Epidemiology of Sepsis and Multiple Organ Dysfunction Syndrome in Children

Proulx, François; Fayon, Michaël; Farrell, Catherine; Lacroix, Jacques; Gauthier, Marie

doi:10.1378/chest.109.4.1033

Cited by 342 publications

(288 citation statements)

References 14 publications

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“…Severity of illness was calculated using the PRISM III score (27). Organ failure was defined according to previously published criteria (28)(29)(30), and for the purposes of this study, AKI was defined as a blood urea nitrogen (BUN) concentration > 100 mg/dL, serum creatinine > 2 mg/dL in the absence of pre-existing renal disease, or the need for dialysis (28)(29)(30). Annotated clinical and laboratory data were collected daily while in the PICU.…”

Section: Patientsmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Wheeler

Devarajan²,

Ma³

et al. 2008

Critical Care Medicine

304

182

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Objective-To validate serum neutrophil gelatinase-associated lipocalin (NGAL) as an early biomarker for acute kidney injury (AKI) in critically ill children with septic shock.Design-Observational cohort study. Setting-15 North American pediatric intensive care units (PICU).Patients-A total of 143 critically ill children with SIRS or septic shock and 25 healthy controls. Interventions-None.Measurements and Main Results-Serum NGAL was measured during the first 24 hours of admission to the PICU. AKI was defined as a blood urea nitrogen (BUN) concentration > 100 mg/ dL, serum creatinine > 2 mg/dL in the absence of pre-existing renal disease, or the need for dialysis. There was a significant difference in serum NGAL between healthy children (median 80 ng/mL, IQR 55.5-85.5 ng/mL), critically ill children with SIRS (median 107.5 ng/mL, IQR 89-178.5 ng/mL), and critically ill children with septic shock (median 302 ng/mL, IQR 151-570 ng/mL; p<0.001). AKI developed in 22 out of 143 (15.4%) critically ill children. Serum NGAL was significantly increased in critically ill children with AKI (median 355 ng/mL, IQR 166-1322 ng/mL) compared to those without AKI (median 186 ng/mL, IQR 98-365 ng/mL; p=0.009).Conclusions-Serum NGAL is a highly sensitive, but nonspecific predictor of AKI in critically ill children with septic shock. Further validation of serum NGAL as a biomarker of AKI in this population is warranted.

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Section: Patientsmentioning

confidence: 99%

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Wheeler

Devarajan²,

Ma³

et al. 2008

Critical Care Medicine

304

182

View full text Add to dashboard Cite

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“…An additional sample was obtained for RNA isolation 48 hours after obtaining the day one sample ("day three" of septic shock). Severity of illness at study entry was calculated using the PRISM III score (14), and organ failure was defined using pediatric-specific criteria (13,15,16). Clinical and laboratory data were collected daily while in the PICU.…”

Section: Sample and Data Collectionmentioning

confidence: 99%

Genome-Level Longitudinal Expression of Signaling Pathways and Gene Networks in Pediatric Septic Shock

Shanley

Cvijanovich²,

Lin

et al. 2007

Mol Med

112

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We have conducted longitudinal studies focused on the expression profiles of signaling pathways and gene networks in children with septic shock. Genome-level expression profiles were generated from whole blood-derived RNA of children with septic shock (n = 30) corresponding to day one and day three of septic shock, respectively. Based on sequential statistical and expression filters, day one and day three of septic shock were characterized by differential regulation of 2,142 and 2,504 gene probes, respectively, relative to controls (n = 15). Venn analysis demonstrated 239 unique genes in the day one dataset, 598 unique genes in the day three dataset, and 1,906 genes common to both datasets. Functional analyses demonstrated timedependent, differential regulation of genes involved in multiple signaling pathways and gene networks primarily related to immunity and inflammation. Notably, multiple and distinct gene networks involving T cell-and MHC antigen-related biology were persistently downregulated on both day one and day three. Further analyses demonstrated large scale, persistent downregulation of genes corresponding to functional annotations related to zinc homeostasis. These data represent the largest reported cohort of patients with septic shock subjected to longitudinal genome-level expression profiling. The data further advance our genome-level understanding of pediatric septic shock and support novel hypotheses.

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“…6 Primary multiple-organ dysfunction syndrome (pres ent at admission or occurring within the first week after admission to the ICU) accounts for 88% of children with the syndrome; secondary multiple-organ dysfunction syndrome is less common (12%) but is associated with higher morbidity and mortality. 7 Organ dysfunction scores were first developed for use in critically ill adults to describe and quantify the severity of organ dysfunction, not to predict mortality. Two scores have been proposed for critically ill children: the Pediatric Logistic Organ Dysfunction (PELOD) score and the Pediatric Multiple Organ Dysfunction Score (P-MODS).…”

mentioning

confidence: 99%

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

Leteurtre

Duhamel²,

Grandbastien³

et al. 2010

Canadian Medical Association Journal

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Epidemiology of Sepsis and Multiple Organ Dysfunction Syndrome in Children

Cited by 342 publications

References 14 publications

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Serum neutrophil gelatinase-associated lipocalin (NGAL) as a marker of acute kidney injury in critically ill children with septic shock

Genome-Level Longitudinal Expression of Signaling Pathways and Gene Networks in Pediatric Septic Shock

Daily estimation of the severity of multiple organ dysfunction syndrome in critically ill children

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