Interactions of Sepsis, Organ Dysfunction, and Outcome of Critically Ill Children

Branco, Ricardo Garcia; García, Pedro Celiny Ramos; Garcia, João Pedro Tedesco; Piva, Jefferson Pedro; Ross-Russell, Robert

doi:10.1164/ajrccm.172.12.1606

Cited by 3 publications

(4 citation statements)

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“…The new report is an extension of the authors’ previous work (2016−2018) (17), now with more sites and patients. There is an accompanying editorial (4). Also, do seek out other 2022−2024 reports in the journals about PICU genomic diagnostics covering the implications of costs (18), ethical challenges (19), and genetic counselling (20).…”

Section: What Is the Diagnostic And Clinical Utility Of Rapid Wgs In ...mentioning

confidence: 99%

“…First, in children supported with mechanical ventilation and receiving vasoactive infusions, the relevance of acute echocardiography findings to the strategy for fluid management (1, 2). Second, in PICU admissions with suspected genetic diagnoses, the experience of using rapid whole-genome sequencing (WGS) for diagnosis and the consequence on patient care (3, 4). Third, in patients receiving treatment in the PICU for severe traumatic brain injury (TBI), the choice of anticonvulsant medication for prophylaxis against early status epilepticus (5, 6).…”

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confidence: 99%

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Tasker

2024

Pediatric Critical Care Medicine

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Section: What Is the Diagnostic And Clinical Utility Of Rapid Wgs In ...mentioning

confidence: 99%

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confidence: 99%

Editor’s Choice Articles for August

Tasker

2024

Pediatric Critical Care Medicine

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“…Sepsis is potentially a life-threatening pathological condition due to an overdriving inflammatory response to bacterial infection [64][65][66]. Severe sepsis can cause multi-organ failures, with the kidney being the most-affected organ [67,68]. It has been estimated that nearly 50% of septic patients would develop acute kidney injury, and there are no effective treatments for septic AKI [69].…”

Section: Sepsis-induced Kidney Injurymentioning

confidence: 99%

Renal-Protective Roles of Lipoic Acid in Kidney Disease

Kamt

Liu

2023

Nutrients

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The kidney is a crucial organ that eliminates metabolic waste and reabsorbs nutritious elements. It also participates in the regulation of blood pressure, maintenance of electrolyte balance and blood pH homeostasis, as well as erythropoiesis and vitamin D maturation. Due to such a heavy workload, the kidney is an energy-demanding organ and is constantly exposed to endogenous and exogenous insults, leading to the development of either acute kidney injury (AKI) or chronic kidney disease (CKD). Nevertheless, there are no therapeutic managements to treat AKI or CKD effectively. Therefore, novel therapeutic approaches for fighting kidney injury are urgently needed. This review article discusses the role of α-lipoic acid (ALA) in preventing and treating kidney diseases. We focus on various animal models of kidney injury by which the underlying renoprotective mechanisms of ALA have been unraveled. The animal models covered include diabetic nephropathy, sepsis-induced kidney injury, renal ischemic injury, unilateral ureteral obstruction, and kidney injuries induced by folic acid and metals such as cisplatin, cadmium, and iron. We highlight the common mechanisms of ALA’s renal protective actions that include decreasing oxidative damage, increasing antioxidant capacities, counteracting inflammation, mitigating renal fibrosis, and attenuating nephron cell death. It is by these mechanisms that ALA achieves its biological function of alleviating kidney injury and improving kidney function. Nevertheless, we also point out that more comprehensive, preclinical, and clinical studies will be needed to make ALA a better therapeutic agent for targeting kidney disorders.

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“…[ 4 5 6 7 ] Delay in the diagnosis and management results in rapid progression to circulatory collapse, multiple organ dysfunction syndrome (MODS), and eventually death. [ 8 9 ] Continuing high rates of morbidity and mortality in PICU due to infections dictate the need for biomarkers to determine the prognosis of critically ill children at admission. [ 3 10 ]…”

Section: Introductionmentioning

confidence: 99%

Relationship of Serum Procalcitonin, C-reactive Protein, and Lactic Acid to Organ Failure and Outcome in Critically Ill Pediatric Population

Siddiqui

Jafri

Abbas

et al. 2018

Indian Journal of Critical Care Medicine

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Objective:To evaluate the clinical and prognostic utility of procalcitonin (PCT), C-reactive protein (CRP), and lactic acid in children admitted to the Pediatric Intensive Care Unit (PICU) of a university teaching hospital.Materials and Methods:Medical records of children (1 month–16 years) tested for serum PCT at the time of admission in the PICU of our hospital from July 1, 2013, to January 15, 2015, were reviewed. Within 24 h of admission, the Pediatric Risk of Mortality Score, blood cultures, white blood cell count, neutrophil counts, serum CRP, plasma lactic acid, and PCT were noted. Patient outcome was assessed at hospital discharge, and the patients were divided into nonsurvivors and survivors.Results:A total of 167 children being admitted to the PICU were enrolled. The median age of the study population was 3 years (0–16 years), with 58.6% being males. Nonsurvivors had significantly higher lactic acid (4.7 mmol/L [2.07–7.6]; P < 0.05) than that of the survivors (2 mmol/L [1.3–3]; P < 0.05). In addition, nonsurvivors (94.4%; P < 0.05) had greater incidence of multiple organ dysfunction syndrome (MODS) than that of the survivors (38.05%; P < 0.05). Binary logistic regression showed age, MODS, and lactic acid to be associated with mortality.Conclusions:This study found that in comparison to PCT and CRP, high plasma lactic acid levels are associated with the development of all-cause MODS and worse outcome in critically ill children admitted in PICU. Prediction of prognosis based on the lactic acid alone may contribute to improve patient management, but further studies are required to endorse our findings.

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Interactions of Sepsis, Organ Dysfunction, and Outcome of Critically Ill Children

Cited by 3 publications

References 4 publications

Editor’s Choice Articles for August

Editor’s Choice Articles for August

Renal-Protective Roles of Lipoic Acid in Kidney Disease

Relationship of Serum Procalcitonin, C-reactive Protein, and Lactic Acid to Organ Failure and Outcome in Critically Ill Pediatric Population

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