.
Sanchez-Pinto LN, Bennett TD, DeWitt PE, et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024;331(8):675–686.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Phoenix Sepsis Score · Paediatric Sepsis

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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