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Children
Special Issues
Diagnosis, Treatment and Outcomes of Pediatric Septic Shock
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Diagnosis, Treatment and Outcomes of Pediatric Septic Shock

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Emergency Medicine & Intensive Care Medicine".

Deadline for manuscript submissions: 1 December 2025 | Viewed by 425

Special Issue Editors

Dr. Marianna Miliaraki

E-Mail Website
Guest Editor
Pediatric Intensive Care, School of Medicine, University of Crete, Heraklion, Greece
Interests: pediatric sepsis; septic shock; hemodynamic monitoring; traumatic brain injury
Dr. Stavroula Ilia

E-Mail Website
Guest Editor
Pediatric Intensive Care, School of Medicine, University of Crete, Heraklion, Greece
Interests: mechanical ventilation in children
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pediatric septic shock remains a major cause of morbidity and mortality, and hemodynamic instability and multiple organ failure can rapidly complicate the clinical course of critically ill children, so alertness and prompt interventions on behalf of healthcare providers may prove to be life-saving. Hemodynamic monitoring and objective resuscitation goals are currently the guide for intensivists, since unstable hemodynamics and cardiovascular dysfunction seem to determine outcomes in sepsis.

The aim of this Special Issue is to gather and share recent knowledge on the diagnosis, management, and prognosis of pediatric septic shock.

Manuscripts addressing diagnostic and prognostic tools for sepsis, as well as treatment approaches for managing these challenging situations, are particularly welcome. We also welcome manuscripts of all types, including reviews or original articles, that focus on novel approaches to pediatric septic shock. Contributions from basic science research are also encouraged, since addressing genetic alterations in animal models or in human studies might lead us to specific genetic signatures, defining the clinical course and treatment responses of pediatric septic shock patients.

We eagerly anticipate receiving your submissions and sharing them with our scientific community.

Dr. Marianna Miliaraki
Dr. Stavroula Ilia
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pediatric
  • sepsis
  • septic shock
  • diagnosis
  • treatment
  • prognosis

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Published Papers (1 paper)

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Review

17 pages, 693 KB  
Review
Hyperferritinemia and Macrophage Activation Syndrome in Septic Shock: Recent Advances with a Pediatric Focus (2020–2025)
by Efrossini Briassouli, Natalia Syrimi and Stavroula Ilia
Children 2025, 12(9), 1193; https://doi.org/10.3390/children12091193 - 8 Sep 2025
Viewed by 158
Abstract
Macrophage activation syndrome (MAS), a hyperinflammatory condition driven by uncontrolled immune activation, is widely recognized as a critical complication in pediatric septic shock. This syndrome shares pathophysiological features with hemophagocytic lymphohistiocytosis (HLH) and other cytokine storm syndromes, and it contributes to significant morbidity [...] Read more.
Macrophage activation syndrome (MAS), a hyperinflammatory condition driven by uncontrolled immune activation, is widely recognized as a critical complication in pediatric septic shock. This syndrome shares pathophysiological features with hemophagocytic lymphohistiocytosis (HLH) and other cytokine storm syndromes, and it contributes to significant morbidity and mortality in pediatric and adult patients. Hyperferritinemia—a hallmark of MAS—is not only a diagnostic clue but also a prognostic marker for poor outcomes in sepsis. High ferritin levels are strongly suggestive of MAS, yet even moderate elevations in combination with the trend of ferritin levels can be indicative of heightened mortality risk. Distinguishing MAS from severe sepsis or other hyperinflammatory syndromes in children (such as multisystem inflammatory syndrome in children (MIS-C)) can be challenging, as clinical features often overlap. However, early recognition and timely immunomodulatory therapy, particularly corticosteroids and targeted biologic agents, can be life-saving. Recent advances emphasize a syndromic approach to diagnosing MAS within the spectrum of hyperferritinemic sepsis, using scoring tools or MAS-specific criteria adapted to sepsis or MIS-C contexts. Ongoing studies aim to refine biomarker-based stratification and therapeutic algorithms. This review synthesizes current knowledge on MAS as a complication of sepsis, including the diagnostic importance of ferritin levels, differential diagnosis with other cytokine storm syndromes, and the latest therapeutic approaches. It underscores the importance of early suspicion and intervention to reverse immune dysregulation and improve outcomes in critically ill pediatric patients. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Outcomes of Pediatric Septic Shock)
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