Rss definition10/7/2023 Septic shock, defined as fluid-refractory sepsis with organ dysfunction encompasses various clinical and pathophysiological entities. The ESPNIC refractory septic shock definition accurately identifies, within the first 6 h of septic shock management, children with lethal outcome. ![]() ![]() The best interval of prognostication occurs after the 12th hour following treatment initiation (AUC 0.973 ). High prognostic accuracy of the bSSS was found in the first hours following intensive care admission. Diagnosis of RSS with bSSS and cSSS had a high discrimination for death with an area under the receiver operating curve of 0.916 and 0.925, respectively. Among patients diagnosed with RSS, the mortality was not significantly different according to vasopressors randomization. Death occurred in 30 RSS patients (85.7% mortality) and in 2 non-RSS patients (8% mortality), OR = 60.9, p < 0.001 with a median delay from sepsis onset of 3 days. In this septic shock cohort, RSS was diagnosed in 35 patients (58.3%) during the first 24 h. The prognostic value of the ESPNIC RSS definition was tested for 28-day all-cause mortality. Sequential bSSS and cSSS from 60 children (single-center study, 53% mortality) were analyzed. Post hoc analysis of a cohort issued from a double-blind randomized trial that compared first-line vasoactive drugs in children with septic shock. We aimed at assessing the accuracy of the RSS definition on a prospective cohort from India. Both bedside SSS (bSSS) and computed SSS (cSSS) were found to be strongly associated with mortality. The European Society of Pediatric and Neonatal Intensive Care (ESPNIC) developed and validated a definition of pediatric refractory septic shock (RSS), based on two septic shock scores (SSS).
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