MANAGEMEN SEPSIS PEDIATRIK BERDASARKAN PHOENIX CRITERIA 2024 : NARRATIVE LITERATURE REVIEW/PEDIATRIC SEPSIS MANAGEMENT BASED ON THE 2024 PHOENIX CRITERIA: A NARRATIVE LITERATURE REVIEW

Abstrak

Latar Belakang: Sepsis pediatrik tetap menjadi penyebab utama mortalitas anak di seluruh dunia. Pengenalan kriteria baru Phoenix Sepsis Criteria 2024 menggantikan kriteria Systemic Inflammatory Response Syndrome (SIRS) yang telah lama digunakan, menandai perubahan besar menuju pendekatan disfungsi organ yang berbasis data empiris multinasional. Tujuan penulisan ini untuk mengulas secara komprehensif konsep deteksi dini, diagnosis, serta manajemen akut dan kritis sepsis anak menggunakan kriteria Phoenix dan pedoman Surviving Sepsis Campaign (SSC) 2026. Metode: yang digunakan adalah tinjauan literatur naratif dengan pencarian sistematis menggunakan kerangka PICO dan seleksi PRISMA terhadap lima jurnal internasional mutakhir. Hasil Menunjukkan bahwa kriteria Phoenix memiliki spesifisitas dan akurasi prognostik yang jauh lebih tinggi dibandingkan SIRS dalam memprediksi mortalitas anak, sehingga secara signifikan mengurangi risiko alarm fatigue. Manajemen awal menitikberatkan pada program peningkatan mutu, pengukuran laktat, kultur darah tanpa menunda antibiotik empiris (target <1 jam untuk syok septik), resusitasi cairan kristaloid terukur (10–20 mL/kg per bolus) dengan evaluasi ketat terhadap fluid overload, serta inisiasi dini agen vasoaktif (epinefrin atau norepinefrin). Perawat di ruang akut-kritis memegang peran krusial sebagai garda terdepan dalam pengenalan dini berbasis skor Phoenix, pelaksanaan bundel perawatan, dan monitoring respons klinis dinamis.

Background: Pediatric sepsis remains a leading cause of childhood mortality worldwide. The introduction of the new Phoenix Sepsis Criteria 2024 replaces the long-standing Systemic Inflammatory Response Syndrome (SIRS) criteria, marking a major shift toward an organ dysfunction approach backed by multinational empirical data. This study aims to comprehensively review the concepts of early detection, diagnosis, and acute-critical management of pediatric sepsis using the Phoenix criteria and the updated Surviving Sepsis Campaign (SSC) 2026 guidelines. method A narrative literature review was employed with a systematic search strategy guided by the PICO framework and PRISMA selection on five recent high-impact international journals. The review demonstrates that the Phoenix criteria offer significantly higher specificity and prognostic accuracy for predicting mortality compared to SIRS, substantially reducing alarm fatigue. Initial management emphasizes performance improvement programs, lactate measurement, blood cultures without delaying empirical antibiotics (<1 hour target for septic shock), targeted crystalloid fluid resuscitation (10–20 mL/kg per bolus) with vigilant evaluation for fluid overload, and early initiation of vasoactive agents (epinephrine or norepinephrine). Critical care nurses play a pivotal role as the frontline in early recognition using the Phoenix score, implementing care bundles, and continuously monitoring dynamic clinical responses.